Apap vs Cpap??

Wulfman... wrote:

DoriC wrote:thanks for all the good advice. I know that controlling leaks is #1 and I have a pretty good handle on that most of the time alternating between Quattro FF and UMFF. For now I'll use straight cpap at 12 and if he still has events with leaks under control than I'll try 12.5 and 13 if necessary. He seems to have trouble with higher than that. I guess I may be in a position where it will be a tradeoff between leaks and events. The other question I have is whether he does better with S9 or PRS1 which I'm experimenting with now this past week. What's confusing is that his numbers seem to be better on S9 but he seems to feel better during the day with the PR even though his data is worse! I think I gave myself a headache!!

If the machines are set up (for all intents and purposes) identically, there should be virtually no difference in therapy. By that I mean straight pressure, no exhale relief, etc. I suspect there might be some discrepancies in the data reporting, but much of that can change from night to night anyway, so it's really hard to nail down the differences. It might be an interesting experiment to conduct. However, I would do at least one week (or month) at a time with each.


Den

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I remember when I had a ResMed S8 auto and then got myself a Respironics auto I had better AHI numbers from the ResMed but I liked the results from Respironics better. Perhaps they just have different event scoring criteria. I agree with Den that a good comparison experiment would be to go straight CPAP with no exhalation relief on both machines (a week or two on each or even changing machines randomly each night by flipping a coin). then compare the data and a log of how Mike feels each day. If mike is not suffering from aerophagia or GERD, going straight CPAP should be no issue.

Great ?
The VA had me on apap for many years. i had since bumped up pressure over time along with finding a mask i could tolerate with minimal leak. then progressing to a used bipap for a year & a half.
Now after latest sleep study have been ordered to go w/ straight cpap pressure. i can't say i feel any worse or better, just lower leak data. 30 day compliance is completed & going to meet with the sleep doc on the 11th. ......like the long time married guy "i have no opinion" ....Other than i would not want to sleep without one or the other !

Unable to get wave form graphs. Dori's older computer and Encore Basic don't play nice together. She is currently using Viewer which doesn't offer wave form. PB is much reduced last night and unless we have a strong need to evaluate PB later...we won't be trying to get it a different way...it can be done but it involves Dori sending me some files via email and my using them on my SD card to fool Encore. Not something she is up to tackling at the moment and I don't think it is a critical issue anyway.

Below is last night's report. Much improved everywhere... These settings do work. Will they work every night from now on...of course not. We all have night's where something odd occurs and normally optimal settings aren't optimal anymore. Since we don't have a crystal ball to see what tonight will need then the best we can do is pick something that we know that will work most of the time. Yes...cpap mode can and will give similar results but it isn't perfect either as in never having a "bad" night.
The 5 AM break was a bathroom break. The ugly last hour...I suspect that he wasn't really fully asleep or was maybe extremely restless. The machine reported snores and wanted to kill them...I don't know if they really needed to be killed. Impossible to know for sure with what we have available here.

Last night's report demonstrates precisely why Mike does better on straight pressure.......at about 12 cm. He always has.
If you will notice, there are virtually no preceding events to his apneas (snores or flow limitations). His apneas are "frank" (sudden and out of nowhere). Consequently, there is no reason to have a range of pressures because the apneas are going to happen and without any preceding events because there is no "trigger" to increase pressures. Snores (or flow limitations) without subsequent apneas are no (good) reason to increase pressures......raising pressures for no good reason just makes the leaks worse and at some point can mess with the quality of sleep. Mike has typically not had many flow limitations in his data over the years, either.


Den

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Thanks for posting my report Pugsy. Den read my reports almost every day at the beginning and many,many times over the years. So has Pugsy. They're both very special to me. Den tried to convinced me long ago that Mike would do best at 12 cms with no flex or anything else to disturb is sensitive sleep pattern. And he did well until last year after hospitalizations and rehabs and everything took a toll on his therapy. I convinced myself that he would do better on apap so he'd have lower pressures because nothing worked for him anymore. So Pugsy has had an uphill battle with me ever since trying to find the "sweet spot" on the S9. She even worked with me on the Vpap with up and down results. So now I'm experimenting with the PR again and lo and behold, it looks like I'm back where I started at 12cm although I do like that he can sleep at 11 some of the night. Not being a cpapper I can't imagine what it must be like to have high pressure blowing all night but I tried wearing a mask at 10cm for a few minutes and it was bearable but I wouldn't want it higher! I hope this report is the start of a long=term trend as Mike is really feeling good today, no nap, cheerful and Dori is good!