Could CPAP be better than APAP??

[Sleeprider]

I think working with fixed pressure is a great idea if you're sensitive to pressure changes, and you get better sleep. I think avoiding disruptions and arousals is more than half the game here. The last part is just fine-tuning for events, but anyone obsessing over event numbers rather than sleep quality is missing the point. That's why I check data about monthly.

[Reznik]

Regarding the desire to check data, I'm just starting, I want to check the data the moment I woke up.  And now that I've got a Contec pulse oximeter, I've got double the data to check.

I'm sure that once I get everything dialed in, I'll do the same as you. 

[AshSF]

I moved from a 5-20 apap to finally a fixed 8cm pressure. I sleep much better on a fixed pressure.

If your pressure need is less than 10, you could switch and evaluate.

[Reznik]

Thanks AshSF!  

I was going to ask you a bunch of follow-up questions, but I see now that all the answers are in your sig. 

[chill]

I doubt the pressure itself is disrupting your sleep.  It could well be that it makes it harder to get to sleep, but a constant pressure while asleep should not disturb you.  Pressure changes may well disturb you.  I decided to try CPAP over APAP some months ago.  I used a pressure of about my 95% pressure and ended increasing it by 1 to lower my AHI.  I seemed to sleep better and for longer stretches and have not changed back to compare.

[TASmart]

Hi TASmart!

Thanks for responding.  When you were on APAP, what were your pressures?

Most recently I have changed masks and I have the APAP set from 10 to 16, the 95% value is in the 13 range. problem is, I have fairly high flow limitations that the machine keeps trying to fix, cannot fix and it just drive the pressure up so I don't sleep as well. Enabling the EPR makes it even worse.

[Sleep2Snore]

Hi everyone,

I'm newly diagnosed with OSA and just starting my therapy with an Automatic CPAP ("APAP") machine.  I was diagnosed based upon a home sleep test and was given an APAP in lieu of a sleep study.  I'm tracking my sleep using ResScan and SleepyHead.  Right now, I'm using it in Automatic mode with a range of 5.0-8.0.  I'm having difficulty adjusting to the APAP.  When I use the machine, I feel much more tired the next day than when I do not, and if the pressure gets up above about 8.5 it wakes me up, which is why I set the machine to 8.0 as the upper limit.  With the 5.0 to 8.0 limits, I get an AHI of about 3.8, which is obviously good.

Why are you limiting the machine to 8, I would have it a bit higher than that, at least 10

In looking at the charts in ResScan, I've noticed an interesting pattern.  Throughout the night, whenever I have an apnea, the machine bumps up the pressure to or just under 8.0, and holds it there for a very short period of time.  The apnea clears, usually right at 10 seconds.  Then the machine starts to decrease the pressure, usually to about 7.0 to 7.4.  After some period of time with the pressure decreasing, another apnea occurs and the cycle repeats itself.

The machine rising in pressure might wake you, or at least disturb you.  What I would do is to set the lower pressure to 7 and the high pressure to 10.
Then use it for a couple of nights to see how you get on.  If the machine gets up to 10 then then you need to increase the high pressure.
However, please post your charts and let these guys help you sort thing out so that you get the best treatment.

Now, most people would say that the machine is doing exactly what it should do.  I start to have another apnea, and the machine ramps up to stop it.  However, I always like to consider the other possibilities, and so I can't help but wonder if it was the decrease in pressure from about 8.0 to about 7.2 that caused the airway to collapse and the next apnea to occur.  In other words, if I just set the machine on CPAP mode, with a continuous pressure, would many of those apneas stop happening altogether.  And more importantly, would it be just as effective at a lower pressure than the APAP is using??

The machine requires 8 to clear the airway, so if you were to use it on CPAP made it might be around 7.5 to 8 that you might need to keep the airway open.

In other words, is a continuous pressure more effective than a changing pressure range that has lower and upper limits than are higher than the continuous pressure?  e.g., is it possible that a CPAP set at 6.0 might be more effective than an APAP that is set to 6.0 to 8.0?

I would think 6 would be to low, however, without you posting your sleep results we can't say what pressure you would require.

Has anyone had any experience with using an APAP machine and then switching to CPAP mode at a lower pressure than what the APAP was doing?

I changed the APAP to CPAP just to see how I woulld get on, however, I needed a pressure just below what my machine said it went up to just to clear the airway.  So if you are looking to use a lower pressure, I think you will find this will not work, it will help, but it will not stop your airway from restricting.  I give you and example:  My machine says I need 11.7 to clear my airway, when I put it to CPAP I needed just above 11,5 to keep it clear if I turned over onto my back, so the APAP is very close to what I required.  My wife kept digging me in the ribs until I was close to the 11.7 the machine said I needed.
Result, I put it back to APAP and I am now nursing sore ribs for my trouble.

The way to stop the machine from waking you is the have the lower pressure closer to the higher, this way there is less of a pressure rise.
You could try putting your machine up to 6 as a low pressure to see how you get on, this would be a small rise and in no time you will get used to it.
You will get used to your setting anyway, however, I would put your high setting up above what you have it, it is just to close to your upper limit and you have no reserve left.  The machine will only go higher than the 8 if it needs to, but it will give you a slight safety margin.

Thank you in advance for your input!

Please post your sleep results using Sleepyhead so some of these guys can advise you how you are doing.