The Autopap Chase

[Sheriff Buford]

Since I retired, there are two things I've started to do... cpap-wise. One was to switch to autopap mode to treat my acid reflux condition, which has helped a lot. The second is that I now have time to monitor my treatment on Sleepyhead. Over the years when I was working, I would often sleep at the station, and I never messed with Sleepyhead. I was on straight cpap, zero leaks and only 2 or 3 events a night.... so what the heck.

Anyway, I notice now on autopap mode, my pressure will jump from the lowest pressure setting of 11 to a 14. It will hover there for a while, then slowly drop to a 12. There are no events taking place, no snoring, no nothing. Why is that? Is that the "mystical" chase of an autopap?

Sheriff

[Julie]

"Just in case" mode?

[LSAT]

Anticipation? Stopping an event before it happens?

[Cardsfan]

It is interesting. I have found I do much better on one fixed pressure of 7. When I have it on auto, set at 7-9, a small variation, or even 7-8, my CA's increase and obstructions stay the same.

[Sheffey]

Is that the "mystical" chase of an autopap?

No.

If you zoom in and look very carefully at individual breath waveforms preceding the pressure increases, you will see some degradation in your breathing. Your machine responds to inspiratory flow limitations (and snoring and apneas).

[Sheffey]

I notice now on autopap mode, my pressure will jump from the lowest pressure setting of 11 to a 14.

Jump? No.

If you zoom in on the pressure graph, there is no "jump" to be seen. It only appears to be a "jump" if you are looking at the pressure graph for a full night.

Here is a graphic from my results showing a smooth pressure increase of about 4 cm over 2 minutes. The algorithm works well. Thanks to Resmed. I can sleep below 14 cm most of the night, but the machine gives me 18 to 20 cm when I need it. I assume, but do not know, that the higher pressures are needed during REM.

[russatore]

My pneumologist is absolutely convinced that only resmedd has got the right algorithms for an auto pap infact she refused to prescribe any auto machine unless is a resmed machine. If I want to buy another brand she will insist is a straight cpap. Wether she is right or not I don't have the experience to tell but I have an air sense 10 autoset and a respironics cpap needless to say that my machine of choice is the resmed airsense

[Not Fade]

Wether she is right or not I don't have the experience to tell

I can't tell either, but doctors, like other humans, often are stuck on what they are most familiar with.

I have an air sense 10 autoset and a respironics cpap needless to say that my machine of choice is the resmed airsense

My ResMed S9 AutoSet works wonderfully. Glad to hear that about the 10. Thanks.

[palerider]

There are no events taking place, no snoring, no nothing. Why is that? Is that the "mystical" chase of an autopap?

first, you have to take anything at all that Den ever said about an auto cpap and toss it out the window, he hasn't ever *seen* a modern machine, much less used one, and they are greatly improved from the vintage that he owns. so much for mystical chases.

second, they never increase pressure for no reason. as Sheffey said, if you know what to look for, you can see why they increase pressure. it IS all in the waveform, but you'll also see the reason in the flow limitation and snore charts.

resmed autos (your autoset and vpap auto, specifically) will increase pressure when they detect snores, flow limitations, hypopneas, and *after* apneas. (they never increase pressure DURING and apnea, because 1) they don't make enough pressure to "blow through" an apnea as some people say, and 2) depending on just where the blockage is, extra pressure COULD make it just a bit worse while the apnea is going on).

snores and flow limitations are a result of a narrowing of the airways, and thus both increase breathing effort, and so make sleep less restful, as well as show that things aren't good, and there may be hypos and apneas at that pressure, so, the machine raises pressure to open things up.

make sense?