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Doctors & APAP?
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Up@2am
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Post: #1
Doctors & APAP?
I've read that the Doctors don't like the auto? Any thoughts?
08-21-2013 12:57 PM
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big_dave Offline

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Posts: 418
Joined: Apr 2012

Machine: PR System One DS560
Mask Type: Nasal pillows
Mask Make & Model: F&P Pilairo Q or ResMed Mirage Activa
Humidifier: PR System One
CPAP Pressure: 14 - 20
CPAP Software: SleepyHead

Other Comments: Former ResMed S8 Autoset II user

Sex: Male
Location: Eugene, Oregon

Post: #2
RE: Doctors & APAP?
It depends on the doctor. When I had my sleep study, I was scheduled for a split study but i did not sleep long enough for a titration. My doctor offered me a choice of an auto-CPAP or scheduling a titration study. I chose the auto. When I went to my 3 month follow-up, my doctor told me that he prefers to prescribe auto-CPAP if the titrated pressure is over 10.
08-22-2013 12:25 AM
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eviltim Offline

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Joined: Aug 2013

Machine: Resmed S9 VPAP
Mask Type: Full face mask
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CPAP Pressure: 5 exhale/9 inhale
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Post: #3
RE: Doctors & APAP?
I didn't do well at all in the titration study (or my first sleep study), didn't get much data, so my doc went straight to an auto rather than put me through that again. I guess I'm lucky.
08-22-2013 01:16 AM
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STL Mark Offline

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Posts: 44
Joined: Jul 2013

Machine: Resmed S9 VPAP Adapt 36037
Mask Type: Full face mask
Mask Make & Model: Resmed Quattro Air
Humidifier: Resmed H5i
CPAP Pressure: Original Titration: 18 cm H2O
CPAP Software: ResScan SleepyHead

Other Comments: Mode: ASVAuto, Min EPAP: 4, Max EPAP: 15, Min PS: 3, Max PS: 15, Ramp: Off

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Location: Saint Louis, MO USA

Post: #4
RE: Doctors & APAP?
(08-21-2013 12:57 PM)Up@2am Wrote:  I've read that the Doctors don't like the auto? Any thoughts?
Auto machines make it much easier for an informed person to self titrate. Limiting repeat visits for those involved in their therapy.
08-22-2013 01:49 AM
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DocWils Offline

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Joined: Jul 2012

Machine: Philips Remstar series 60
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Humidifier: same as machine
CPAP Pressure: 5-15
CPAP Software: SleepyHead

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Sex: Male
Location: Switzerland

Post: #5
RE: Doctors & APAP?
Auto PAPs are the norm* over here - Not much controversy about it.



*"Norm!"
"Afternoon everybody!"
"What would you say to a beer, Normie?"
"Daddy wuvs you."

Sorry, couldn't resist.
08-22-2013 05:49 AM
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Paptillian Offline

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Posts: 474
Joined: Jun 2013

Machine: S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: H5i
CPAP Pressure: 4 - 10, EPR x2
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Pennsylvania, USA

Post: #6
RE: Doctors & APAP?
My doc prescribed an auto, no issues. He probably would have done so anyway but I'm not sure. I made sure to ask for it before the Rx was written.

It might depend on how you ask. If the doc senses that you want an auto just because you read somewhere that they're the "best" (and not even sure why) you're likely to get some eyerolls.
08-22-2013 02:14 PM
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trish6hundred Online

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Posts: 6,622
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #7
RE: Doctors & APAP?
Hi Up@2am,
WELCOME! to the forum.!
The first machine I got was a straight CPAP machine and I am sure glad that I was able to move into an S9autoSet.

trish6hundred
08-22-2013 06:43 PM
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archangle Offline
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Posts: 3,164
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #8
RE: Doctors & APAP?
The medical mafia types don't like auto CPAP because reduces their profit opportunities for repeat visits, adjustments, sleep tests, etc.

The dumb or lazy types don't want to go to the trouble to do APAP right, and CPAP is simpler, especially if you don't really care about finding the right pressure for the patient.

Some DMEs (CPAP salesmen) don't like APAP because it costs a little more and they are usually paid a fixed fee for any CPAP.

Some honest doctors don't know much about CPAP and may have even been steered wrong by the dishonest crowd. They think that APAP machines are simply set to "wide open" settings and run the full pressure range of 4-20 cmH2O. An auto CPAP should be set to a narrower pressure range for most patients, so it starts at something close to the right pressure for the patient.

If you set the minimum pressure too low, the patient may feel they're suffocating until the APAP adjusts upward. This can be avoided by raising the minimum pressure.

On a limited number of patients, the pressure will "run away" and get too high. Sometimes the patient actually needs the higher pressure, sometimes the machine is just "wrong." Either problem can be fixed by reducing the maximum pressure setting. Runaway pressure can make your apnea worse by causing central apnea. This scenario is fairly rare.

Some patients are bothered by the changes in pressure.

It may be more difficult to prevent mask leaks if the pressure changes much. You fit the mask when you put it on, but when you go to sleep, it may leak if the pressure increases.

There may be a small price increase for some patients, but I believe all patients should be given auto CPAP machines. All auto CPAP machines can be set to a narrow pressure range, or even manual CPAP if the medical professionals can't "tame" the auto CPAP.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-22-2013 09:30 PM
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