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Do Sleep Doctors hate APAP machines?
#1
Angry 
I am new to sleep apnea therapy but have gotten this feeling that sleep doctors do not like to use auto cpap settings or RX these APAP machines. Is it because they like to keep you" on the hook" for every little issue or pressure change and to squeeze every dime out of you and the insurance company. Or is it because of REAL sound medical practice that they prefer not to use auto therapy? I have a new S9 autoset that was keeping my AHI to 1.5 or below when on auto. After titration study the Doc set the pressure to 8 and now my AHI is a times up to 4.
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#2
Mine does. I had that impression talking to him and it was confirmed both by the RT at the DME he sent me to, and by the 2 others I consulted when arguing with him to get my S9.
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#3
I think a lot of doctors don't even know what a APAP is. I think you should call your doctor's office and tell them what you told us.

Do you have enough data yet? How long have you had it set at a constant pressure of 8?
Sleepster
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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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#4
(06-03-2012, 05:50 PM)Maxdave Wrote: I have a new S9 autoset that was keeping my AHI to 1.5 or below when on auto.
What was the minimum and maximum pressure setting and the pressure, leak shown on the screen


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#5
Maxdave, this thread may become the longest on the board as it begs the two main questions we all have, 1) CPAP vs APAP, and, 2) the medical industry's effort to "keep you on the hook".

My opinion is that doctors disagree on CPAP vs APAP for reasons of health, not financial gain. However....(again my opinion only)...whereas doctors may be altruistic, the medical industry as a whole holds back information to generate income. They disclose information to avoid liablility. It's a game and as I see it, that game is most obvious in the sphere of "continuous positive air pressure", a new medical industry created by the medical industry.

Your question is timely. As PAP technology gets better (by that I mean, more "auto-capable") the machines perform more and more of the original titration sleep study steps automatically. My DME is also a close friend and he has disclosed to me that many of the physicians he is dealing with are saying that medical restrictions should be loosened up, that apnea patients should be able to buy APAP machines without restrictions and set their own pressures.

As far as your particular case, I'm not sure you've sited all the data required to make the point your are making. If your S9 is an "auto" and your doctor changed the pressure to 8, the machine may still be on "auto", simply with different minimum or maximum pressure. That's different than setting your machine to CPAP mode with a fixed pressure of 8. Perhaps you know this but didn't say it.
--==<< old, experienced, but still curious >>==--
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#6
Yes, my sleep doc is against them. The DME says a lot of the docs in this area are and they don't distribute many of them at all.

But then, my DME didn't know the S9 has a take-apart humidifier tank. Rolleyes
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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#7
I was fortunate that my doctor approves of APAP machines. I was scheduled for a split-night sleep study, but I was unable to sleep long enough for them to do the titration. I was prepared to insist on an APAP when I went to my consultation, but my doctor suggested it before I had the chance to say anything. He was prepared to schedule a titration study, but his preference was for the APAP.

In my case, I doubt that I could receive effective therapy from a straight CPAP since my pressure can end up anywhere within my range. It is usually between 11 and 13, but it shot up to 16 (the maximum) last week when I had a cold.
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#8
Angry 
Yes, I do still have the Autoset S9. The settings were changed to 8 in CPAP mode. I used the machine for several weeks in Auto mode ( 6-16) and the AHI was 1.5 and below. After the sleep study the Doc changed the RX but I was able to keep the Autoset machine.
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#9
Then I agree with Sleepster, you should contact your doctor and ask him why he changed your machine to CPAP at a fixed pressure. I don't doubt at all your experience of greater AHI on fixed CPAP, than APAP. That intuitively makes sense to me. But I also believe 6-16 on Auto is a catch-all setting, designed to create a maximum data spread for the purpose of logging an ample profile (seeing what pressures the machine adjusts to). Thereafter, I would guess the reset to CPAP on 8 cm/h20 was an effort to set your machine to the upper mid-range of what your auto-log showed. My guess is only a guess, you should ask your doctor what his reasoning was.
--==<< old, experienced, but still curious >>==--
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#10
A lot of users of APAPs do this. They use the auto feature to determine the best pressure then put it on straight CPAP with that pressure. It is self-titration.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


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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