I switched from APAP to CPAP

Dude, you are a lost cause, I give up!

Autopapdude wrote:

The results of your little experiment only apply to you. It doesn't mean you get to generalize the results to everyone. In addition, your prescribed pressure might not be high enough. I still don't understand why you are so adamant about this on this thread. It does not hurt the OP if she tries the straight CPAP for a while.

Why are YOU so adamant that she use a straight cpap? Because you're operating on self-justification?

Autopapdude wrote: Trouble getting a prescription for autopap? What are you talking about? Have you been driving your Escalade into too many trees? Most doctors write exclusively for autopap. Or maybe your barbershop won't?

CPAP.com will sell you an APAP even if your Rx only specified CPAP (according to the phone call i had with a customer service rep on the topic).

LinkC wrote: I wonder why so many people have trouble getting a prescription for APAP if it's the "preferred method of treatment by most physicians"?

My physician actual prefers CPAP over APAP and claims most of his patients are on CPAP and he sees more complications with his APAP patients.

Also to quote my doc "Big government and HMOs love APAP"

KatieW wrote:Good morning everyone. I'm enjoying the lively debate here.

Night 2 on cpap pressure of 10 cmH2O, just under 8 hours of sleep:
AHI 3.7
AI .3
HI 3.4

1 month average on apap:
AHI 5.0
AI .5
HI 4.6

Looking good....numbers are a little, though not significantly better than my 1 month average. But I feel much more alert, and less aerophagia than on apap 8.6-10. I'm liking this, but will know more in a week.

I changed the setting for EPR INHALE. Found the "fast" setting was starting the next inhale before I finished exhaling. The "medium" setting suits my breathing pattern better.

Hi Katie,

I agree, it is interesting to read the passionate arguments for and against various modes of treatment. I think you're doing the right thing in experimenting.

I just wanted to mention that I've been playing around with the EPR and INHALE settings lately. I've noticed that I prefer different settings depending on which mask I'm using (nasal vs. pillows). I'm keeping records to see how (if) different combinations affect my nightly results, but haven't been doing it long enough yet to see if there is a clear trend.

~ DreamOn

My doc will only prescribe an autopap if you fail on standard cpap. He claims that they do not do what they are expected to do and with proper titration cpap will work for most people. Then he goes on to say that those who fail on cpap will move beyond to bi-paps or v-paps. Autopaps to him are overrated and the cost doesn’t justify the results.

Autopapdude wrote:That was a one night experiment that I have tried before. As regards the original poster having better numbers, I don't think hers were significantly different if I recall.

Guess it depends on your definition of "significant". They were better. If APAP treatment is superior, as you claimed, shouldn't they be WORSE?

Autopapdude wrote: Most doctors write exclusively for autopap.

Exclusively??? MOST doctors?? Now you're just being silly! You went from "preferred method" to "exclusively" in less than a day! Making it up as you go along, aren't you? BTW, cpap.com sales figures show CPAPs consistently outsell APAPs. Look for yourself.

At the risk of setting you off into an apoplectic tirade, what's your source for the claim regarding "most" doctors and "exclusive" APAP scripts?

(You will note I'm ignoring your childish taunts/remarks. They add nothing to this discussion. Well, except to make you look desperate and foolish...)

Well...I disagree with the latest posts quoting doctors on the APAP being over-rated. For me the APAP has worked extremely well where the straight CPAP did not. I tried different settings on the straight CPAP and my AHI went way up every time. This short range I have it on seems to be perfect for me. I think these doctors, like my doctor, probably don't know how to prescribe for the APAP. It takes some experimentation to get the right range and also it can't be wide open like many "professionals" seem to want to go with. My doctor originally prescribed mine with a very wide range which was a disaster for me. The people at the DME insisted that this was the "best way" to set an APAP. Thank goodness for this group helping me figure out that a shorter range with the low end closer to my needed pressure was the best way to set it! Now I sleep great in my steamy filtered air

Nobody,

I was quoting my doctor who believed that for most peoples straight cpap was best. For those who failed cpap then other options would be explored. For some the constant change of pressure would cause arousals negating the therapeutic benefits. I have no malicious intent and my reason for pointing this out was to show autopapdude that there were other professional opinions that contradicted his and his doctors. Who is right, I don’t know, all I know is what works for me. If autopap works for you great, and I am sure it is helping many others as well.

