Help-needed-with-change-from-APAP-to-CPAP

[Pat Knoll]

Hi Experts in Apnea  matters : 

I have a Resmed Air 10 Auto .

Today  I  went  to see sleep doc . My current  CPAP pressure is 7- 17 .  He  instructed   the following  change :

Change from APAP to standard  CPAP 10cm  H2O 

Can anyone walk  me through  the exact steps to take to do this . I had a clinic technician  at one point but that probed a very unsatisfactory arrangement . Now I'm on my  own except for  the sleep doc who will not do CPAP tech changes . 

Thanks a lot in advance  to anyone who can help.

pk

[Sleeprider]

You can set your machine to CPAP mode, but the better way is to stay in Autoset mode and just set the minimum and maximum pressure the same. Why? Because you will get more data in Autoset mode than fixed CPAP mode. Your doctor does not mention "exhale pressure relief" (EPR), but it has real therapeutic effects.

Pat, if you'd like a second opinion, please fee free to post a graphic form OSCAR. but the procedure is really simple. I promise we can give you a more thoughtful recommendation If you simply want to change to a CPAP pressure of 10.0, then here is a pictoral tutorial on how to access settings. Just stay in Autoset mode, and make minimum and maximum pressure the same at 10.0. Be sure EPR is off. I will make a bet that your doctor's reccommendation will not work as well as what you've been using...DAMHIK
https://www.apneaboard.com/resmed-airsen...setup-info

[70sSanO]

You can send an email to get a clinical manual here:

https://www.apneaboard.com/adjust-cpap-p...tup-manual

Or you can:

1)  Hold the Home button and the round Dial for three seconds.
2) Turn the Dial so Settings is highlighted and press the dial.  It will probably show APAP and Min Pres and Max Pres.
3) Turn the Dial to Mode and press.
4) On the next Menu Screen select CPAP and press the Dial.
5) Turn dial to the Pres value and press Dial.
6) Turn dial clockwise or counter clockwise to raise/ lower pressure to get to 10.0 then press the Dial.
7) Turn dial to highlight Exit Clinical Menu and press Dial.

I see you use OSCAR, I wonder if your doctor reviewed you detail OSCAR data before making the recommended change.  Obviously you didn't skip into his office telling him how great you felt.  I'm asking this because if he didn't analyze your detail data and graphs, I don't know how he could make an assessment.

You may want to download your data prior to making the changes so if the straight CPAP isn't everything you an your doctor have hoped for, you can post some charts to see if the 10.0cm makes sense.

John

Edit Added: If your doctor did not look at, and analyze you detailed data, please beware that 10.0cm is kind of a default pressure for straight CPAP. When someone is just throwing out a number to try for straight pressure, I've been told it is usually 10.0cm.

[Pat Knoll]

Hi Sleep Rider and  70 sSanO ( John ) ;

I" ll try to post the Oscar data tomorrow . 

The sleep  doc  in fact looked through the  Resmed  data and then he recommended the  fixed CPAP 10 setting . I asked why ,and he gave an explanation that I could not entirely  follow . But  basically it seemed that if I was  set at 7 on Resmed , as the  low end ,  and  breathing was required at pressure  at say 7.5 ,and then I  needed a presume of 8 or  9 ,then I would likely have an apnea(s)  to force the CPAP to produce at the higher level than 7, and so on  . This way at 10 that would that  never happen as there would always be sufficient  pressure , whether  my demand is 7 , 8 or 9 . Also he looked at  the entire month of data and observed that I was never over 9.5  pressure for demand - therefore there was no need to have the range set  above 10  . That was my take on it but as you may well know a lot slips by during these  visits . 

I should add, however, that this is a long experienced sleep specialist - thats all he does and has been doing for   over 15 years . So he has some depth in this -but of course ,  no one is infallible ( or so it seems ) . He  appeared quite sure that this is   worth a try . Bur , he never indicated it would be a sure fire  rocket to sleep heaven  . 

All of  this said I'm  concerned about this because at 7 and 17  I have had no difficulties and my AFI has averaged below 5 in 15 out of  last 25 sleep nights  . Some at 7, 8, and 9 - but 2/3 ( 14 in all )  below 5 . The sleep doc advised that the AFI although providing important data is not the Holy Grail and that how one feels ( refreshed, energized  or not )  is perhaps the best  marker .  

So I'm unsure  and given your responses even more unsure . But I must give it at least a few days try because he  is an " expert" in the field  and has the actual  medical training  and post MD, sleep  courses etc  . Otherwise why ever go to them ??? 

One follow up question I have for both of you is - Why would he not have it set  at 10-17 . What advantage is there in ever having  a fixed pressure .  I do not  understand this - how can this possibly  help to have one fixed setting when sleepers range on demand for  higher to lower  need for air, and so on . If my pressure  requirement has not been over 9.5  in  30 days " so what " - why not always allow the higher range as a possibility(  even now )  that it  might occur -even if there is a 30 day indication of no more demand than 9.5 . What is the advantage for the sleep apnea person ?  . Can either of you say what general advantage accrues for  a fixed pressure over a range of pressures-  all things otherwise  being  squeal  ? 

 Very much obliged for all your help . 

pk

[sleepyp]

Some patients are disturbed by changes in pressure or experience increased leakage when the pressure increases. They are often more comfortable at a fixed pressure that is high enough to keep their AHI in check.

[Pat Knoll]

PS to earlier thread : 

Hi Sleep Rider :

Further to my earlier post - I will follow your advice and  set  minimum and  max at  10  and as otherwise recommended .And I will turn off EPR - nothing was said by sleep doc on that .
 Thanks a very  lot !

pk

[Gideon]

Also it is not uncommon that some with central apneas are better with a compromise without pressure increases to minimize the central apnea. Some like to titrate with a single fixed pressure, it is what is done in a sleep lab. Many other prefer an APAP titration (6-20 or 4-20) and then to narrow it as indicated. Two different schools of thought.

[70sSanO]

Just make sure you download your current APAP data from the SD card to OSCAR before going to CPAP.

I’ve used Rescan in the past, but this site prefers OSCAR as it gives some detail not provided by Rescan.

Your change may be perfect for you, but if it isn’t the APAP data will help to see where you were without having to go back to APAP to titrate some numbers.

John

[Pat Knoll]

Thanks a lot all responders . 

John - Im going to stay on APAP as Sleep Rider has recommended - with  both  settings at 10 , so  that should not impair  data - I gather ? 


Thanks 

pk

[70sSanO]

In reality if you have been using an SD card all along you will automatically get yesterday’s, last week’s, etc. data when you download tonight’s data at 10min/10max.

John

Edit Added: Follow Sleeprider s recommendation.