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CPAP and APAP pressure settings
#1
CPAP and APAP pressure settings
Hello Everyone!!! I have a question for those of you interested in pressure settings. Given an optimum pressure setting from a titration, how do you determine a good range for an APAP? And, why is this range better than, say, a set pressure for a CPAP?
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#2
RE: CPAP and APAP pressure settings
For CPAP, just use the optimal pressure.

For APAP, it is pretty subjective. I was never a fan of using the lowest and highest machine range (4-20). For me I’d start out at around 4 or 5 above and below. Using software will tell you how well the range is working. After I had my APAP pressure dialed in I tightened the range a bit, maybe a couple below and 2/3 above. I made sure I covered my max plus a little fudge.

I never used EPR, but that might cause a tweak on the min/max.

I imagine others will provide a more analyzed approach.

John
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#3
RE: CPAP and APAP pressure settings
Thank you John.
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#4
RE: CPAP and APAP pressure settings
I've got an APAP capable machine.
The convention seems to be to set a range +-2cmH2O from the titrated value.
My experience has been that APAP even with a tight range causes me sleep disturbances purely from the pressure change itself.
With a range of 9-14cmH2O I get apneas and centrals, apneas before the pressure rises and centrals once it gets past 12.
Even a range of 10.5 - 12 causes me problems. Best results with this range being AHI = 3 and a couple of wakes.
Straight CPAP of 11.5 with no flex or ramp seems to work perfectly for me - peaceful sleep throughout the night, I feel great in the morning and AHI = 0.5 ish.
I don't think you can say that APAP is better than CPAP, in my case CPAP is far superior.
I suspect your ideal range will be trial and error, and may even be straight CPAP.
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#5
RE: CPAP and APAP pressure settings
Thank you Sleepyp. Interesting take on APAP vs CPAP.
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#6
RE: CPAP and APAP pressure settings
I'll put in my pennies worth, not that it is critical for APAP.

Best way is not to have it at a low (LOW) setting, start around 6 to 8 depending how bad you think your apnea is.
Leave the machine (HIGH) set at maximum, it will only go to what pressure it needs anyway, unless you give it a problem it can't fix, than there is a small chance it might, this might wake you, but it might you were wakened anyway if that is the case.
This s what I would do.
Set low to 6 or 8 to start with.
Set high to 20.
Use it for a few nights to see what the highest pressure it gets to.
Then I would set the low 4 below the highest pressure and if it helps with comfort move the low to within 2 or 3 of the highest pressure.
I have my machine set to within 2.5 of the max pressure it gets up to, this way the rise in pressure never disturbs me.
Others might want more of a gap between pressures, but it depends how bad you Apnea is, I find it helps me a lot the closer it is.

CPAP, well, it depends what pressure you need to keep clear of Apneas.
If it is an older machine with limited data on it and it might only record hours used there is no real way of setting it.
You can use Snoreclock which will help it you stop breathing, but the phone or iPab or Tablet needs to be quite close to you to pick up when you stop breathing.  For CPAP use, I would recommend you get tested and use what settings they give you and if it is not quite enough (they tend to set them to cover most events but not all) adjust it up a tiny bit at a time until you feel better, but only after a couple of month to allow the tiredness to leave and your body to catch up.
If you are buying a machine, buy an APAP, for all the rise in price it is more than worth it.

Setting a machine up yourself if you have not a lot of cash to spare is fine if you buy an APAP.  However, there are more complicated sleep problems than straight forward Sleep Apnea.  If you are unlucky to suffer from one of these you may require a better machine.  These are expensive, so in any case, if you are pushed for cash, it might be worth getting tested anyway, it might save you throwing good money away.  If you do have complicated Sleep Apnea a CPAP or APAP might not cut the mustard nd you will still have to spend a lot more.
Having said that, if it is straight forward Sleep Apnea you are sure you have go for an APAP like a ResMed Airsense10 Autosense or a Respronics Dreamstation.  There are others on the market, some are good, others not so good, but get one that has a card that reads all your data during the night.  This way you can get software to read how you are doing.  If you can't read it, you can ask people here, they will tell you how you are doing until you learn to read the data yourself.  Now there is Sleepyhead (now not being developed anymore) or there is a continuation of Sleepyhead here that the team here is developing further.  I have forgotten what they are calling it at the moment.

I hope this helps you.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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#7
RE: CPAP and APAP pressure settings
Sleep2snore—vey much of a different approach, with the higher pressure settings. Thank you for the thoughtful response.
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#8
RE: CPAP and APAP pressure settings
Thank you Sleep2snore—very much of a different approach, what with the higher pressure settings and all. Thoughtful reply.
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