Regular Cpap vs Apap?

I was just diagnosed with moderate sleep apnea. I've received my Resmed AirSense 10 Elite a few days ago. My pressure is set to a constant 9.0. I noticed huge improvements in mental and physical energy the first day. My AHI averages from 2-5 via Sleepy head (less than a week's worth of data) but I can't help but wonder why my doctor didn't prescribe an auto-cpap. I would think a machine that intelligently adjusts pressure based on patient's indivualized and variable needs throughout a night would offer more efficient. I'm also wondering about full face mask vs nasal pillows. He's prescribed the latter for me along with a chin strap but I can't help but feel that a full face mask would suit me better, considering I have congestion and allergies.

I also am on testosterone replacement therapy and occasionally take benzos for generalized anxiety. I am an occasional drinker as well. It is my understanding that all of these things can worsen sleep apnea. If I for example come home drunk one night, I may need more pressure than if I were sober. An autopap would be a great solution for this, wouldn't it?

Try a few FF masks (lying down - your face changes a lot then). Unfortunately many doctors are ignorant and out of date about equipment even if they know the science of apnea, and they may either prescribe inadequate therapy or leave machine settings to dealers. You would be better off with an autopap if only because they can, if necessary, run as plain Cpaps, but those cannot be run as Apaps. You should have a copy of your prescription as well as the results of your study because we can help sort out your set up to be sure you're effectively treated. Chin straps are often problematic and aren't as effective as FFMs can be, plus also can be uncomfortable. You may or may not need a FFM depending on whether you mouth breathe when asleep, but I imagine the script you got for a strap had some basis as seen on your report.

Guest - I suggest you start your own thread... but I will say that upping pressure so you can drink more is not a good idea for a few reasons - why not work on not drinking instead? You're sabotaging treatment and kidding yourself about how it would be ok to raise pressure to deal with it.

Guest wrote:I also am on testosterone replacement therapy and occasionally take benzos for generalized anxiety. I am an occasional drinker as well. It is my understanding that all of these things can worsen sleep apnea. If I for example come home drunk one night, I may need more pressure than if I were sober. An autopap would be a great solution for this, wouldn't it?

A better solution would be to NOT come home drunk.

LSAT wrote:. (Snip)
A better solution would be to NOT come home drunk.

Every drink kills some brain cells. Getting drunk kills so many more.
Small wonder "guest" asked the question . . . Nobody's home.

Some people find the straight pressure of a cpap treats them more effectively, and let's them sleep more soundly - some people find the changing pressure of an apap wakes them.
But yes,better to have an apap so it can be set as a cpap. Also long term it is easier for self diagnostic type stuff.
It's good you seem to have gotten off to a good start though - hopefully it keeps up

The APAP doesn't quite work that way. It doesn't try to capture events. In simple terms it has an algorythm where if you have an event then it will raise the pressure hoping to prevent others. If you minimum isn't high enough to prevent most of them then can spend all night chasing the magic number.

Unless you see a demonstrable need for the auto adjusting feature I wouldn't feel bad about not having an APAP. I've had 5 machines over the years - one of them an auto. After a few years I went back to using straight pressure at the request of my sleep doc just so she could rule out the fluctuating pressures as being a cause of my continued fractured sleep. I couldn't tell a difference in my sleep from one to the other, but since my pressure needs didn't fluctuate much and I wasn't having trouble at my that pressure, I decided to stay with straight pressures and let it prevent apneas rather than chase impending ones. Yes, an APAP offers you a choice of delivery modes and I think another data feature not in the CPAP data. (not certain about that.) Those who have troubles at their highest needs during parts of the night (like air in the belly, etc) may need the APAP so they can spend much of their night at a lower more comfortable pressure. Why don't you check your data after a night that you expect might cause a need for higher pressure and see if your concerns are substantiated. If so, a very slight bump up in your set pressure may suffice.

Diamondminek wrote:Some people find the straight pressure of a cpap treats them more effectively, and let's them sleep more soundly - some people find the changing pressure of an apap wakes them.

