New with many questions (Canada)

You asked, "...is Auto better than Fixed..."

Yes and No is the answer that I've learned from this forum, but overall it may depend on how you get used to PAP therapy, your "titrated" pressure, meaning the pressure that works best for you at preventing apneas (most of the time).

With an Auto machine, APAP, it will work both ways, on Auto and on Fixed pressure, so it's a good machine to help you figure out what pressure will work best for you, and that is pretty straight forward with time, for you to figure out on your own, even without a sleep study. Just read and search this forum.

A fixed pressure machine / CPAP, it will cost a bit less than an APAP machine, and is perfectly fine, but will be a bit slower to use to figure out what pressure works best for you. Once you have your best pressure figured out, either from a sleep study or trial and error, then many people with APAP machines switch them to CPAP mode and just use the fixed pressure.

APAP machines can work well but can also be irritating, especially if you keep it set to cover too wide a pressure range, which you'll learn about from this forum. I use mine on APAP, as I seem to need a lower pressure MOST of the time and I like a lower pressure as it's more comfortable to breathe for me and my FF mask can be much looser. But the APAP machines are a bit slow sometimes to react to apneas, even set on Fast reaction, and if they do react, they can either go too high in pressure, and often stay sort of stuck at the high pressure setting, even after the apneas are over. Using a narrow pressure range helps reduce this, but it's still a "reactive" system and not always perfect.

But I'm still opting to use APAP despite the run on high pressure from time to time, vs. just using a higher pressure all the time as with CPAP. Once I live with it more, I may switch and with an APAP machine, I have that choice. Others may have more to add.

Hawthorne wrote:
Someone will correct me if I am wrong, but I think you need the pressure setting on the prescription to get a machine online.

bought an APAP and a straight CPAP both from cpap.com - no pressure on my Rx - they called and asked me about the pressure for the straight cpap - if I had bought the CPAP first it might have required a pressure

Alayne wrote:if you get an automatic machine, does it really matter what your titration is? Is auto better than fixed?

Better duck! That question has been known to make the fur fly...

Yes, the Auto mode will adjust to what it determines to be the optimum pressure. However, it will do this EVERY time it's used, and may fluctuate slightly thru the night. That means you could spend a significant amount of sleep time at a "wrong" pressure while it searches. You will likely do your titration at the full range of the machine. Then they will set the range tighter (usually 1 cm below optimal to 2 cm above). Plenty of people do just fine in auto mode that way. Others feel there is still too much searching and prefer CPAP mode at optimal. (Your optimal pressure is usually reported as the "90% pressure". It will usually be your prescribed pressure, as well.)

The strategy I use (and many others!) is to set the the machine in CPAP mode at the optimal pressure. Then every month to 6-weeks, spend a night or two in Auto to verify that my optimal hasn't changed. Then back to straight CPAP. I find I get better numbers in CPAP.