CPAP vs. APAP

GumbyCT wrote:For me the biggest reason is to have a lower pressure until you need more. But also if (as) things change or you just want to try CPAP - there is no need for an equipment change. Plus I think with APAP - you are sure to get a machine capable of FULL data, not just compliance.

Overall, APAP is more versatile and makes more sense. (We) I have (all) wondered why they continue to make just the plain vanilla cpap.

Ditto. Very well put!

Charts will show APAPs compensate for pressure variation needs during the night. APAP's also compensate for pressure variations from night to night, week to week, month to month, etc. Humidity, pollen, dust, body position, alcohol, caffine, sinus issues, colds, flu, mask fit, are just a few of the contributing pressure variation factors. After upgrading to APAP from over 68 months of using CPAP, I too came to the same conclusion as above by GumbyCT. APAP should be the new standard.

jbn3boys wrote:

dtsm wrote:

RipVW wrote:Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

Concise and right to the point...

Concise and to the point, yes, but I'm not trying to decide on which machine to buy. I already have an apap.
I'm trying to decide how to run the machine, in apap or in cpap mode.

Thanks, and keep the advise coming, please!

That's where experimenting and having data becomes useful in watching numbers and gauging how you feel. Do a week on straight cpap and a week in auto mode. Before we changed to auto we used straight cpap for over a year with good results but I would change the settings to auto occasionally for a week to make sure we were still on track. That helped me discover that my hubby slept mostly at a lower pressure with equally good results. That was my goal. Everyone's experience is different but that's why an auto is so helpful in zeroing in on what's the best option for you.

Jbn3boys, I went 2 days after a change and actually dialed everything in very quickly. I have only been on xPAP for 6 months and check my settings every 3 months just to make sure. To check my settings, I change over to APAP for a couple of days and see what numbers I end up with.

This last check my APAP pressure indicated 13, but I still am not showing O2 desaturations below 90%. I think I will just leave everything the same and check again in 3 months.

dtsm wrote:

RipVW wrote:Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

Concise and right to the point...

Your needs will change during the +/- 5 year lifespan of the unit. There will be times when you want to self-titrate. Keep the same settings for at least a week to get a better idea of an average, not just 1 or 2 good/bad nights. I like auto cpap because my apnea is positional, worse on back so more pressure needed, auto does that. john

Note: If you don't already have a notebook, do get one to keep track of things that worked and things that don't - things to try next along with pressures, AHI, ramp and other machine settings. Or just questions to ask your doc. Be sure to leave room below the Question for the answer.

You do know that OSA affects our memories? Get the notebook
You don't want to have to run to the computer to write things down and you want to be able to write as soon as you get up BEFORE you forget, again.

GumbyCT wrote:You do know that OSA affects our memories? Get the notebook
You don't want to have to run to the computer to write things down and you want to be able to write as soon as you get up BEFORE you forget, again.

You must be in my brain, gumby! I do keep most info on my computer, since that's where my reports are, and I have no usable data on my machine. I do have a small notebook by my machine, but I guess I should use it more.

On another note, I guess I will try to self-titrate, although I'm not sure just what I'm doing. lol My titrated level was 11, so I set my machine for min 11 max 12 last night. Numbers look about the same as the day before (which was a good day for me). I'll give it a few more nights, but then I'm not really sure which way to go from there. Guess I'll wait and see what my data looks like--maybe just up the max to 13.

Feel free to keep commenting!

jbn3boys wrote:You must be in my brain, gumby! I do keep most info on my computer, since that's where my reports are, and I have no usable data on my machine. I do have a small notebook by my machine, but I guess I should use it more.

On another note, I guess I will try to self-titrate, although I'm not sure just what I'm doing. lol My titrated level was 11, so I set my machine for min 11 max 12 last night. Numbers look about the same as the day before (which was a good day for me). I'll give it a few more nights, but then I'm not really sure which way to go from there. Guess I'll wait and see what my data looks like--maybe just up the max to 13.

Feel free to keep commenting!

What do you mean no usable data on your machine? Aren't you using the software that you have listed?

Many people who know their titration use the 2+/2- setting to experiment, so in your case with a titration of 11, you can set the auto at at 9-13cms for a few nights and see the trend. You list the software, so daily data is essential.

I was titrated at 11 and prescribed an APAP machine with a range of 7-15.

That was three and a half months ago. I had a terrible time the first two weeks or so because every time the pressure went up, I'd wake up with the pressure full blast and a leaking mask. Fall back to sleep, only to wake up again. I was miserable, and my AHI even worse. Finally, with the help of the forum, I switched to CPAP and a straight pressure and immediately noticed a difference. I was able to sleep through the night. I still had mask issues and high AHI but I was sleeping. It took some experimenting with pressure and raising it by .5 each week, and found things work best for me (at least for now) at 11.5.

It's only gotten better for me in the last week since I finally found a mask that works and my AHI has consistently been below 5. I'm perfectly happy with CPAP at this point, but someday I may experiment with a narrower range in APAP.

cflame1 wrote:What do you mean no usable data on your machine? Aren't you using the software that you have listed?

Yes, I do have the software, and would be lost without it right now. I just meant that the information available ON the machine itself is pretty useless as it only lists 7 day and 30 day averages for AHI. That's why most of the information that I keep is on my computer, since there is where I "discover" how the therapy has been going.

On a good note, I just had two good nights in a row! That's only happened a few times in the entire 3 months I've been on therapy. I did set my machine yesterday to a very narrow range of 11 to 12 (I almost went with a straight pressure, but decided to give myself a "little" wiggle room.) My 90% pressure was 12, and my average pressure was 11.3 last night.

On an "odd" note, I have noticed that my mask has been irritating my upper lip the last few nights, mainly as I'm waking up in the morning. It just feel "odd". Also, I have noticed some water leaking out in the same area (from humidity condensing in the mask). I looked at it closer this morning, and it is actually cracked! So I called my RT at the DME, and he said to just bring it in and he'd exchange it for me. Here's hoping for another great night tonight with a new (but same kind of) mask!

RipVW wrote:Certainly, in my view, if one has the choice, one should choose an APAP, since an APAP will always provide the option of using it in auto mode or as a straight CPAP.

The OP already has an Auto machine in her profile. I think the question was about which mode to run in...and the various reasons to consider when deciding. Not which machine to choose.

With that in mind, my answer is BOTH. I found I get lower AHI with CPAP, so I usually run CPAP @ .5 under my 90% pressure. But about every 6 months I do a week on APAP ( Range -2 to +3 of 90%) to determine if the 90% has changed any. Then I go back to CPAP.

My AHI usually rises during my week on APAP, but stays under .2 on CPAP.

LinkC wrote:The OP already has an Auto machine in her profile. I think the question was about which mode to run in...and the various reasons to consider when deciding. Not which machine to choose.

EXACTLY! And the information gleaned from the personal experience of others is proving to be very helpful!

Thank you to all who have shared! Feel free to continue, if you wish!

Best sleep with APAP...I have completely unpredictable, terrible congestion issues so an APAP delivers the pressure needed to keep my airways open regardless of the state of my airways.