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I want APAP, sleep center wants CPAP
#1
Had my followup appointment after several months of CPAP use (Dreamstation Auto CPAP).  They were generally happy and wanted to now set a constant pressure of 8 cm after having a range of 5-20 cm (I never had a titration).  I had changed the pressure (thanks to you guys) to 6-12 or 7-11 starting around day 36 in the graph.

I said I feel comfortable with a range of 7-12 but they insisted at setting it at 8 cm.  The best reason I could get out of them is basically that's how we do it around here (a set number, not a range).  Looking at this data (which I didn't put together until after the meeting), it would that 8 cm is too low:

https://imgur.com/a/EAhRj

I'm leaning to setting the pressure back to 7-12 cm after they set it to 8. 

Do most people here have a range or a set pressure?  What are the advantages of having a set pressure, with the exception of being able to get a cheaper machine?

I move between back sleeping and side sleeping plus have been having winter nose stuffiness at night, so I would think a range would be better.


Secondary question - I've now tried the Amara View Full Face Mask and the Dreamwear Nasal Mask.  Do people keep the same pressure when switching between masks?  I seem to think I like a little higher minimum pressure with the Dreamwear. 

Thanks everyone.
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#2
cchild, Without knowing the types of events your having it's hard to answer the pressure question. Could you poat a sleepyhead chart with a daily detailed data on it?

There are times when fix pressure works better for some people most do better with Auto though.
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#3
cchild2, you have Sleepyhead which can perform the statistical analysis of your pressure needs and better define what kind of events are happening. Based on the chart you posted, I would estimate your best CPAP pressure is about 10, but for many of us auto-pressure works just fine. It is there for changing health needs, sleep stage and sleep position which affects many people. I really don't understand the insistence of your sleep doctor to use fixed pressure, although that is not uncommon.

Under HIPAA you have the right to decline any doctor's recommendations or a procedure. Without getting all "legal" about this, you can just say no, and use this pressure range. What I would do (and have always done) is talk to my primary care doctor about transferring your continuing sleep apnea treatment to his care. He can write the prescriptions and document your compliance and continuing benefit of using CPAP. That is all insurance requires for continuing coverage. Once your doctor agrees, tell your sleep doctor you're done unless you need a future sleep study. I have never used a sleep center for continuing care. It means more appointments and more costs, and the medical need can be met with your PCP at your annual physical.
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