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Why Auto over CPAP?
#1
I've been trying my new PRS1 machine in AutoIQ mode for the past couple of nights and I must say I'm more comfortable with a constant flow. I've been using a constant flow for 8 yrs and never had an option, but I find it harder to breathe, and I'm just not as relaxed. I turned on AutoIQ to find out if my pressure should be lowered .. I'm at 14(based on sleep study from '04) but sleepyhead is saying that's about right. AHI is all over the place with Auto (as high as 5) .. but is consistenlty below 1 with CPAP. I think I'm going to go back to CPAP at 13 or 12 for a night or two and see how that feels. Am I on the right track? Maybe Auto isn't always better?? Thoughts?
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#2
I had a somewhat same problem, when first starting on the AUTO after using a CPAP for many years. It was doing its job reference to raising pressure to catch apneas, but I was uncomfortable with the pressure changes, even as I had set the gap fairly close. They kept waking me up. So I operate in the CPAP mode most of the time. Occassionally I will slip it back to AUTO for a night or so and run the results on Sleeyhead. It usually turns out fairly equal( CPAP vs AUTO)
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#3
Sorry just learning the site.
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#4
JudgeMental,

I got into this to see if my pressure setting could be lowered since I lost all that weight, but doesn't look like its changed much. .. I don't mind CPAP and I'm used to the constant flow, but when I was looking I got a lot of suggestions on trying an Auto machine. I've been using the brick for so long I was very used to it and my wife actually loved the hum? I know crazy right? I'm still getting used to sleeping with no machine noise!

I think I'll go back to CPAP .. but drop the pressure a little bit and see how it goes.
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#5
APAP's offer two possible advantages.

1. They can be used for at-home titrations. That is, you can use them, along with software and knowledge, to find a better CPAP pressure. Of course, you can do the same thing with a CPAP, it just takes longer.

2. They change the pressure throughout each night's sleep, something a CPAP can't do. This may ar not be an advantage. Some report it is, but despite my queruies, no one has ever offered an explanation of why they think this is an advantage. We do see a few reports, like that of the OP and one responder, that it's not an advantage.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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#6
BigRon..You've got the "cream of the crop" in your new Respironics Auto cpap. However, sometimes even driving a Cadillac is more then we need or are comfortable with. However its nice to have a machine with all the bells and whistles, so we can fiddle around with the mechanics of of it sometimes. With you having been on the "hose" for a long time, I'm not about to tell you what to do.
Autos are great instruments, but some people just don;t need them.

Why are you thinking about lowering your pressure down to 12 or 13. If Sleepyhead is giving you good returns at the setting of 14 and your AHI is below 1 most of the time...Man, if its working,,don;t fix it!!

I commend you on the weight loss. It might not have helped reduce your required CPAP pressure or even eliminated or reduced any apneas, BUT, it did take some of the stress off of some of your other orgins.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#7
(06-27-2012, 12:00 PM)Bigron 452 Wrote: I've been trying my new PRS1 machine in AutoIQ mode for the past couple of nights and I must say I'm more comfortable with a constant flow. I've been using a constant flow for 8 yrs and never had an option, but I find it harder to breathe, and I'm just not as relaxed. I turned on AutoIQ to find out if my pressure should be lowered .. I'm at 14(based on sleep study from '04) but sleepyhead is saying that's about right. AHI is all over the place with Auto (as high as 5) .. but is consistenlty below 1 with CPAP. I think I'm going to go back to CPAP at 13 or 12 for a night or two and see how that feels. Am I on the right track? Maybe Auto isn't always better?? Thoughts?

