Is one night enough to declare this experiment a fail?

I've been using BiPAP pretty successfully for a year now, but have recently been looking for a travel size machine which only seem to come in CPAP configuration. I was originally prescribed BiPAP with pressures of 17/13, which I have now worked down to 11/7 on my own with good results. My "new" doc (more on that later) says that BiPAP was likely originally only prescribed for comfort at higher pressures and I would probably do fine on straight CPAP at a pressure around 9.

So in an effort to save money by getting a CPAP machine for travel instead of a BiPAP, last night I changed my PRS1 to straight CPAP @ 9. The results weren't great. AHI was 4.4, which I could probably tweak and work down some, but RERAs and PB were around 14% each! With BiPAP my RERAs are normally under 3 and my PB is usually 0-2 with an occasional foray up to 4-5. And I feel good the next morning. This morning after one night of CPAP I am a little foggy for the first time in almost a year. And as an extra little "bonus", my PRS1 760P machine is a lot, I mean a LOT louder set on CPAP @ 9 than set at BiPAP @ 11/7- and, I woke up much more congested than usual.

So, given that I'm likely going to have to go with a full-size machine like a DS460 for travel anyway (since the Z1 and the Transcend appear to be duds), should I abandon the CPAP project and just bite the bullet and get another 760P BiPAP since I do so well on it? I could scrape up the money if I had to and maybe that would be the way to go, but I feel a little wimpy giving up on the CPAP when I know so many of you tolerate it perfectly fine at pressures higher than I'd need. But on the other hand, sometimes effective therapy can be elusive so I hate to change what seems to be working.

Any thoughts?

The body and the brain likes predictability. You were used to the bipap way of doing things and you changed things. By your own admission the noise level bothered you. That alone could have disrupted your general sleep quality. It may or may not have impacted your therapy itself. The PB increase...were there any events associated with it or was it just PB green without any events?

Your body may just like the way Pressure Support works. You could probably get used to cpap with time but is it worth it? I don't know. There's a reason I have a bilevel back up machine.

You might do better with a S9 and its EPR at 3 as it comes close to what Pressure support feels like.
When you tried cpap last night...what was your CFlex setting? Even set at max of 3 I don't think the amount of reduction can go above 2 cm and that's with forceful breathing since the reduction is flow based. There is no way to measure it to be sure though.
I did try my S9 VPAP in cpap mode with EPR set to 3 and then tried fixed bilevel with PS set to 3 and it felt similar enough that I could probably do it full time if I had to with minimal problems. I have never tried CPAP on my PR S1 760 though.

Of course even if you could use a S9 and EPR...like the Elite...they aren't cheap and aren't small like you were wanting.
What you might try is your 760 in fixed bilevel mode with PS of 3....to give you an idea if that is comfortable to you.
That would be EPAP 7 or 8 (your choice) and IPAP of 10 or 11. I think I would probably look at 8/11 if I was going to do that.

If you shop smart and have a lot of patience, there are deals out there on craigslist but you have to be able to move quickly. Just yesterday I spotted a S9 AutoSet new...with humidifier/climateline hose and other accessories for $225. In the past I found a PR S1 650 for $100 with 400 hours on it. No humidifier with the 650 but Secondwindcpap.com had one for $50 (price at that time). So for $150 a really nice PR S1 650.

Pugsy, I think your words here may tell the tale:

"The body and the brain likes predictability. You were used to the bipap way of doing things and you changed things. By your own admission the noise level bothered you. That alone could have disrupted your general sleep quality. It may or may not have impacted your therapy itself. The PB increase...were there any events associated with it or was it just PB green without any events?

Your body may just like the way Pressure Support works. You could probably get used to cpap with time but is it worth it? I don't know. There's a reason I have a bilevel back up machine. "

I think I've given up on small, and given that I already have two 760Ps ( one at each of two houses a long way apart) it would probably be smart to stick with that machine for familiarity and even accessory interchangeability purposes. My 760Ps are actually already set in fixed bilevel mode at 11/7. I never quite got the hang of setting the machine for Auto BiPAP and the fixed pressures of 11/7 seem to work just fine for me.

I suppose I just needed some reassurance that I wasn't completely spineless for giving up on the straight CPAP when it would save me a few hundred bucks. This is not a cheap hobby, but there are a lot of folks who would gladly pay those few hundred bucks to have effective therapy I'm sure. So I'll probably just stick with what I know works for me, even if 11/7 seems like a pressure that wouldn't ordinarily require BiPAP.

Thanks for your thoughts. Sometimes one just needs a little validation in this complex arena.

This goes back to something I have said about mask experiments....I always learn something from my experiments. Sometimes all I learn is how much I hate something. Yeah, I could probably "get used" to a so and so mask but to me it just isn't worth it.
I figure my sleep is already fragile enough and there's just no sense in using something that is likely to make it worse.

I didn't realize you already had a second 760 machine. I don't know that I would bother with a 3rd machine unless you just want to have a quick back up machine at your house for quick travel or whatever. I know those tiny travel machines look inviting but there's always a trade off it seems.

Watch your local craigslist. You never know what might show up...you might get lucky like I did with the PR S1 model 650 that I found....and before anyone asks...I was looking specifically for someone else and I didn't keep it. Since you already are using fixed bilevel mode...getting the model 650/660 wouldn't be a problem since you are already using fixed pressures anyway.

You might do well with the S9 Elite...since EPR at 3 is going to feel real close to your PS of 4 now....but it would have to be a big "steal of a deal" to make it worth the experiment.

"I didn't realize you already had a second 760 machine. I don't know that I would bother with a 3rd machine unless you just want to have a quick back up machine at your house for quick travel or whatever. I know those tiny travel machines look inviting but there's always a trade off it seems."

Pugsy, that's exactly what I'm looking to do. The peace of mind of knowing I have a backup and/or a quick travel machine is worth it to me. Given how bad my untreated apnea was, coupled with my anxiety, I wouldn't sleep a wink without therapy regardless of how long it took me to replace a machine.

I hadn't thought about a 660-that's the same as my 760s except it just doesn't have Auto BiLevel but is fixed BiLevel only, right? Now that would save a few bucks since I don't use Auto mode anyway!

old dude wrote:I hadn't thought about a 660-that's the same as my 760s except it just doesn't have Auto BiLevel but is fixed BiLevel only, right? Now that would save a few bucks since I don't use Auto mode anyway!

Correct. The model 650/660 is the BiPap Pro model. It has 2 modes of operation...cpap mode and fixed bilevel mode.
The 750/760 has 3 modes available...the cpap mode, the fixed bilevel mode that you are using now and the auto adjusting bilevel mode.

So what you are using on your 760 right now can be duplicated on the 660 since fixed bilevel mode is the same on both machines.