For those that use auto CPAP

If you use auto CPAP is it because your doc prescribed it, or because you have chosen to set it up yourself that way? I am interested in the percentage of people on Auto vs constant, and reasoning for auto.

Bavinck,

My sleep physician ordered my CPAP pressure too low and at a constant rate.

I had all of my sleep physician notes, tests, and test results sent to my primary physician, bought a ResMed Autoset, and programmed the appropriate settings with my primary MD's oversight. I will never go back to that sorry excuse of a sleep doc.

I've learned more on this board than the sleep physician ever told me.

Sleep well,
TheWino

I got an apap because it was prescribed for me. My AHI goes up in REM sleep. But I never would have gotten an apap otherwise because my HMO Kaiser is my DME and they choose the specific model of machine they will pay for. This is unusual, however. Most insurers do not care one way or the other.

Could not fall asleep with high pressure so I switched to apap. Have not missed a night for a year now.

My doctor prescribed an auto machine because my needs vary based on my sleep position. On my side, I need a pressure of 11-13. If that was all I needed, I could probably do fine at a straight 13. But when I sleep on my back, it goes up to 15 sometimes, and rarely, but still occasionally up to 17. Also, as a nice side effect, when the pressure goes up, I turn back onto my side. So while using my apap, I tend to sleep on my side most of the night and not need the highest pressure setting. But if I take the mask off, I will end up on my back where my sleep apnea is worse. So, while it seems like I don't need the auto all that much (if you just look at the data), it is actually doing more than is visible, just be keeping me off my back.

I think folks ought to try both treatments, give it enough time to "set in"... maybe a few or a little longer, and see how they feel. My theory (as been discussed here before, with little objection) is that in the autoset mode, the Resmed autoset will not start increasing pressure to treat an apnea event until 7 seconds. This allows for yawns, coughs, temporary events that folks hold their breath, etc... Once the machine starts to "ramp-up" during an apnea event, it may take 4-7 seconds to achieve the needed pressure to treat the apnea event. This means your body went thru an apnea event for 11-14 seconds before being treated. My theory is that I didn't feel as well as if the machine was blowing a set rate of air (cpap mode). I've done enough tinkering to accept this for me. Whatever mode you use, I strongly suggest folks to switch to the alternate mode once or twice a year to see how you feel. Everyone is different and the 11-14 second delay the autoset causes does not make a difference in how they feel. To each his own!!

If you have an autoset machine, you can use both methods of therapy. I would kick myself if I went a long period of time one one therapy method, eventually "tried out" the alternate therapy and felt much better. Most folks have excellent reasons on why they stick to one method of treatment. This suggestion is for those that don't know or haven't ever tried the alternate method. My AHI and other readings do not differ in either mode of treatment, but I do feel better using straight cpap therapy... so... thats my story and I'm sticking to it.

Sheriff

I used straight cpap for years (from 2002 to 2008). I chose to move to an auto myself and bought the machine myself. With lots of help from this forum, I got it set up to give me excellent therapy (AHI almost always under 1. My sleep study showed severe sleep apnea (63). I sleep about 6 1/2 hours a night and have no or little leak problems on auto.

I am a back sleeper because of Rheumatoid Arthritis pain. I was already a back sleeper when I was diagnosed with sleep apnea and did my sleep study on my back.

For me, the apap also stopped the gas and abdominal pain that goes with it. I have a narrow setting (11 cm t0 14 cm). My last titration study (at home with an auto on loan from a Provider before I had my own) set my pressure at 11 cm. My Sleep Specialist would not give me a prescription for an auto or even a machine with exhalation relief.

I rarely go above 11.5 but sometimes it is up a little depending on many things (sickness, what I ate and when I ate it) etc.

I had an Elite for 9 months before I bought my Autoset from our hosts. (hubby liked his that much).
I discovered immediately that I had been titrated (and was using) 3 cm higher pressure than necessary.
Doctors may understand the human machine, but most appear to be baffled by cpap devices.
Whatever the DME tells them, they tend to believe.

