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[CPAP] New S9 Autoset Setup
#41
That's consistent with what I've heard reported here on Apnea Board by folks with APAP's. People with relatively high prescription pressures like APAP's because they allow them to spend more time at lower pressures.

APAP's do make it easier to do an at-home titration, but that can also be accomplished with a good data-capable CPAP.

APAP's also have the advantage of being able to respond to higher pressure requirements when sleepers roll over on to their backs. This would be hard to measure, though, so I don't think we'll see it show up on any kind of study.
Sleepster
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www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#42
What is the general consensus of what constitutes a "high" pressure?
PaulaO2
Apnea Board Moderator
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Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#43
(02-03-2013, 08:04 PM)aehjr Wrote: I was curious to see if I could find some medical literature on the issue of CPAP over APAP so I did a Google search "advantages apap over fixed pressure cpap."

These studies come up again and again.

There are at least two problems with these studies.

1) They tend to be studies of unmanaged APAP vs. managed CPAP. i.e. they give one group an APAP set at auto pressure of 4-20 and left alone. The other group gets a CPAP with a pressure set properly by a GOOD doctor and monitored and followed up.

That's the wrong way to use an APAP. An APAP needs to be set to start at a reasonable pressure that stops most of the patient's apneas, and monitored to see how it's working and adjusted as needed.

2) The studies are done by people who have a bias to use manual CPAP and generate more followup office visits and new $leep $tudie$.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#44
That's why I will probably experiment once I get through my monitoring period with my doctor. Bigwink
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#45
(02-04-2013, 06:43 PM)archangle Wrote: An APAP needs to be set to start at a reasonable pressure that stops most of the patient's apneas, and monitored to see how it's working and adjusted as needed.
good point. you don,t want starting pressure to be too low because it only goes something like 0.2 cm H2O every 70 seconds
at that rate, I,ll be choking and ripping the mask off before necessary pressure is reached

my average pressure about 12. I set the minimum pressure at 9 with ramp off, which is comfortable for me to fall asleep
and by the time fallen asleep, doesn't take too long for the machine to adjust the pressure


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#46
(02-05-2013, 02:55 AM)zonk Wrote: you don,t want starting pressure to be too low because it only goes something like 0.2 cm H2O every 70 seconds
at that rate, I,ll be choking and ripping the mask off before necessary pressure is reached

Doesn't take anywhere near that long in raising pressure.

When I first started APAP (before I found Apnea Board and was able to set my own pressures), I had a Respiratory Therapist who refused to set the APAP to anything but wide open. Needing high pressure while sleeping, but starting out so low, made it impossible to fit the mask comfortably, reduce leaks, get used to the pressure, etc. Knowing I needed to start at higher pressure, but clueless as to how to get into the settings menu, I had to experiment. If you start from normal breathing, then suddenly block your airway with your tongue and hold your breath it will take something like the amount of time you mention to raise pressure and you'll likely pass out before you can get it to go from 5 to 14 or so. What I found, with ResMed machines anyway (most experimentation was done with Escape Auto the DME gave me), was that the machines respond much better to realistic simulated conditions. Instead of suddenly holding your breath; close your mouth, inhale through your nose and lightly block your airway with your tongue so you simulate a light snore high in the back of your throat. With the next breath close the airway a little more and snore a little harder and simulate struggling to breath a little by randomly closing the airway completely for a fraction of a second. Struggle a little harder with the next breath, etc. With a little bit of practice I was able to get the machine to go from 5 to 20 in about 10 or 12 seconds. With a lot more practice I was able to adjust my "fake snoring" routine enough to get it to go up to pretty close to 15 and stop. The biggest problem was having to occasionally do another light fake snore while going to sleep in order to get it to stay up there.
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#47
Thumbsup 
After 13 years on a brick (with great success I might add) I decided it was time to try something smaller and better. After researching I became intrigued with the data recording APAPs and was able purchase a S9 autoset. with quite a bit of great info on line, especially this board, I have had great success with it. My brick was set at 15 so I set up the S9 to a range of 8 to 16. I have had a low of 8.5 median, 95th of 9.6, max of 10.1 and a high of 10.1, 11.2, 12.3. I had some mask leak issues but resolved them to 95th of 4.8 and a max of 16.8. I then raised the low limit to 9.8 and now I have a median of 20.3, 95th of 11.6, max of 13. My AHI average for the nine days I have had this machine is 0.4 and a feel as good as ever. I really like this machine and I really like the ability to see how my night went and react to things like mask leaks.
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