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Why ACPAP?
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parrst Offline

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Post: #1
Why ACPAP?
Is the purpose of the Auto mode to help those who have trouble with the static CPAP? I had been reading a while and I finally tried the Auto mode. My level was prescribed as 12. I have been using that for a couple months. I set the auto to 7.4 to 16.something. I found 7.4 to be too low as I felt like I was suffocating (a little overstated but I think some of you know what I mean). When I checked my numbers over three nights (the third I raised the lower pressure to 10) my max pressure was about 12. Makes me think that 12 is right for me but thinking I may not need the auto as I adjusted to it pretty quick, to the point that in the mornings, I an mot sure there is pressure until I open my mouth.

Bob
06-25-2016 11:45 PM
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PoolQ Offline

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Machine: AirCurve 10 VAUTO
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Post: #2
RE: Why ACPAP?
Not "needed" unless you need it. If your numbers are fine and you are sleeping well then that's all that matters. If you try it and find it more comfortable without effecting your numbers then great.
06-26-2016 01:04 AM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
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CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Location: Perth, Western Australia

Post: #3
RE: Why ACPAP?
The auto mode serves a number of purposes, but some people find a fixed pressure is preferable. Generally speaking an APAP will run at the lowest pressure until some event triggers a rise in pressure - that may be snoring, flow restriction, hypopnea or apnea. This will often allow a more comfortable sleep for those who can't tolerate high pressure.

The APAP can also adjust to your needs as they change over time. Remember that your sleep test was just a snapshot - as you age or experience environmental or health changes your pressure needs may also change - the APAP automatically adjusts for this. No two nights are the same, so it's not reasonable to expect that exactly the same pressure will give you the best results all the time.

Having said all that, some people don't like the pressure changes, which can disturb your sleep. They find that a constant pressure is more comfortable and gives good results. Like all things CPAP, it comes down to a personal choice of which best suits your own particular needs. If you're buying a new machine, I would always recommend an APAP as it can be used in constant pressure mode, but a constant pressure machine can never run as an auto.

DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-26-2016 05:26 AM
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shawn42 Offline

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Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
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CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

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Post: #4
RE: Why ACPAP?
I had great numbers but a terrible experience & feeling afterwards from my study with a CPAP. When I explained this to the doc, he said it's one of those things that some people get used to, and others never do. He explained that the constant pressure tends to keep your lungs at a fuller volume because exhaling is so much harder than inhaling. You should still take breaths the same way, but with CPAP, your lungs are fuller and more expanded during the process. Some people have a sensitivity to this full feeling as it affects the whole structure of your abdomen. This sensitivity causes some people to change their overall breathing behavior.

He explained that some people in this situation experience more central apnea events where they stop breathing without any obstructive cause. This is because the the constant pressure can cause them to take deeper breaths and hold them longer. Your breathing is automatic, but your brain regulates it based on the levels of O2/CO2 in your bloodstream. As your O2 levels get too high and your CO2 too low, your body will actually stop you from breathing automatically while asleep. As the CO2 levels rise back to normal limits, your body starts breathing again. He said one of the goals of this treatment is to keep these levels more constant so that your body doesn't experience these spikes and dips in oxygenation levels. Your averaged-out oxygenation numbers may look good, but you're simply better off if these levels were flat throughout your night.

As such, auto mode has different pressures that kick in when you exhale vs when you inhale. With the relief in exhale pressure, it allows some people to breathe more normally where they would otherwise be adversely affected by a constant pressure. This is why I needed an APAP in order to accept my treatment. My doc said he's been using CPAP for years and never had the same issue as me. It just boils down to whatever works for you-- whatever keeps your AHI down and your oxygenation flat and normal.
(This post was last modified: 06-26-2016 06:45 AM by shawn42.)
06-26-2016 06:36 AM
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DeepBreathing Offline
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Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Perth, Western Australia

Post: #5
RE: Why ACPAP?
Quote:As such, auto mode has different pressures that kick in when you exhale vs when you inhale. With the relief in exhale pressure, it allows some people to breathe more normally where they would otherwise be adversely affected by a constant pressure.

G'day Shawn. I think your doctor might be getting a bit confused between the different modes and machines. The difference between a straight CPAP and an APAP (ie auto-titrating PAP) is that the APAP can adjust pressure up and down as needed through the night, depending on whether it is detecting apneas, hypopneas or their precursors. It's not related to pressure changes on inhale and exhale. That is a different function, called EPR (expiratory pressure relief) on Resmed machines and C-Flex or A-flex on Respironics. These settings drop the pressure by up to 3 cm during exhalation.

Your machine, being a bilevel, offers a more sophisticated control of the pressure difference and offers a substantially greater pressure drop. (Actually it works a bit back-to-front, with a set exhale pressure and a boost called Pressure Support during inhalation). Bilevel machines typically have additional settings to manage inspiration time, sensitivity etc. In this way, they offer much greater control for people who need it, or who are running very high pressures.

DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-26-2016 07:08 AM
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shawn42 Offline

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Posts: 36
Joined: Jun 2016

Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
Mask Make & Model: Philips DreamWear
Humidifier: detachable-- currently not using this
CPAP Pressure: 4-10 EP/IP, 2-4 PS, 3 BiFlex
CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

Sex: Male
Location: US

Post: #6
RE: Why ACPAP?
(06-26-2016 07:08 AM)DeepBreathing Wrote:  I think your doctor might be getting a bit confused between the different modes and machines.

I think it's just me who was confused-- I'm really glad you pointed this out. Since my experience brought me straight from one night on CPAP to home-use on an Auto BiPap, I wasn't aware of all the intricate differences that are offered. I just thought mine was called APAP for short (so many different terms out there!). Pressure Support must be that "PS" number in my SleepyHead stats. I need to go learn more about this stuff-- thanks for setting me straight!
(This post was last modified: 06-26-2016 07:20 AM by shawn42.)
06-26-2016 07:20 AM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #7
RE: Why ACPAP?
shawn42,
Do you have the Clinicians Manual for your machine?
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

This is not meant as anything negative toward your doctor, but a lot of sleep doctors are all about the straight pressure Cpap, and don't educate themselves on APAP's, BiPaps, let alone any of the comfort settings.

Other helpful stuff:
http://www.apneaboard.com/wiki/index.php?title=Acronyms
http://www.apneaboard.com/wiki/index.php?title=Definitions

OpalRose
(This post was last modified: 06-26-2016 08:12 AM by OpalRose.)
06-26-2016 08:07 AM
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shawn42 Offline

Preferred Members

Posts: 36
Joined: Jun 2016

Machine: Philips DreamStation AutoBiPAP
Mask Type: Nasal mask
Mask Make & Model: Philips DreamWear
Humidifier: detachable-- currently not using this
CPAP Pressure: 4-10 EP/IP, 2-4 PS, 3 BiFlex
CPAP Software: SleepyHead

Other Comments: Using CMS50IW Pulse Oximeter; Diagnosis AHI 60.2 with 74% O2 Desaturation Nadir

Sex: Male
Location: US

Post: #8
RE: Why ACPAP?
(06-26-2016 08:07 AM)OpalRose Wrote:  shawn42,
Do you have the Clinicians Manual for your machine?
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

This is not meant as anything negative toward your doctor, but a lot of sleep doctors are all about the straight pressure Cpap, and don't educate themselves on APAP's, BiPaps, let alone any of the comfort settings.

Other helpful stuff:
http://www.apneaboard.com/wiki/index.php?title=Acronyms
http://www.apneaboard.com/wiki/index.php?title=Definitions

I just got the manual now. I didn't bother before since I wasn't planning on changes settings myself. I guess it's time to at least figure out exactly what's going on in there currently.

Also bookmarked the links-- thanks! =)
06-26-2016 08:36 AM
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parrst Offline

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Post: #9
RE: Why ACPAP?
[/quote]
... I need to go learn more about this stuff-- thanks for setting me straight!
[/quote]

This is a GREAT place to learn more. I came here AFTER my DME gave me the low end Repironics CPAP but CHARGED my insurance for the Auto! I called them out and got the one I wanted. I went with the for her due to a different algorithm (should I want or need it) and one of the recorded measurements looked to be hit or mis on the standard but was always on the for her and I could care less if my CPAP is pretty!

One thing to keep in mind, is that if the information doesn't make total sense to you, be sure to talk to your Dr. As the disclaimer goes, these people are not clinicians. They have some great knowledge and experience but it is YOUR health so do what you think is best for you.

Everyone else, thanks, as always for the info. I think I will leave it on Auto but keep the low pressure at a higher level so I am comfortable but if needed, the pressure can rise from there.
06-26-2016 09:32 AM
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OpalRose Offline

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Posts: 3,167
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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #10
RE: Why ACPAP?
parrst,
It would be helpful to us if you would fill out your profile.

It's great you were able to get an Apap, but which brand did you get?
Is it the ResMed for Her? I don't believe Respironkcs makes a "for her" model.

As far as changing pressures, yes, you have to do what makes you comfy, but... If your not using software such as SleepyHead, how can you gauge where your pressure should be?

We here on Apnea Board don't advocate just changing pressures without seeing some data, like pressure graphs. Leak rates, AHI and total makeup of that number.

Granted, we are not doctors and don't claim to be.....just one apnea patient trying to help another. Smile

Anyone who isn't comfortable changing their pressure or comfort settings should always talk to their doctor.

Download the SleepyHead software and post us a couple screenshots, then someone can take a look.
http://sleepyhead.jedimark.net/

OpalRose
06-26-2016 09:48 AM
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