CPAP vs APAP

I've been collecting data for the last few months; my first three months were on CPAP at a constant pressure of 11 as prescribed, while the last few months I've enabled APAP with the settings of 4 to 12. On the CPAP, I was having a great deal of trouble sleeping through the night or getting back to sleep without using the RAMP feature 2-3 times each time I awoke. With APAP, I routinely sleep through the night.

The average pressure I've been receiving on APAP has been 6.2. The 90% pressure has been 8.2. The number of OAs has declined, and averages around 1 on APAP, versus 3 on the CPAP. On the other hand, the number of HAs has gone up on APAP, from an average of around 2 to an average of 3.5, giving me an AHI of 4.5, for either CPAP or APAP.

I think the APAP is working better for me, but I would be interested if the results are consistent with other people's experiences.

Thanks!

From the sound of things, you need to bump that min pressure up higher. Maybe 6 or 7 to see what happens. It sounds like events are happening before the machine can get high enough to compensate.

Any chance you could post a few nightly reports?

Yes, you're below 5 AHI, but I think we can do even better.

I've seen it frequently suggested in this forum that when using an AutoPAP it seems a range of 4 cms to 5 cms between minimum and maximum pressure works best for most people.

Well, for most people it's not the width of the range, but the minimum number that makes a difference. If you have lots of snores or for another reason make the algorithm run away with the pressure, then that's when the max number starts to matter.

Hi,

Speaking from a technologist standpoint, Auto PAP is never as accurate as a good titration study. Our job during a titration study is to eliminate all of the apneas and hypopneas. Sometimes this is just not realistic in the home.

The bottom line, though, is compliance. The machine is not doing you any good if you are not using it. Although you should always speak with your physician first, using the machine on a consistent basis with a slightly less than optimal pressure is much better than not using it at all.

Good luck....Joe

Anonymous wrote:Hi,

Speaking from a technologist standpoint, Auto PAP is never as accurate as a good titration study. Our job during a titration study is to eliminate all of the apneas and hypopneas. Sometimes this is just not realistic in the home.

The bottom line, though, is compliance. The machine is not doing you any good if you are not using it. Although you should always speak with your physician first, using the machine on a consistent basis with a slightly less than optimal pressure is much better than not using it at all.

Good luck....Joe

Hi Joe,

For the most part, I agree with you.....except for the "you should always speak with your physician first" part. Between the over-titrating, under-titrating, giving out the cheapest, low-end machines and masks, those entities (doctors and DMEs) are the ones that are contributing the most to the "NON-compliance" of this therapy......and it makes me mad as Hell!
Even less-than-optimal pressure is not going to do much good if the patient is leaking THAT air out their mouths......and most of the time they don't know it......they just know they aren't feeling any better from the therapy. Too many times, the doctor will bump up the pressure, thinking that's the problem.....and the extra air is also flowing out the patient's mouth.

In my opinion, the professions that I mentioned need to "step up to the plate" and do a much better job. The manufacturers need to quit making these low-end, non-data-recording machines and provide the software to the patients to monitor their progress. For the most part, this therapy is a "joke".....the people who NEED "successful" therapy AREN'T getting it without coming to these forums. I feel sorry for the many thousands of people who are clueless about it.

Sorry for the rant, but I'm in that kind of mood today.

Best wishes,

Den

Wulfman

Exactly my sentiment, thanks for expressing it!

Wulfman,

That is well said.

I just got back from my sleep doc where I observed many of the inadequacies in the "business".

rooster

I totally agree with Wulfman. I have only been to one sleep doctor, but after three visits with him I have concluded that he is among the worst human beings on the planet. Comparable to a policeman assaulting a child, a doctor who takes advantage of sleep-deprived people should be jailed. And the fact that they have offices filled with co-conspirators (technicians, nurses, administrative assistants, etc) makes me sick as well.

I guess I've branched from your topic, Billm, but my name is tangents, after all. Sorry for the rant.

Cathy

From someone who is in the business, I agree totally with all of you.

At times, I am very frustrated by this business when sleep labs are started purely for monetary reasons with no idea of what it takes to perform a sleep study or run a sleep lab. Unfortunately, this happens a lot more than you realize.


Some physicians are in this because there is good reimbursement for "reading" a sleep study with little knowledge of what actually happens during a sleep study or how to proper recognize or treat sleep disorders.

But I do want to say that there are lots of quality labs out there and plenty of caring, qualified physicians. Proper treatment requires a good sleep lab, knowledgeable patient, qualified and caring physician and a good DME. If one part does not go their job properly, care can be compromised.

Sorry about my rant also

Thanks...Joe