Autoset vs. CPAP

[CBELFORD]

Greetings everyone –

So I’m one of the noobs in the forum and want to thank everyone for their questions and responses all which have helped to inform and prepare. This feels like a great forum and I feel very fortunate to be a part of it!
I’ve been on my ResMed Airsense10 Auto and AirFit P10(Large) for about 3 weeks now and love the better sleep I’m getting. I am thankful that the adapting has been very smooth and quick. Currently dealing with some mouth leaks and sinus discomfort/allergies but working the humidifier settings to turn that around. Also waiting to see the first month of info from Doc before getting the data through sleepyhead – as an analyst/statistician the wait is killing me but I want to get one review under my belt beforehand.
Here are the obligatory stats (I only have the basics so far):
• Sleep study AHI = 14/hr (mild/moderate apnea)
• Now: ~2/hr
• Pressure starts at 4 ramps to 6.
• Very few mask/pillows leaks <4 l/min

Knowing I am a low pressure level user I am wondering if changing the setting of my machine (since I have the clinical manual – THANK YOU to the group who will remain anonymous )from CPAP to Auto set would be of any benefit? And how to determine the settings that would be best?
Or is it early in the process, I’m doing well therefore hear the grandpa’s voice in my head “if it ain’t broke, don’t mess with it” philosophy and/or discuss with my Doc or DME (LinCare) provider?

[OpalRose]

Welcome CBELFORD,
It looks like you are doing good, but it's hard to advise you on pressure changes unless we have some stats. to go on. Most here don't like the ramp feature and turn it off.
I believe that you should be utilizing the Auto feature, then you could set a pressure range of say 6-10.
Download Sleepyhead and start looking at your 90% pressure numbers, then let us know and someone will help you.

[retired_guy]

You're on a fixed pressure of 6. I would prefer to see a narrow range of possibly minimum 6 and maximum 10. That sort of thing. That's why we have autoset machines, so that especially in the beginning the machine can help titrate the optimal settings.

But what are the optimal settings? For that you do need to download/install Sleepyhead and see what results you are getting now, even before you change any pressure settings. How many CA's, OA's, Hypops --- that sort of stuff. Also what is your ramp settings? I can't think of a good reason with a fixed pressure of 6 why it should be set to anything other than "off."

Good job getting started with the program. You're going to do great.

EDIT: (Yeah, what she said.........)

[OpalRose]

You're on a fixed pressure of 6. I would prefer to see a narrow range of possibly minimum 6 and maximum 10. That sort of thing. That's why we have autoset machines, so that especially in the beginning the machine can help titrate the optimal settings.

But what are the optimal settings? For that you do need to download/install Sleepyhead and see what results you are getting now, even before you change any pressure settings. How many CA's, OA's, Hypops --- that sort of stuff. Also what is your ramp settings? I can't think of a good reason with a fixed pressure of 6 why it should be set to anything other than "off."

Good job getting started with the program. You're going to do great.

EDIT: (Yeah, what she said.........)

retired_guy,
I'm starting to think like you, except I'm different! :grin:

[trish6hundred]

Hi CBELFORD,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and hang in there for more responses to your post.

[Mark Douglas]

Again I am not yet in treatment so what do I know?
However a straight CPAP machine cannot be the best solution.
Sinus cold, allergy season, sleep position changes....
Is like driving a car with one throttle setting. How often will the load equal the demand?

[CBELFORD]

Thanks everyone for the great replies!

Takeaways:
-Definitely need to see the expanded data in SleepyHead
-Turn the ramp off (now that my lungs are used to the rush)
-Variable is (almost) always better than constant

Sleep well everyone! Thanks again

[Terry]

Once you're done seeing your doc, you can set the machine to auto.

Over time, you can monitor the data in sleepyhead and see what pressure is required to give you the best results.

Then you can set your minimum pressure to start a little lower than what SH says is your "90%" or "95%" pressure, and your upper limit, a little above the highest the machine wanted.

It's a little bit of a balancing act because leaving the machine wide open (5-20 on auto) will disturb the sleep of a lot of people as the pressure ramps up, while leaving it with too narrow a range means that if you have apneas, the machine might not have enough available range to fix them.

Once you know what pressure you need, over time, you can decide if you want a fixed pressure that will handle your needs, or auto with a reasonable range.

Auto vs manual is mostly a personal choice because some people are easily disturbed by pressure changes while others aren't. Almost everybody is disturbed by huge pressure changes, so if your machine is set for "wide open" but you need 16 cm every night, it's going to keep waking you up as the pressure goes up and down.

[TyroneShoes]

...a straight CPAP machine cannot be the best solution.
Sinus cold, allergy season, sleep position changes....
Is like driving a car with one throttle setting. How often will the load equal the demand?

Well, yeah. I agree with Mark. A CPAP is dumb; a blower, a brick. A glorified hair dryer with humidity instead of heat. It's legacy technology from the 80's.

APAP is intelligent. It can adjust to changing conditions during a sleep cycle to provide dynamic therapy. It is a thousand times better than CPAP from the point of view of the patient, and significantly (potentially, depending) more effective. Plus, it's also a CPAP, and if the doc says "fixed at 8 cm", it can do that.

It's a no brainer. CPAP should be retired, outlawed, sent to the dustbin of history. Companies should stop making it. It is economically more effective for those companies to drop that product line altogether, since the money saved doing that likely offsets the difference in price. The APAP technology is burned into a chip, which costs very little.

xPAP today already has a lock mode that a doc can invoke for a CPAP-mode prescription, so there is no down side for even that patient to have APAP capability, especially if things change down the road for that patient.

[iSnore]

My new sleep doc, a younger fella, told me he doesn't write prescriptions for less than automatic models. It's his basic standard of care.