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New User, Apex XT Auto -- would welcome your thoughts - Printable Version

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New User, Apex XT Auto -- would welcome your thoughts - scronch - 12-14-2020

Hello,

I'm a new CPAP user. I was diagnosed as borderline three years ago, insurance wouldn't cover a machine, ended up buying an Apex XT Auto but not using it. I had an ApneaLink sleep study recently that showed 60+ apnea events per hour, so told to start using the machine.


I have:

Apex XT Auto machine
Apex Humidifier (not using yet)
Amara View Full Face Mask (I don't remember how I chose this mask)

I would like to hear if most people are running the Apex XT Auto in CPAP or APAP mode, and the settings they are using.

I would like to hear if others are having success with the Amara View Full Face Mask.

I have obtained the software from this website (thank you) but haven't had time to set it up yet.


I have had three nights using the machine:

The first night, I slept for 6 hours straight, which I haven't done in a long time. The machine was in APAP mode, min p 10, max p 14.5, PVA off. While falling asleep and a few times during the night, I had the sensation of not being able to get enough air.

The second night, I turned PVA on set at 3, which I believe means the machine can drop the pressure 3.0 cm during the exhalation phase of each breath. Honestly, I feel like the machine might be adjusting the pressure out of phase with my breathing--as in higher pressure when I'm trying to exhale--but I'm not sure. I only got a total of 2 hours of sleep and felt miserable all day long.

The third night (last night), I used the same settings but adjusted the head gear to hold the Amara mask against my nostrils a little better. This reduced the leakage blowing into my eyes, but I get a terrible feeling while exhaling that it takes too long because of the pressure, and I'm not convinced the mask has been scavenged effectively of CO2 when I draw the next breath immediately at the end of exhaling. I got 3 hours, then 2 hours, then 1 hour of sleep. Not very beneficial yet.


I am very interested to hear if people have had the most success with the Apex XT Auto in CPAP or in APAP mode, and with or without PVA.

I ordered a Bluetooth pulse oximeter which is arriving today. When I get it set up, I will supposedly have a graph of my SpO2 throughout the night. I believe the real goals are to limit the number of apnea events and to maximize SpO2 throughout the night.

I'm still a little unclear on the Apex panel display values in the morning, but I think they will become clearer to me once I start using the software. I have had HI 42 to 50 and the other two at 0. I have read I have to divide by the number of hours. It's not clear to me when the counter(s) reset.

It's also not clear to me how much data the machine stores before I transfer it via SD card to the computer. Does the Apex XT Auto hold just one night of data, or many nights (do I need to transfer every day)? Does transferring to the SD card clear the values in the Apex machine?

Finally, any hints or tips on the Amara View Full Face Mask would be appreciated. I looked into a Resmed Airfit F20, but the full face mask over the nose bothers my eyes, so the minimal-contact Amara makes sense, I guess. I cannot use just a nasal mask because I sometimes mouth breath due to mild asthma.

Thank you very much in advance.  Smile


RE: New User, Apex XT Auto -- would welcome your thoughts - Sleeprider - 12-14-2020

Just curious how you ended up with an Apex rather than Resmed or Philips. That Chinese machine is usually a price-point decision to maximize DME profit. Your machine is not support by OSCAR for data, so it's a lot harder to give you objective suggestions, however, if you feel good, it's usually good therapy. If you purchased it on your own dime to save some money, I apologize for the jab at the medical suppliers. There are many people getting comfortable therapy out of the Apex, but it is not well suited for those that want to get involved in their therapy and track progress through data.


RE: New User, Apex XT Auto -- would welcome your thoughts - scronch - 12-14-2020

No offense taken. I bought it online three years ago. I haven't used the software yet, but it appears to provide a fair amount of data. If I end up not getting decent therapy using the Apex, I'm sure I'll be able to get a different machine through the medical department I'm working with. But I'll be into 2021 which means a new deductible.


RE: New User, Apex XT Auto -- would welcome your thoughts - Sleeprider - 12-14-2020

The Apex data has been posted before, and the machine reacts similarly in Auto mode to the Philips Dreamstation. I have seen the machines used in both fixed and auto pressure modes, and either can work well. In general, the fixed pressure needs to be set near the 90th percentile of pressure attained under the auto setting, and if using Auto, you want to increase minimum pressure to an effective therapeutic level. This is common with nearly all auto CPAP. While the Resmed reacts faster than Apex or Philips to obstructive events, we try to coach users to set pressure to a level that minimizes pressure changes during the night as this results in less disrupted sleep. Where hypopnea, flow limitation or snores are present, we try to increase the exhale pressure relief, provided it is comfortable. I guess the point is, you can be effectively treated in fixed pressure, but it takes more diligence to fine the the effective pressure. In auto pressure it is still important not to depend only on the auto algorithm, but to get the machine into the zone.


RE: New User, Apex XT Auto -- would welcome your thoughts - scronch - 12-16-2020

That makes sense. With min 10.0, max 14.5, PVA on at 3, I have woken up with the APAP at 14.5, another time at 12.5, another time at 10.0. I believe the Amara View cushion that I have is too small and I have ordered a large cushion. What do you mean by, "The Apex data has been posted before"? I've looked through the Apex threads (found with search).

I think my biggest concern is still the feeling that exhaling takes too long because of the pressure, and I'm not convinced the mask has been scavenged effectively of CO2 when I draw the next breath immediately at the end of exhaling. I hope that makes sense.

Anyone with Apex XT Auto experience that can share their thoughts?

Thanks.


RE: New User, Apex XT Auto -- would welcome your thoughts - Sleeprider - 12-16-2020

With regard to charts, I may have been thinking of BMC. Does the machine offer on-screen information on AHI, pressure or anything useful? It just feels like poking at the dark to find an effective strategy for you to use. With data and especially a detailed respiratory flow rate chart we can see respiratory timing. As long as you are in good pulmonary health, the natural recoil of the lungs is usually sufficient to overcome CPAP pressure. I think if you convert your CmH2O pressure to PSI you will grasp just how low CPAP pressure really is. If PVA is pressure relief, then at 14.5 cm exhale pressure drops to 11.5? I just don't know how the Apex works to be honest, which was part of the bias reflected in my first post.


RE: New User, Apex XT Auto -- would welcome your thoughts - Sergio Pittelli - 01-23-2021

Hi, do you have the software to download the data from the SD card in the computer? Do you know how can I achieve it?


RE: New User, Apex XT Auto -- would welcome your thoughts - OpalRose - 01-23-2021

(01-23-2021, 07:50 AM)Sergio Pittelli Wrote: Hi, do you have the software to download the data from the SD card in the computer? Do you know how can I achieve it?


There is software available for the Apex in the Private Files and Links Forum. Please read all directions carefully.

http://www.apneaboard.com/forums/Forum-Private-Files-and-Links