chillywig,(time=1286237149) Wrote:I have been thinking about this and I have decided to go to the lab and have the sleep study done. After getting the results I may not go back for the titration. I kept thinking how it would be to my advantage to see where a tech would set a cpap but right now my sinuses are totally plugged. What ever number I may have needed last week, this week I would need more power. An auto cpap seems like the only way to go.
If you that have the auto adjusting machines, do you run them wide open or narrow the range? I would think if you were sleeping fine you would want the pressure reduced and if you needed more why limit the machines output?
Glad to hear you're going to have the sleep study done. That's really the best route. Be sure to get the full and complete copy of your study results and diagnosis. I do agree with Ltmedic66 that it's best to get the titration also, for the reasons stated above.
It's best to have the sleep study done when your sinus are not blocked and you have no illness to complicate the sleep study and possibly skew the results. I'd consult with the sleep lab prior to your appointment to get their input also - might be best to wait until your sinuses are completely clear.
There are two main camps when it comes to operating auto-CPAP machines:
First, is the "wide-open" camp
- these auto-CPAP users believe that it's best to let the machine "do it's thing" and adjust within the widest possible range of pressures (4-20 cm/H20), and the result will be the best possible outcome for most patients. The only exception for most would be to start the lower pressure a bit higher, since pressures less than 7 or so seem to make many people feel "suffocated". My titrated pressure was 14, and I start my auto-CPAP at the lower pressure of 9.6 and high pressure of 20.
Second, is the camp of auto-CPAP users who insist that the "wide-open" method is flawed
, and will result in a higher overall average AHI. Their method includes scientifically analyzing each and every change, and operating their auto-CPAP in the tightest possible range of pressures that will give them an optimized, lower overall AHI. For instance, their average pressure is around 12, so they set their CPAP for a range of between 10-14. Granted, they "mess around" with the ranges over time to arrive at this optimum range of pressure and are more involved with using software like ResScan for their daily analysis.
I'm sort of somewhere between each of these two camps - I realize and respect the fact that much analytical work with experimentation of pressure ranges can result in a lower overall AHI, but I also realize that (for me anyway), my physical situation changes from time to time, and if I were to "lock in" my machine to a tight range of pressures, I might eliminate the possibility for my machine to compensate for any physical changes I might have (such as whether I had a cold, not enough rest the night before, not enough exercise, too much or the wrong types of food, not staying hydrated properly, not sleeping in the same position, the temperature and humidity, etc., etc... So for me, I tend towards the wide open method.
I have found out using ResScan that while my average pressure is around 12.5 now, at times, my S9 AutoSet has found it necessary to "punch through" a series of apnea events, raising the pressure to as high as 18. Had I limited my machine to 15 or 16, I have to believe I would have not been getting enough pressure to eliminate these events.
The argument from the anti-wide-open people is that auto-CPAPs respond much better and react quicker to events when they are limited to a smaller range of pressures. They say that the machines can't handle it well when they are set to wide-open, which results in higher overall AHI numbers. My thought is that this used to be generally true with older auto-CPAP machines; however, the newer machines have vastly improved algorithms to quickly adapt to ongoing patient needs, and operating wide open is not as much a concern today.
I think the jury is still out - there are good arguments and adequate evidence on both sides, and one method or the other may be best for you based upon your individual situation, health and physical needs. I think patients can use their own logic and come to one side or the other, or even end up with a compromise of both, tightening up their pressure ranges a bit from the wide-open 4-20 range if they are unsure.
Hope others will post their experience and thoughts on this also.