Hey Bigron, I'm glad you posted this! I too was DX in '04 (and was non-compliant for a long time) but I was given a brinck, probably the same one! REMstar Plus or whatever. The only thing this machine can do is tell you how many hours and how many day over 4 hours. I just today ordered a DS550 Auto, sounds like it could be the same machine, so I am going to be anxiously following its trek across the country to my doorstep. It's good to know that not everyone can deal with the Auto. I got this because I just can't sleep during a sleep study. Talk about putting pressure on someone! "Put on all this foreign gear, attach all these wires, clips, belts, etc and get a good night's sleep" Yeah...right!
My idea was to get an Auto so that I can reassess my pressure without going through all that pain! Not everyone has the same experience, but it is good to hear someone report that they are not comfortable with something. This way if I have issues I won't think I'm a freak! LOL! It should be interesting to have data! I really look forward to it! I hope everything works out well for you. Just remember those machines work just fine in CPAP mode! Get your thera[py however you need to, but get your therapy!
As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
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#8
(06-27-2012, 06:20 PM)Sleepster Wrote: APAP's offer two possible advantages.

2. They change the pressure throughout each night's sleep, something a CPAP can't do. This may ar not be an advantage. Some report it is, but despite my queruies, no one has ever offered an explanation of why they think this is an advantage. We do see a few reports, like that of the OP and one responder, that it's not an advantage.
Oh I can take this one. :-)

Here's my story. After my first sleep lab, the tech told me "you have severe apnea. So severe that I'm going to fast track your results and fax them to your doctor in the morning. Expect a call tomorrow or the next day, I'm recommending he get you on a loaner auto-pap ASAP."

2 days later I'm walking out of a DME with a respironics m-series set at 10 - 18. Used it for 9.5 hours the first night, felt great the next morning, and with only the exception I'll talk about it a moment, I've never looked back. Here's the exception. After 3 weeks they had me come in to dump the data from the machine. It said my 95% pressure was 18. RT decided "18 is your pressure." I asked... "how do you figure? 18 is the top end of the range, the machine couldn't go higher then that... how do we know it's not 19?" He agreed I had a point, set the machine to 12 - 20, and in 2 more weeks we found I was right and 19 was more likely. Now my doctor, who "never prescribes APAP machines..." according to all 3 DME's in town, decides that it's time to put the machine into CPAP mode, at 18.

Blows the mask off my face. Ramp is useless, letting it ramp up onlyh delays the massive leak until I'm comfortably asleep. Wake up 10 times a night with leaks and/or aerophagia. Felt miserable after the first night. Pitched the mask across the room during the second. Went back to the DME that day. Pressure down to 16, and swapped me to a ResMed S8 CPAP - "because a lot of people find it easier to get used to." Hated it. Woke up multiple times a night, started having to get up 3 time to hit the bathroom - something that stopped the first night on APAP. Woke tired, etc. Had to put up with this miserable machine for 2 months until my 2nd lab. Which was miserable, I slept less then 2 hours. Doctor comes up with my prescript - 14 cm h20 CPAP. "No, absolutely you don't need APAP , you don't show any fluctuation in pressure when you change position, we need to see at least 5 cm h20 variance..." Which I had 2 months of data from the APAP that showed such a variance. Not to mention, as much data showing that 14 was way too low.

I refused to let him prescribe me a fixed CPAP. Had him write me an APAP prescription, told him not to worry about justifying it to insurance, I'd buy the thing myself. Did so - bought my trust S9 Autoset. His prescription was for 10-18. The RT (not the one he sent me to) had no argument about setting it to 12 - 20 after I showed that a) I knew how to program it anyhow, and b) I knew as much about the machine and OSA as any patient he'd ever seen.

Took it home. Used it. Felt better then any time on fixed CPAP. Never woke up all night, and still don't.

Here's the thing that I realized - what was causing me issues was 2 things. First, starting with the fixed pressure was uncomfortable to me. I don't even use the ramp setting on my autoset, I don't need it. Second - I don't suffer with aerophagia at all even when the machine does run at 19 cm h20 - because it only does it for as long as it needs to. I still have nights where the pressure hits 19+ but usually my 95% is 16-17. And when I start to rouse, the pressure backs off and I go back to sleep.
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#9
Whatever works for you is the right answer.

Some find autoCPAP adjusts up through the night when they need it, and leaves them more comfortable when they don't need it. Some like 100% manual CPAP.

As long as you get good results in terms of apnea.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#10
(06-27-2012, 08:44 PM)CHanlon Wrote: Oh I can take this one. :-)

Thanks. I take your point. Sometimes I wonder if I'd be better off with an APAP.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
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