Autopapdude wrote:Trouble getting a prescription for autopap? What are you talking about? Have you been driving your Escalade into too many trees? Most doctors write exclusively for autopap.

Not mine!!! He's a board-certified sleep specialist who has been heavily involved in the sleep medicine field since the early 1970s, and he rarely prescribes autopap.

From what I read on this forum, I would say that many (maybe most?) people who have autopap machines had to request that specifically, and often had to strongly insist on it! And the people on this forum are not typical sleep apnea patients. I would say that we're much more informed and interested in our treatment than most. Look at all the basic Plus and Escape machines being sold to people! Unfortunately, most of those people don't even make it to a forum like this because they don't know there's anything better out there. They just accept what they're given and either muddle through somehow or give up.

Personally, I think that every sleep apnea patient should be prescribed an APAP machine, so they can try both CPAP and APAP and find out for themselves what works best for them. But that isn't happening....

~ DreamOn

LinkC wrote:Original Poster

(or Outstanding Person)

Oh...ok then.

DreamOn wrote: I just wanted to mention that I've been playing around with the EPR and INHALE settings lately. I've noticed that I prefer different settings depending on which mask I'm using (nasal vs. pillows). I'm keeping records to see how (if) different combinations affect my nightly results, but haven't been doing it long enough yet to see if there is a clear trend. ~ DreamOn

Since we both have Resmeds, I'm interested in what you find out. I know your Elite II is a cpap, I assume you can set the Ramp Time and EPR Level. Do you also have these options:

- Start cpap: Sets the pressure at the start of the ramp up to fixed treatment pressure

- EPR Inhale: Sets the rate at which pressure returns to therapy pressure during exhalation. The
options are: Fast and Medium. I like Medium better.

DreamOn wrote: From what I read on this forum, I would say that many (maybe most?) people who have autopap machines had to request that specifically, and often had to strongly insist on it! And the people on this forum are not typical sleep apnea patients. I would say that we're much more informed and interested in our treatment than most. Look at all the basic Plus and Escape machines being sold to people! Unfortunately, most of those people don't even make it to a forum like this because they don't know there's anything better out there. They just accept what they're given and either muddle through somehow or give up.

From what I understand, the insurance billing code is the same for all CPAPs and APAPs, since the APAPs cost more, it's more profitable for the DME, and possibly the doctor (as some are affiliated with the DME) to prescribe straight CPAPs.

Personally, I think that every sleep apnea patient should be prescribed an APAP machine, so they can try both CPAP and APAP and find out for themselves what works best for them. But that isn't happening....

I agree!! The more choices people have, the better, the more likely they will continue with the therapy.

KatieW wrote:Since we both have Resmeds, I'm interested in what you find out. I know your Elite II is a cpap, I assume you can set the Ramp Time and EPR Level. Do you also have these options:

- Start cpap: Sets the pressure at the start of the ramp up to fixed treatment pressure

- EPR Inhale: Sets the rate at which pressure returns to therapy pressure during exhalation. The
options are: Fast and Medium. I like Medium better.

As far as I know, our machines have the same settings options. I can set the Ramp Time and and do have the Start CPAP option to set the starting pressure. I no longer use the ramp feature, as my pressure is quite low.

I can set EPR to fulltime, ramp only, or off. I have the same three EPR Levels (and off) as you do on the Auto machine. And I have the same EPR Inhale settings -- Fast and Medium. Sometimes I prefer Medium, and other times Fast. I think it depends on the EPR Level I have set at the time, and maybe the mask too, but I'm experimenting with that right now. I'll let you know if there's any clear difference in results once I've tried the various settings for a while. I'm writing it all down.

