titration done, UGH. Now I need a machine, APAP vs CPAP q's

So I just did my titration, after 2 PSG's and an MSLT the past 6 months. Brutal night, was half asleep at the start but still hardly slept, the whole night whizzed by in a blur. Felt like I was awake while still being in stage 1 sleep, aware every 2-3 mins... hallucinations, the whole bit. The room smelled awful, like an old sewer.

Anyway, yeah, I'm on pressure 7 now, using an s9 autoset, and I was on a diagnostic machine for the first time ever, and I'm wondering if that's going to be similar to what I'll be using when I get my own, since an APAP is too expensive. It felt like it was more difficult to exhale, even on pressure 5.

I was under the impression that an APAP would adjust the RX'd pressure as needed, so, if I'm having difficulties with 7, it'll compensate to raising itself to 9 when appropriate. Currently on the machine, When I inhale I can feel (and hear) it pushing more air, and stopping when I exhale. Is this indicative of all CPAP, or just a function of an APAP? It felt like the machine I was on during the titration was always pushing.

Had my worst night last night, hit a 1.44 and woke up with a headache.

So anyway, yeah, should I really shell out for an APAP, when my AHI was only 16 at most on my PSG, and is now averaging 1, or will an S9 elite suit my needs, as I'd originally planned?

ironhands wrote:When I inhale I can feel (and hear) it pushing more air, and stopping when I exhale. Is this indicative of all CPAP, or just a function of an APAP? It felt like the machine I was on during the titration was always pushing.

Sounds more like the S9 EPR exhale relief.
Is EPR turned on and if it is...at what setting?

The auto adjusting pressure feature you won't really notice the changes in pressure because they are much more subtle and won't be happening while you are awake anyway.
So it isn't auto adjusting while you are awake..but the changes you feel may be the EPR doing its job.
If it is on....you might try selecting a different setting.
Also, I think there is a selection in the clinical setup menu for adjusting the timing of the breaths with EPR. It may be a little too fast for you. I think the default is medium.

Which machine to get??? Straight cpap or the apap which also has cpap mode available...
where are you located? I got the impression you weren't in the US and if you are somewhere else then that will affect the responses that people will give to that question.
Most will respond assuming you are in the US and use traditional DME and insurance..
if you aren't in the US then your options may be totally different.
For some reason I was under the impression you were in Canada....

Pugsy wrote:

ironhands wrote:When I inhale I can feel (and hear) it pushing more air, and stopping when I exhale. Is this indicative of all CPAP, or just a function of an APAP? It felt like the machine I was on during the titration was always pushing.

Sounds more like the S9 EPR exhale relief.
Is EPR turned on and if it is...at what setting?

The auto adjusting pressure feature you won't really notice the changes in pressure because they are much more subtle and won't be happening while you are awake anyway.
So it isn't auto adjusting while you are awake..but the changes you feel may be the EPR doing its job.
If it is on....you might try selecting a different setting.
Also, I think there is a selection in the clinical setup menu for adjusting the timing of the breaths with EPR. It may be a little too fast for you. I think the default is medium.

Which machine to get??? Straight cpap or the apap which also has cpap mode available...
where are you located? I got the impression you weren't in the US and if you are somewhere else then that will affect the responses that people will give to that question.
Most will respond assuming you are in the US and use traditional DME and insurance..
if you aren't in the US then your options may be totally different.
For some reason I was under the impression you were in Canada....

Mostly likely. I can't remember what they had the EPR set at on the machine when I picked it up, but I remember asking for it to be high, since I was new to it. I'm betting the titration machine didn't have it set as high as I'm used to.

Yes, I am in Canada, so it'll be $260 for the S9 elite after the government kicks in their portion. If it's just the EPR that was making all the difference, question answered, S9 Elite it is, thanks!

I don't know if you have made a decision yet, but I will never ever get another CPAP over an APAP. I've been doing this a long time and as life goes on and things change your numbers start to go bad and it is so tough to get back to the correct pressure because it comes down to lets pick a number tonight and see how it goes. With an APAP you can set a range and the machine will automatically adjust. After a few nights you can dial it in and then go back to straight CPAP pressure.

I'm not advocating always doing a self titration in lieu of a complete sleep study, but even with a study, you may have to still tweak things and if you do, you'll wish you had an APAP.

John

It's a case of $$$ I don't have. I'm just scraping by this month because I need to take the bus with this cold weather, so if an APAP isn't necessary, I can get by with just the basic CPAP. Thing is though, I'm still not convinced that the CPAP's going to the complete solution. Still not noticing a change after 2 weeks, and both of my PSG's showed some very abnormal sleep architecture. Anxious to see how the 3rd went this week. My AHI only peaked at 16 when I was on my back, overwise it was ~8... and with the cpap my highest has been 1.4 (which was last night). Somehow I don't think I'll need to be changing it around that much, since it's not very severe anyway. The other oddity is that my first PSG registered a 0.0 AHI, and my o2 didn't drop either, so it wasn't a case of a sensor malfunction. My REM latency was also ~8 minutes the first time around. Wondering if it's time to do a proper EEG to see if it's something neurological

In your case I would have to agree with you. If it is a matter of money and the CPAP is providing enough therapy, your numbers are good, then I would have to agree with you.

I went 10 years on a non-data (they didn't exist at the time) CPAP machine with no issues, so even with an S9 Elite you are way ahead on the game.

John