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Do sleep studies ever suggest AutoPAP right away?
#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?
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#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.
Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#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
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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
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.
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#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
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#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

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#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
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#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

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#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.
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#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 P*ssed 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.
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