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Why CPAP and APAP machines.
#21
Keying on what Dawei said, setting CPAP pressures based on one night's observation and titration in a strange environment, in a position you may not naturally sleep in, with all kinds of boondongles stuck to you, is kind of, well, kind of haphazard. I would argue that to get a good read, you would need several nights of titration in your own bed, without a ton of electronics hooked up to you. That magi pressure number can change from day to day, with a hundred variables feeding it.

Big meal before bed? A little nasal stuffiness from seasonal allergies? Big cold front coming through making that arthritic shoulder ache so that sleeping on it is uncomfortable so you have to sleep on your stomach instead of your side? Fluctuation in weight?

I did the one night titration with my first machine and it worked pretty well for me, but over time as I gained weight, I found that Ihad to bump the pressure up from 9 to 11.

OMMOHY
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#22
It's really good to have the option of both apap and cpap on a machine. It gives you more options for adjustment during the year where conditions may change. I went 5 months with no problems, then bam, furnace goes on and I've struggled most of the winter. Doing some suggested experimentation, I switched to straight cpap for 2 weeks and that gave me a lot of relief. The problem with it though, is at the higher pressure, it takes ages for me to fall asleep, so what I gain from better therapy for the moment, I lost due to fewer hours of actual sleep.

I have now switched back to apap but with a tighter range (9-11 instead of 8-12). Once the heat is off, I will just go back to my previous settings of 8-11.2). You may not experience this sort of problem, but I'll bet that there are a large percentage of people, that if they knew how to do their settings, would be fiddling with them to improve their comfort and therapy.

FYI- my problem is low oxygen from a slow heart rate. I only have apnea or RERA events, untreated, during near REM and REM - so 1.5 - 2 hours a night.
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#23
(02-26-2016, 10:03 PM)Dawei Wrote: the explanation you heard about the straight CPAP being better because it supplies the single, constant pressure that is needed to keep your airway open, this, to me, is an over-simplification and therefore misleading. In my experience, that single, fixed pressure necessary to keep my airway open has been found to change both short-term and long term. (I've been on the hose for more than 9 years). I also see changing pressure needs at times from night to night. And if a machine is blowing a fixed pressure at me which is higher than what's needed to keep my airway open that night, or that point in time, I don't like it at all. It's uncomfortable, and it becomes a leakage problem, since my pressure needs often get up close to the top of the scale, near 20cm.
As for AHI, like pressure, mine changes over time. I'm coming to the idea that my AHI can be connected to my of state of mind at bedtime--to things like anxiety level, with my AHI changing in step (higher anxiety resulting in higher AHI and vice versa).

David

Thanks, I will qualify in the future that this works for me, maybe not others. Not sure if I'd call it misleading or over-simplification in the sense that I suggested experimentation for individuality. Fact is, that pressure holds my throat open consistently and snoring is totally eliminated. My pressure is much lower than yours, my 10.2cm is not causing me any issues or varying results. 99% of the time my AHI falls below .5 and I'm not dealing with any anxiety issues .... yet.

My P10 mask has very low leak rates. Only been at this 1.5 years so admittedly my experiences are limited compared to yours but I don't feel you or anyone should compare your results to mine or vice-versa. We are sharing unique experiences so others may learn. Fortunately we get to hear from those with mainstream apnea and those with special needs.

My main point is everyone should experiment, they may find a better way (with the aid of software) to monitor their results. This worked for me and may work for others. There are plenty with similar experience on other forums that are very pro Cpap as opposed to Apap. Reasons why it may work better may be a mystery but the speculations exist and it helps some achieve better numbers.



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#24
(02-27-2016, 10:44 AM)Mosquitobait Wrote: It's really good to have the option of both apap and cpap on a machine. It gives you more options for adjustment during the year where conditions may change. I switched to straight cpap for 2 weeks and that gave me a lot of relief. The problem with it though, is at the higher pressure, it takes ages for me to fall asleep, so what I gain from better therapy for the moment, I lost due to fewer hours of actual sleep.

I have now switched back to apap

All of our issues are unique but if your results were better on Cpap, I wonder if you tried or considered going back to the ramp feature, this may enable you to get to sleep or get those hours back.
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