I switched from APAP to CPAP

If you have an APAP set for 10 - 15 and you're sitting at 10 and you have a sudden apnea (which takes a pressure of 13 cm. to clear).......I can guarantee that machine will not stop them. I don't know of an APAP that will actually STOP an apnea in progress......and they have to have preceding events (snores, flow limitations or hypopneas) to give the machine a reason to increase pressure. If you normally have a 12 second apnea, that comes from out of nowhere, the machines can't get there in time.

I beg to differ. First of all, that first "rogue" apnea would signal the machine to increase pressure. It isn't the first apnea that would be stopped--it is subsequent ones within a short interval, and all of the apaps if adjusted properly will respond after the first apnea, and prevent others--that is their purpose, and they do it well.

I really don't have bad nights. My AHI is a consistant 0.5 to 0.9.

Katie, some do better on straight CPAP than on Auto mode. I am not one of them; I do not fare well on straight pressure and sleep much better with the APAP with significantly fewer wakeups. Everyone's a bit different in this regard. The only way you'll know is to try it and review your numbers.

I really don't have bad nights. My AHI is a consistant 0.5 to 0.9.

Of course you do. EVERYBODY who is on xpap therapy has had or will have bad nights--doesn't matter what your AHI is. Don't get hung up on the numbers alone. If you say you haven't had a bad night, I just don't buy that one bit. Cpap/Apap therapy is difficult, and an adjustment for everybody. Perhaps your recent AHI is consistently below 1 (doubt it), but that alone doesn't mean that you won't have a night that is sleepless, and where there are many awakenings. Numbers change over the years as well--how long have you been on 'pap therapy?

Katie, I sure hope you already got what you needed from this thread.

kteague wrote:Katie, I sure hope you already got what you needed from this thread.

Well...while the boys were duking it out, I quietly went to bed.

But seriously, I did appreciate the opinions and the passion with which they are expressed. No holding back here.

Last night, my results were encouraging:

AI .4
HI 2.1
AHI 2.5

Comparing to my 1 month averages:

AI .5
HI 4.6
AHI 5.0

I know, one night does not a trend make..... But I slept over 8 hours, and feel great!

I don't mean to be negative on your threat, Katie. It is just that people tend to give up too quickly on autopap therapy, and it is so far superior for MOST people, it makes no sense to switch to straight cpap, unless one has a specific condition that makes it virtually impossible to use it (such as a very high titration near the upper limit, where changes would awaken folks suddenly), or lots of central apneas (which is a "whole 'nother" treatment in itself--usually a bipap or vpap). The machine, when set properly, can do therapy far better than a cpap--this is one of the reasons that the autopap has taken over the market. It allows for one thing that a cpap simply doesn't handle, and that is change.

Autopapdude wrote:I don't mean to be negative on your threat, Katie. It is just that people tend to give up too quickly on autopap therapy, and it is so far superior for MOST people, it makes no sense to switch to straight cpap, unless one has a specific condition that makes it virtually impossible to use it (such as a very high titration near the upper limit, where changes would awaken folks suddenly), or lots of central apneas (which is a "whole 'nother" treatment in itself--usually a bipap or vpap). The machine, when set properly, can do therapy far better than a cpap--this is one of the reasons that the autopap has taken over the market. It allows for one thing that a cpap simply doesn't handle, and that is change.

Thanks for your comments, and I do hear where you're coming from.

Do you have an opinion on my particular situation? On apap, my low was 8.4, high was 10, with an EPR of 2. Looking at my graph, therapy pressure was at 9.8 or 10 most of the time. And I don't want to raise the high above 10 because of my experience with aerophagia.

I'm guessing here, but thought if I could get used to a steady pressure of 10, after awhile, I could tolerate a little higher, to catch those last few apneas.

Katie, I noticed at one point that lowering the top end of my range actually made my AHI come down quite a bit and I felt better during the day. I think once it gets up beyond a certain point (point where I was swallowing air) the pressure actually causes events that arouse me. You might try tightening up your range a bit by raising the low end and lowering the high end, or just lowering the high end by a half or 1 cm. My AHI is consistently below 1.0 with this very narrow range that I keep my machine on, but I sometimes have a night with 2.5 or 3.0, still not bad.

Katie, stay the course for a few days. Get some data.

Autopapdude... I don't have bad nights. I'm NOT hung up on numbers. I've been on CPAP 2 and a half years AND it was a server Apnea problem in the beginning... ANNNND you have GOT to be a liberal! I've been reading your posts around the forum and you are one unhappy SOG. Enough said. I don't waste my time with idiot liberals.

Katie--

I've found I get better numbers with CPAP than Auto. I normally run CPAP at my 90% pressure; but about every 6 months I do a week of APAP as a "re-titration" to ensure nothing has changed.

In APAP, the machine starts at the minimal pressure and it takes an apnea event to make it bump up. If you start at 2-3 cm below "optimal", it takes several events before the machine reaches equilibrium at an appropriate pressure. Those events that are avoided if you start out at the optimal pressure. That is the precise reason my doctor was reluctant to prescribe APAP initially, and likes the fact I do what I now do.

I also know of others who run APAP, but with the lower and upper limits the same (in effect, they are running CPAP). They do it because APAP mode reports something that CPAP does not (FL or VS maybe? Don't recall off the top of my head.)

IMHO, running APAP with a starting pressure that REQUIRES apneas to get you up to optimal just makes no sense.

Autopapdude... I don't have bad nights. I'm NOT hung up on numbers. I've been on CPAP 2 and a half years AND it was a server Apnea problem in the beginning... ANNNND you have GOT to be a liberal! I've been reading your posts around the forum and you are one unhappy SOG. Enough said. I don't waste my time with idiot liberals.

Very nice--have a good day. You're misinformed, and nasty about it! Sorry you can't engage in intelligent dialogue. You're messing up Katie's thread, which was otherwise intelligent and sensible in discussion. And, you DO have bad nights--everybody does.

IMHO, running APAP with a starting pressure that REQUIRES apneas to get you up to optimal just makes no sense.

IMHO, running Cpap, with the pressure blasting away far above what you need for 95% of the night makes no sense. Let the autopap adjust it for you, when events come up. It is a myth that autopaps don't do a good job of catching events--you might get one or two partial events if it is set properly (most likely hypopneas, not apneas), and then the machine takes over. My doctor concurs with that theory, and takes the exact opposite view. He doesn't like to write "scripts for straight Cpap, as he feels pressure change is a nightly event, and what would be appropriate for one night might not work for another. Unless you put up a brick wall against your back, you'''ll inevitably end up sleeping on your back, and pressure needs will be different. NO ONE has pressure that is totally flat graph every single night--hence the efficacy of the autopap.

Katie, I do fine either way -- on straight CPAP or on autopap. I also do fine with BiPAP either in bilevel mode or autotitrating bilevel mode.

I don't know of any studies out there that would support a generalization about autopaps being "far superior for MOST people."

I agree with those who say it's worth giving straight CPAP a try when using an autopap.

I particularly agree with Den's statement about whether to try CPAP mode with your autopap:

Wulfman wrote:Hi Katie.

In my opinion, the only "downside" would be in NOT trying it.
When a person has a multi-mode machine, I think it's always advantageous to explore some of the options that are available.
You've got some options with your "workable" pressures and some other options with regard to the EPR settings.


Den