I had a cpap machine which worked fine for me. Last year I had an opportunity to purchase an Apap with more upto date data collection and smart card so I did. I set it to 1cm less then my titration and discovered my needs had gone up. I now have it at my original titration with the top wide open and the pressure bounces between 9 - 11.

You are going to be on this machine every night. Life is not constant, our body changes and ages. It is not the same as it was 5, 10, 20 years ago. It will not be the same 5, 10, 20 years from now and neither will your pressure.

BlackSpinner wrote:I had a cpap machine which worked fine for me. Last year I had an opportunity to purchase an Apap with more upto date data collection and smart card so I did. I set it to 1cm less then my titration and discovered my needs had gone up. I now have it at my original titration with the top wide open and the pressure bounces between 9 - 11.

You are going to be on this machine every night. Life is not constant, our body changes and ages. It is not the same as it was 5, 10, 20 years ago. It will not be the same 5, 10, 20 years from now and neither will your pressure.

Does your physician know you did that? Just curious about their level of involvement.

I originally got a sleep study because I snored awfully. (Or if you prefer, I snored extremely well!! ). I was prescribed a CPAP machine.

My girlfriend said that the CPAP did not eliminate my snoring, it only reduced it. So I bought myself an APAP machine, and that has really pretty much eliminated my snoring.

I can't say if the APAP is doing a better job with my apnea than the CPAP did. I would imagine it is, but the CPAP machine I got wasn't data-capable, so I don't know. I have found the APAP machine a little more comfortable, because it has exhalation relief and the CPAP did not, but I was 100% compliant with both machines.

bavinck wrote:
Does your physician know you did that? Just curious about their level of involvement.

My sleep doctor was in Quebec at the Lachine Hospital. I doubt he would care since he was very enthusiastic about me taking control of my therapy and buying online. As far as he was concerned as long as I kept my AHI under 5 and my symptoms didn't come back he didn't need to see me. He was not the slightest bit interested in the machine I had bought.

However If I hadn't shown that I knew what I was talking about, I would have been sent to the lab every 6 month/year to take home a titration machine.

I love my auto pap I was on straight CPAP at 19, and switched to a range of 13-19. I average around 15 and sleep much more comfortably. Would not go back to straight CPAP except short term for my travel machine, and even then I changed my pressure to 15.

Jen

Auto cpap was prescribed for me. And it has worked well over the past couple of years. I tried constant pressure cpap for a while, but the highest pressure that I need is high enough that it is too much for a whole night. The variable variety just goes up to the higher pressures when it needs to, and then drops back. Works for me.

bavinck wrote:If you use auto CPAP is it because your doc prescribed it, or because you have chosen to set it up yourself that way? I am interested in the percentage of people on Auto vs constant, and reasoning for auto.

Seems to me that all you're interested in is the "reasoning for auto". The Subject says it and practically everything in your post says it.

Lots of things have changed (in the area I live in) in the way some of the DME shops fill the prescriptions, since I started therapy almost nine years ago.
Back then, virtually NOBODY got an APAP (like lots of stories we read on the forum). However, last Fall I dropped in to one of the DME shops I talked to back then and the gals running the place told me that that's ALL they hand out anymore (for CPAP prescriptions). However, I got the impression that even though they give out APAPs, they don't necessarily set them to a range of pressures.

I started out with a data-capable straight pressure Respironics machine (bought from CPAP-dot-COM) and used it for the first year. Then, I had a chance to buy a lightly used Respironics APAP for a reasonable price. I used it in a range of pressures for a week and found that the pressure changes wrecked my sleep but that it agreed with my selected pressure on my straight pressure machine. I ended up acquiring three more APAPs over the next three years because the prices were dropping on those models and the newer models were coming out. Then, through CPAPAuction and other sources, I managed to pick up five more (virtually identical to my first one) data-capable straight pressure machines (cheap)......some hadn't even been used.

For me, straight pressure is the only way I can get a good night's sleep, but APAPs are "versatile" machines for those who can use a range of pressure or prefer straight pressure.


Den

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