Where did you get this information?

Guest wrote:I also am on testosterone replacement therapy and occasionally take benzos for generalized anxiety. I am an occasional drinker as well. It is my understanding that all of these things can worsen sleep apnea. If I for example come home drunk one night, I may need more pressure than if I were sober. An autopap would be a great solution for this, wouldn't it?

A better solution would be to not get drunk! Jim

wrote:If I for example come home drunk one night

You are doing it wrong. I stay in a diner drinking black coffee until my wife has gone to work.

ChicagoGranny wrote:

Diamondminek wrote:Some people find the straight pressure of a cpap treats them more effectively, and let's them sleep more soundly - some people find the changing pressure of an apap wakes them.

Where did you get this information?

While this question wasn't asked specifically of me, my sleep doctor saw it as a possibility. It was her sole reason for wanting to see me on CPAP. Nothing about the "better" treatment mode or health aspects of the apap v cpap debates. Just whether the changes affected my sleep continuity. I've been at both ends of the sensitivity spectrum and everywhere in between. At some points my sleep was so fragile and my nervous system on such high alert I likely could have felt and heard a gnat fart. Other times, I could sleep through a dental appointment. (Have done that. lol) People have posted on here about an awareness of pressure changes. I'm not one who can even tell when my ramp ends, but it seems entirely reasonable that this could be reality for highly sensitive people. Maybe not for the average person, but I'm guessing this forum has a subset of outliers. And if there is but one reader with the problem, the information could be useful.

kteague wrote:highly sensitive people

You are only arguing supposition. I could just as easily argue that highly sensitive people will do better on APAP because it allows lower pressures much of the night.

kteague wrote: my sleep doctor saw it as a possibility. It was her sole reason for wanting to see me on CPAP.

Many doctors will have the machine set to 4 - 20. Of course we know that is rarely a good setting for sensitive or non-sensitive patients.

ChicagoGranny wrote:

Diamondminek wrote:Some people find the straight pressure of a cpap treats them more effectively, and let's them sleep more soundly - some people find the changing pressure of an apap wakes them.

Where did you get this information?

I can't remember specifically - I've had related discussions with my sleep clinic, plenty of research online, read a lot of other stories, in various places.

WarmBodies wrote:

kteague wrote:highly sensitive people

You are only arguing supposition. I could just as easily argue that highly sensitive people will do better on APAP because it allows lower pressures much of the night.

kteague wrote: my sleep doctor saw it as a possibility. It was her sole reason for wanting to see me on CPAP.

Many doctors will have the machine set to 4 - 20. Of course we know that is rarely a good setting for sensitive or non-sensitive patients.

And, YOU are arguing supposition.
I doubt that you really understand how APAPs work and how/why pressures change.......and how long it takes to get from one pressure to another. They won't go from 8 cm. to 15 cm. instantaneously. And, if they did, you would be snapped out of deep sleep for sure.
APAPs change pressures due to detecting Flow Limitations and Snores and, depending on the algorithms of the machines, sometimes Apneas.....after they're over. If you don't have many if any FLs or Snores, the Apneas are going to occur without pressure increases to head them off. And, if the pressure changes DO cause the users to be bumped out of their needed sleep stages, the users may spend more of the night in lighter sleep stages (if it doesn't actually wake them up) which will leave them feeling unrested.

And, if you're arguing FOR ranges of pressures, why would a 4 - 20 setting NOT be beneficial?

And, finally, if a user does have lots of Flow Limitations or Snores, their pressures are quite likely to max out whether or not they have Apneas. So much for the "sleeping at lower pressures much of the night" in their cases. Not all Apneas are preceded by FLs or Snores. Some people have Apneas or Hypopneas "out of nowhere".

APAPs are good to have because they allow for more options. But, the users NEED to monitor their therapy with software and be able to identify what settings work the best and how they can achieve their optimal therapy, which includes sleep quality.


Den

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