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Concerned with results of CPAP Titration study
#1
Hello all-

I just got the results of my CPAP titration study, and wanted to get some input here before seeing the doctor in a few days.

In my original study, my AHI varied greatly between REM and NREM sleep. For example: my AHI during NREM was only 5.1, but shot up to 16.9 during REM sleep. During my CPAP titration study, I only achieved 1.5 minutes of REM sleep total. So while the pressure they had me on controlled the apnea/hypopneas during NREM sleep, I'm wondering if it will be enough to control them during REM sleep. Has anyone had a similar experience? Should I request an APAP machine from my doctor just in case the pressure they determined during the titration study isn't high enough?

My final pressure # was 6.0, and AHI for the night was 0.9.

Thanks in advance for your input!
-Dan
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#2
Hi Dan.

Yes, this reminds me of my sleep study. I tend to stop breathing while dreaming. I was diagnosed with complex sleep apnea, but the majority of my events are central ones. My brain forgets to keep me breathing. I had hardly any REM sleep, and my AHI was calculated at 92/hr.

Now I'm on a Resmed VPAP Adapt, running in ASV mode. It's a kind of backup breathing machine that prompts me to breathe when I stop for too long. Since treatment I have no centrals or obstructives anymore, just a few hypopneas, with AHI's under 2. So this machine works, although I have trouble with swallowing air at the moment. But it's made a huge difference in my health.

On the other hand, lots of people here have not slept well during their studies and so end up learning their best pressures afterwards, with the correct machine such as an APAP and software. And of course, great advice if they're a bit lost in all of this.

Your ending AHI was great. Anything under 5 is considered normal. If you get an APAP, watch out that you don't leave the default range wide open for too long, if at all. Doctors usually leave it at that, but many people here would advise you to narrow the range closer to your final pressure.

I'm sure others will chime in as well...
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#3
(10-27-2014, 03:59 PM)danf183 Wrote: Should I request an APAP machine from my doctor just in case the pressure they determined during the titration study isn't high enough?
Very good reason, APAP is two machines in one
1- Fixed CPAP
2- Auto-PAP

Here is someone who knows machines inside out .. Archangle:Machine Choices
http://www.apneaboard.com/wiki/index.php...ne_Choices

Edit: there are all sort of machines, old ones and new ones but my all time favorite is the "S9 AutoSet"
I can highly recommend this machine, best in its class
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#4
(10-27-2014, 03:59 PM)danf183 Wrote: Hello all-

I just got the results of my CPAP titration study, and wanted to get some input here before seeing the doctor in a few days.

In my original study, my AHI varied greatly between REM and NREM sleep. For example: my AHI during NREM was only 5.1, but shot up to 16.9 during REM sleep. During my CPAP titration study, I only achieved 1.5 minutes of REM sleep total. So while the pressure they had me on controlled the apnea/hypopneas during NREM sleep, I'm wondering if it will be enough to control them during REM sleep. Has anyone had a similar experience? Should I request an APAP machine from my doctor just in case the pressure they determined during the titration study isn't high enough?

My final pressure # was 6.0, and AHI for the night was 0.9.

Thanks in advance for your input!
-Dan

Hi Dan,
First of all, welcome to the forum. You have found a great place to find answers.

Since you are asking about an APAP machine before you have a machine, this is a good time to ask and decide. Others have found it is MUCH harder to get a machine swapped once you already have one.

Recommendations:
1) It is paramount to get a machine that provides full therapy data, not just "compliance" data. You, your Dr, your Respiratory Tech, whomever are all flying blind without the data.

2) Get an APAP over a CPAP. Any APAP can be setup to operate as a basic CPAP (single pressure), or as an auto-adjust APAP within a range, so it is 2 machines in one. Most people seem to adapt well to APAP mode, some don't. But even if you don't adapt well, you can operate in CPAP mode most of the time, and use APAP mode to perform a re-titration at any time. Pressure needs can change: you gain some weight, you lose weight, you have an allergy flare-up, you get a cold, etc. An APAP will auto-adjust to these kinds of circumstances very well.

When I got my unit in January 2014, all I had to do was ask my Dr. to write the prescription with a range of pressure: 2 numbers, low and high. I don't know what you may have to do, it could depend on your insurance.

Here is a link to an article that gives good advice about selecting machines:
http://www.apneaboard.com/wiki/index.php...ne_Choices

Hope this is helpful,
Good liuck on your journey.

A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#5
Thank you all for your replies. After doing my initial research here, I was thinking of going with the ResMed AirSense 10 (A10) AutoSet. I already have ResScan installed on my computer ready to download the data.

From what I understand this machine will give me all the data that I need. It is very important to me to be able to see hard data that proves the therapy is working.
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#6
Have you seen the back and forth with views on the A10. Should be the latest greatest thing and sounds good on paper but some had issues. I have no knowledge myself as I'm using the last best model S9 autoset that everyone still seems to love.
Good Luck!

Doc J (despite my nickname I am not a doctor)

Remember to donate to the board if you can, it has helped a lot of people including myself.
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#7
Second get the Apap. Can run it either straight Cpap or Auto mode as you need too. Id also just myself recommend getting the climateline hose if resmed or a Sixty series if Respironics and the heated hose option.

Just my two cents
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#8
Thanks again everyone for your input! I saw the doctor today and she agreed that APAP would be the best way to treat my apnea. After telling her I had done some research, she even asked what machine I wanted and wrote the prescription especially for it.

Can't wait to get it and see how things go.
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#9
Way to go Danf183. That is just great.
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