~ DreamOn

Exclusively??? MOST doctors?? Now you're just being silly! You went from "preferred method" to "exclusively" in less than a day! Making it up as you go along, aren't you? BTW, cpap.com sales figures show CPAPs consistently outsell APAPs. Look for yourself.

At the risk of setting you off into an apoplectic tirade, what's your source for the claim regarding "most" doctors and "exclusive" APAP scripts?

(You will note I'm ignoring your childish taunts/remarks. They add nothing to this discussion. Well, except to make you look desperate and foolish...)

HEY LINK, if you want to go analog in a digital world, that is fine with me. The autopap is definitely the preferred method of treatment, and the far more modern one. If you want to continue blowing air at an unnecessary volume for 90% of the night into your respiratory apparatus, so be it. NINETY percent of the time, you'd not need that volume of air at x number of centimeters. The other 10% of the time, the MACHINE makes the choice for you (while you are asleep), and according to studies out there (no point in quoting them--they are on the Wiki) the autopap is quite capable of making the increase in pressure as per need. You may not believe it, but it has been documented, and experienced by many here on this board, who smartly choose to use an autopap. The cpap is venerable and was a lifesaver 10-20 years ago, but it is an OLD technology. Autopaps are getting better and better, and you just won't admit that they do an excellent job of therapy for MOST folks. Certain people cannot take a variable pressure, so cpap is a viable therapy for them. HOWEVER, for MOST, the autopap is the method of choice. Doctors who refuse to write autopap 'scripts are probably of the old school, who have not read the research. As regards sales figures, since so many of the 'paps are provided by DMEs, they will go for the cheaper one any time, as they don't want to lay out money they are NOT getting back from insurance companies, commensurate with price. That is a business decision, not a medical one, and you know it.

In terms of taunting, you are generally the one who resorts to sarcasm, condescending behavior, and insults initially. I respond to you in kind, as you're incapable of kindness, sincerity, or humility.

So your answer is "I made it up and now cannot justify such a ridiculous claim." Thank you. I'll bet not even YOUR doctor writes APAP prescriptions EXCLUSIVELY.

BTW, regarding sales figures, cpap.com does not supply units to DMEs. They offer xPAPs to end-users who have prescriptions. Wrong again.

Autopapdude wrote: the autopap is quite capable of making the increase in pressure as per need.

Indeed it is! And it allows unnecessary events as it does. That's how they WORK!

You have yet to produce even ONE of the studies you keep citing to support your various bogus claims. (There are no "studies" in the Wiki. Everything there is user-written, experiential wisdom. And the wiki exhibits the same differences of opinion as the forums do. That's what a "wiki" is.)

You really should stick to facts, not exaggeration/preverication.

BTW, regarding sales figures, cpap.com does not supply units to DMEs. They offer xPAPs to end-users who have prescriptions. Wrong again.


Autopapdude wrote:
the autopap is quite capable of making the increase in pressure as per need.


Indeed it is! And it allows unnecessary events as it does. That's how they WORK!

You have yet to produce even ONE of the studies you keep citing to support your various bogus claims. (There are no "studies" in the Wiki. Everything there is user-written, experiential wisdom. And the wiki exhibits the same differences of opinion as the forums do. That's what a "wiki" is.)

You really should stick to facts, not exaggeration/preverication.

YES, and how do you really feel? This is just his usual "prove it" tirade, when anyone disagrees with him. Nice person, issn't he? One question: Who died and made him King of the Realm, so that he can DEMAND answers? We all relate our experiences here and share for mutual benefit. Doesn't this prince of a man get the fact that he's not born right--we have differing opinions, and that is the way life is? What a pain in the posterior he is!!! I like autopap, and he loves cpap. Big deal---like that is reason to go into insult and flame mode? Also it is prevarication, not preverication. Since that's your game.