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Nedd Help With APAP Settings
#1
I was on fixed pressure 11 for 3 months. When I saw my doctor I asked about trying APAP. He agreed (I didn't see the doc--saw his assistant a respiratory therapist/DME adviser). He set the pressure at 11-14. we do have to watch CAs. I was delighted the first night when I had no CA's but for the 10 days that I've used the APAP settings 3 nights have had 8 and 11 episodes. All are very short--20 seconds was the longest. My 90% figure has varied from 14 to 12.3. The CAs don't show a pattern of happening at the higher pressure. I am planning on dropping the low number to 9 or 10 and see what happens. What is the advice of some experienced hose-heads out there? Thanks, and Merry Christmas!
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#2
Some people find the pressure changes in APAP to be bothersome. That can cause partial arousals which sometimes get scored as CA's. For those people, the CPAP mode is preferable.

My brother riuns a CPAP set at 16 cm H2O and I loaned him my APAP and set it at 15 min and 18 max. It wrecked his previously splendid AHI of being always <5 and gave him consistent reading around 8 for several days. He brought it back and said thanks but no thanks.

You may possibly fit that same pattern.

Dude
edit. I will add that you may be able to narrow the pressure range down and eventually be able to overcome the CA issue. I have some doubt about it being worth the effort unless you have some specific indication that APAP might be better for you in some situation that you are trying to address.
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#3
Thanks, Dude. I'm wondering the ssame thing--that the straight pressure might work best. CAs had dropped to usually under 5 and sometimes 0. RERAs are high usually on the straight pressure--dropped a few times on APAP but rose again last night. May drop the pressure to 10 tonight to see what happens. ythink I'll experiment for about another week or 10 days. Appreciate your comments.
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#4
(12-24-2015, 08:28 PM)SideSleeper Wrote: I was delighted the first night when I had no CA's but for the 10 days that I've used the APAP settings 3 nights have had 8 and 11 episodes. All are very short--20 seconds was the longest. My 90% figure has varied from 14 to 12.3. The CAs don't show a pattern of happening at the higher pressure.

Hi SideSleeper,

I suggest focusing on minimizing the overall RDI rather than placing more importance on avoiding CA events at the cost of an overall higher RDI.

CAs should not necessarily be more worrisome than obstructive events, and I think usually should be less worrisome. Unless the CAs are long and cause arousals or O2 desats, CA's tend to stress the body less than obstructive events.

If the Flow waveform at the time when a CA is ending shows a gradual and smooth return to normal breathing, I think this is clearly less stressful to the body than the sudden gasping for breath which typically occurs after partial strangulation by obstructive events.
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#5
Thanks, vsheline for the advice. After 10 days of 11-14 pressure I lowered it to 10-14. I've been analyzing the waveforms carefully--CAs are short and it appears there is no gasp for air at the end. Last night the 3 CAs occurred at pressure 10 so pressure isn't the problem! I will run at this pressure for 10 days then possible raise the higher pressure to 15. OAs haven't been a factor since switching to APAP--highest was 3 twice--had 0 four nights, 3 of those at the lower bottom pressure. Last 4 nights on the lowered bottom pressure show AHI is down--range from 1.5 to 0.3. RERA numbers are still high--range from 48 to 11 for the 2 weeks so far. Would like to get those down. I feel better during the day when they are below 20.
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#6
CA being short could ,probably are false flags. I have the same machine as you. Sometimes you just dont breathe as soon as the machine thinks you should and bingo it flags a short CA.
Dont know if you use aflex or not. Myself if I use it on more than setting one ill toss a few ca flags.
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#7
Ghost, I do use A-Flex--used C-Flex also on straight pressure. I have it on 3--the first night on APAP it wasn't on--didn't check that the doctor's assistant didn't change any settings except high high and low pressure. Had a bit of a struggle breathing, but not enough to shut it down and reset it that night. I think I'll set it to 2--read in another thread about that. Thanks.
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