Post Reply 
Do sleep studies ever suggest AutoPAP right away?
Author Message
StoopidMonkey81 Offline

Preferred Members

Posts: 67
Joined: Oct 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integrated + ClimateLineAir Tube
CPAP Pressure: 9.8-14, EPR 3
CPAP Software: SleepyHead

Other Comments: Started therapy November 20, 2015

Sex: Male
Location: NJ

Post: #1
Do sleep studies ever suggest AutoPAP right away?
Just a curiosity. I get the feeling that sleep studies want to keep things very basic and titrate patients using simple CPAP, and hence that's what gets put on the prescription. Still, I get the feeling that most people here use AutoPAP with a pressure range. Is this at the recommendation of a sleep study or doctor, or is this largely the result of personal experimentation?
11-08-2015 08:24 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
justMongo Offline

Monitors

Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: Do sleep studies ever suggest AutoPAP right away?
My Opinion:

The sleep study, titration and straight CPAP route is old school.
It makes more money for the equipment provider.

More enlightened physicians are inclined to prescribe autoPAPs.
In some locals and other countries, a trial on an autoPAP is routine.

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.
11-08-2015 08:42 AM
Find all posts by this user Post Reply Quote this message in a reply
OpalRose Offline

Monitors

Posts: 3,180
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #3
RE: Do sleep studies ever suggest AutoPAP right away?
From my experience, Sleep Centers, as least where I live don't recommend a machine. They only give a titrated pressure to the Sleep Doctor. In other words, the best pressure that they found to treat your apnea. They never recommend a pressure range. That is up to your doctor.

Most doctors don't like to prescribe an APAP. My doctor originally prescribed a CPAP with a pressure of 9cm. Only after doing some research here, I went back to him and asked that he give me a script for an APAP, which he seemed reluctant to do, but he gave me what I asked for. I was then able to return my CPAP for an APAP. The only thing he did wrong in my opinion is put a pressure range of 4-20 on the script.

From this forum, I learned how to narrow my range to give me the best treatment.

If I left it up to my doctor, I would still be at 4-20 with an AHI of 10+.

My AHI numbers are usually <1.

Now, I am aware from reading a lot here, that there are Sleep Centers that titrate, and prescribe machine, and you report to them for treatment, but in my area it is
not set up that way.

OpalRose
11-08-2015 08:50 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
foss Offline
Wiki Editor
Advisory Members

Posts: 203
Joined: Jun 2015

Machine: ResMed Autosense 10
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View FFM
Humidifier: Resmed
CPAP Pressure: 9 - 13.4
CPAP Software: ResScan SleepyHead

Other Comments: Marine Chemist, Science Teacher & Counselor, Internet Server Admistrator

Sex: Male
Location: Under The Rainbow

Post: #4
RE: Do sleep studies ever suggest AutoPAP right away?
My sleep study indicated APAP directly. At 82 events per hour, my AHI was quite high. I didn't have any knowledge of CPAPs when I had my sleep study. I had never even seen a machine prior to that time. I guess, due to my age I was a target of CPAP mask advertising and thought I probably needed one due to snoring complaints from my wife and constant fatigue and sleepiness during the day. My regular doctor in Houston, that I had seen for many years never even suggested a sleep study, he just tried to refer me to an ENT for laser surgery to remove excess tissue in my throat. He said it was a "simple" procedure. Fortunately, I never took him up on an offer. It wasn't until I was in the hospital for an unrelated reason that the nurses told me I needed a sleep study. My GP here in Kansas scheduled a sleep study. Afterwards, she prescribed an APAP and I was fortunate to receive a ResMed A10 Autosense with all of the bells and whistles. My setting range has ended up 7 -13 with auto ramp and and humidity including a heated hose. A straight CPAP would have been much less comfortable for me. In addition, the capability to transfer data to Sleepyhead software has allowed me to tailor my settings for maximum benefit.

I am very fortunate that I had an excellent doctor that was looking out for my best interest.

Just a thought: I would think the supply system would tend to providing the more capable and expensive xPAP machines. It is probably the insurance companies that try to limit their expense and tend push toward the low end equipment.

Jeff

PS. I was lucky to find this forum and the educational information that it provides. This information has made my treatment much more comfortable and effective.

Sleep is worth the effort.
(This post was last modified: 11-08-2015 08:58 AM by foss.)
11-08-2015 08:55 AM
Find all posts by this user Post Reply Quote this message in a reply
OpalRose Offline

Monitors

Posts: 3,180
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #5
RE: Do sleep studies ever suggest AutoPAP right away?
The insurance companies pay the same regardless if it's a CPAP or APAP. That's why the DME's and suppliers love to give you that lower end machine. They make more profit that way.

I have no idea why a doctor doesn't perscribe an APAP over a CPAP.

Jeff, yes you are very fortunate to have a doctor looking our for you. I wouldn't say my sleep doc is not an excellent doctor, as a matter of fact, he is a very sought after sleep specialist/Pulmonologist in my area, but he is extremely busy and doesn't take much time with you.

OpalRose
11-08-2015 09:19 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
49er Offline

Advisory Members

Posts: 239
Joined: Apr 2012

Machine: VPAP-S
Mask Type: Nasal mask
Mask Make & Model: Sleep Weaver Elan Soft Cloth Nasal Mask
Humidifier: H5i
CPAP Pressure: 13.6/9.6
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location:

Post: #6
RE: Do sleep studies ever suggest AutoPAP right away?
(11-08-2015 08:24 AM)StoopidMonkey81 Wrote:  Just a curiosity. I get the feeling that sleep studies want to keep things very basic and titrate patients using simple CPAP, and hence that's what gets put on the prescription. Still, I get the feeling that most people here use AutoPAP with a pressure range. Is this at the recommendation of a sleep study or doctor, or is this largely the result of personal experimentation?

