how do you know

I think I have narrowed my machine to a resmed S9 CPAP or APAP not the ESCAPE.. The tech explained he wasn't convinced that a APAP was any better than a CPAP, he felt that the APAP may allow more apnea than should occur before changing pressure. He did say someone who changed positions from side to back often an APAP was more appropriate. He was going to note that in my test if he saw that being the case. I do not know the results at this point as I had to get home to get the kids off to various places.
My question is more to do with masks. I know it will take me time to get used to any mask and machine. Last night I had a Swift Mirage nasal mask on. It wasn't comfortable nor uncomfortable. I put up with it. Do you try to just "man up" and ignore the pressure of the machine and focus on the mask comfort before saying this wont work for me. I know I will have to adjust to some uncomfort and do not want to waste my money or insurance money on trying lots of different masks. What were things that jumped out to people that this is the mask.. I know mileage will vary but any info will help
Suzy

I tried 2 masks during my titration. A full face.. FAIL, couldn't get to sleep and the Swift FX, went right to sleep and have been using it every since. I have a swift LT too and I rotate them, don't know why one works better than the other sometimes, it just does.
On pressure, the APAP is a more versatile machine. Could most of us get by with straight cpap, probably so. Could you adjust your pressure going forward without an apap or another sleep study....? The apap is more bang for your buck. Your insurance is paying the same for either machine.

A cpap can only run at a straight pressure while an apap can run in auto (a range of pressures) AND straight cpap. Get the suto, they are giving you a pile of bs saying that they are the same.......NOT. An auto is 2 machines in one and can be set either way, a cpap can only stay at straight on pressure.

Suzy,

I think you are smart to separate the comfort between the pressure and the mask itself. I found it took a few weeks to get used to the pressure, and I expect that is independed of mask selection. It is just too different to have the alien blowing into your nose

For mask comfort, I would ask some of these questions:
- Can you maintain seal in a variety of sleeping positions?
- Does the mask press or rub uncomfortably?

Note that all the masks seal and are most comfortable when properly fit, which means loose enough for the cusion to inflate.

Only you can judge if the discomfort level is high enough to say "this mask won't work". I expect that no one on the board would say that if the OSA fairy would wave her magic wand and I don't need CPAP anymore to sleep without suffocating, that they would keep wearing the mask because it just feels so good. But I will tell you that you can reach the point where strapping the mask on at bedtime becomes no big deal.

The CPAP is better than the APAP in all respects but cost.

You can make the APAP be exactly like a CPAP if necessary by setting it to CPAP mode. It will then behave exactly like the Elite machine.

sbullett wrote:The tech explained he wasn't convinced that a APAP was any better than a CPAP, he felt that the APAP may allow more apnea than should occur before changing pressure.

That's easily fixed. Suppose you would do CPAP at 8 cmH2O pressure. You can set the AutoSet to do Auto 8-12, for instance, and it will always give you 8 cmH2O and only go higher if necessary. Or more realistically, set it to 6-12 and look at the data to see where it settles out.

Unfortunately, a lot of people think you should always set an APAP to start at the lowest possible pressure, for instance, 4-20 auto. That's a bad idea for several reasons. It should be set to something closer to what the patient needs. For instance, if you'd set a manual CPAP to 8, you could set the APAP to 6-10.

The S9 AutoSet in particular is very good at adjusting upward to the right pressure without waiting for you to have a lot of apneas.

sbullett wrote:Last night I had a Swift Mirage nasal mask on. It wasn't comfortable nor uncomfortable.

If it doesn't hurt, rub your skin raw, or leak, you'll probably get adjusted to it.

For apnea that comes and goes, auto offers more comfort.
Positional apneans should have the option (whenever possible) of higher pressure only when they need it.

I can say from experience that the Auto is indeed better for me. It may not be for you, but for me it was a lifesaver.

My pressures change nightly. some nights I'm around 15.5, others I need it as high as 16.6. With the APAP, I can set a range of pressures (14-17 for me) and the machine adjusts itself as necessary within that range. With the regular CPAP I had to watch the results every morning to see if I was at the right pressure, making small changes to keep my AHI under 2. Now, I am under 2 nearly every night and can just check in on my full graphs once a week to make sure all is well.

However, the choice is a personal one. Many in these forums swear by "straight CPAP" so it is not a "wrong" decision to go with such a machine. It's entirely up to you, I can only report my experiences =)