When I was initially diagnosed with sleep apnea, it was through a home study. Since I didn't have health insurance at the time, the sleep doc's only option was to prescribe an autopap machine. She prescribed it at 9-20 which still needed some adjusting but was definitely better than the 4-20 that is normally used.

When I had a titration study last year, I was already using the VPAP-S so obviously an autopap wasn't going to be prescribed unless I said I wanted to go back to that type of machine.

49er
11-08-2015 09:27 AM
Find all posts by this user Post Reply Quote this message in a reply
DariaVader Offline
Apnea Board Facebook Editor
Monitors

Posts: 1,827
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #7
RE: Do sleep studies ever suggest AutoPAP right away?
My doc never considered prescribing anything but APAP. I had a home study for diagnosis, and skipped the titration study. I have 100% coverage for both the study and the PAP and supplies, and the Insurance company recommends home study, but not if other sleep disturbances are suspected. My Doc could have easily justified a lab study, but actually feels the home ones + APAP are a better tool for 90% of the time.

I think that even in Canada I would qualify for apap since my pressure needs during REM are markedly higher than non-REM. This is the "old fashioned" requirement for APAP in the US as well.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
11-08-2015 08:48 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaytonA Offline
Wiki Editor
Monitors

Posts: 3,013
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #8
RE: Do sleep studies ever suggest AutoPAP right away?
(11-08-2015 09:27 AM)49er Wrote:  
(11-08-2015 08:24 AM)StoopidMonkey81 Wrote:  Just a curiosity. I get the feeling that sleep studies want to keep things very basic and titrate patients using simple CPAP, and hence that's what gets put on the prescription. Still, I get the feeling that most people here use AutoPAP with a pressure range. Is this at the recommendation of a sleep study or doctor, or is this largely the result of personal experimentation?

When I was initially diagnosed with sleep apnea, it was through a home study. Since I didn't have health insurance at the time, the sleep doc's only option was to prescribe an autopap machine. She prescribed it at 9-20 which still needed some adjusting but was definitely better than the 4-20 that is normally used.

When I had a titration study last year, I was already using the VPAP-S so obviously an autopap wasn't going to be prescribed unless I said I wanted to go back to that type of machine.

49er

But you could have used the VPAP Auto which has an S mode as well as the bilevel auto mode.

Best Regards,

PaytonA
11-08-2015 10:14 PM
Find all posts by this user Post Reply Quote this message in a reply
usertc Offline

Preferred Members

Posts: 32
Joined: Oct 2015

Machine: ResMed AirSense 10
Mask Type: Nasal mask
Mask Make & Model: F&P eson
Humidifier: integrated
CPAP Pressure: 4 to 14
CPAP Software: Not using software

Other Comments: AHI= 50 with asthma, GERD, and chronic migraines

Sex: Female
Location: California

Post: #9
RE: Do sleep studies ever suggest AutoPAP right away?
I was first diagnosed in 2009 at Stanford. They prescribed me an autopap with a pressure range. My dr said they had trouble titrating me to specific pressure. I don't know what that means, but it is what they said.
11-09-2015 12:14 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
StoopidMonkey81 Offline

Preferred Members

Posts: 67
Joined: Oct 2015

Machine: ResMed AirSense 10 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: Integrated + ClimateLineAir Tube
CPAP Pressure: 9.8-14, EPR 3
CPAP Software: SleepyHead

Other Comments: Started therapy November 20, 2015

Sex: Male
Location: NJ

Post: #10
RE: Do sleep studies ever suggest AutoPAP right away?
Thanks for the replies. I guess the next loaded question is: If I was prescribed static CPAP under what conditions would I try to use Auto mode? My initial instinct is to try static mode for a few weeks since I imagine my ENT will want a follow-up and would likely be pissed if I did Auto right away after I told him I wouldn't when I was trying convince him to write me a script for an Auto machine when he was set on static CPAP as per the sleep study recommendation. If I get the feeling from the follow-up that this really isn't his specialty then I may end up looking for a dedicated sleep specialist and go from there. Still, if there are certain signs I should be looking out for or results from SleepyHead that indicate Auto would work better for me, I'd be interested in hearing them.
11-09-2015 06:09 AM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  Autopap questions on how it works KSMatthew 6 312 10-10-2016 02:51 PM
Last Post: Sleeprider
  Opinion on what to do next regarding sleep studies & diagnosis / similar stories? azone 6 1,720 03-31-2016 08:07 PM
Last Post: woozie38
  Can sleep studies be wrong? shewhorn 14 1,291 03-04-2016 03:15 PM
Last Post: shewhorn
  Clinical Studies 0rangebear 6 584 02-24-2016 09:33 PM
Last Post: PoolQ
  DO I NEED TWO SLEEP STUDIES? BoyertownCasket 14 1,312 02-24-2016 05:07 PM
Last Post: 0rangebear
  on Autopap one month- central 90'% time sue60 12 879 02-06-2016 10:14 PM
Last Post: trish6hundred
  AutoPAP: When to change min/max pressure? StoopidMonkey81 14 1,607 12-01-2015 03:29 PM
Last Post: StoopidMonkey81

Forum Jump:

Who's Online (Complete List)