RE: CPAP, APAP or ASV
Just watched the entire video of the Dr. Krakow interview and it was very interesting. I'm eager to see the input of the knowledgeable people in this forum.
I'm one who seems to be doing well with APAP but sometimes wonder if I'd do better with bi-level. After much trial with getting my pressure range very narrow, I'm leaning toward fixed pressure CPAP with EPR of 3 or maybe 2. I certainly get better flow limitation results with EPR of 3, but the CAs edge back up. And I still wonder if I might try to convince my sleep doctor to prescribe bi-level or see if I can pay the difference between my APAP machine and a bi-level.
I've watched these videos before of Lefty Lanky and Uncle Nikko and know they are controversial. What is the consensus concerning Dr. Krakow? He seems extremely knowledgeable and reasonable.
RE: CPAP, APAP or ASV
I know nothing about Krakow and is why I started this thread. But so far not much interest.
From what I understand. The ONLY difference between the AS11 and the Bi-Levels are software. So a bi-level can be a cpap, apap and a true wider range fast response bi-level.
But that video uncle nikko posted was eye opening about how bad the Resmed EPR response to build pressure is after the exhale is finished. I wonder if that is why my class 6 chair looking flow wave looks the same no matter what. It seems that that little flat line pause on the inhale is from a partial airway collapse because the pressure raise lags so far behind the completed exhale.
RE: CPAP, APAP or ASV
Hopefully more will comment. I've seen other things about Krakow and he sure sounds like he knows his stuff. He made very compelling arguments. I've only been on the PAP journey since December 2024. It does make sense to me that fixed pressure could be better simply because variability can be disturbing. Sort of like getting accustomed to a constant sound contrasted with sudden, different sounds.
Some of the things I've heard from both Lanky Lefty and Nikko sometimes make me question them. But both are playing to audiences some. Not saying that's necessarily a bad thing. And both LL and Nikko sound very knowledgeable too.
RE: CPAP, APAP or ASV
This also makes me think of the PAP machine firmware alteration discussed at the start of COVID 19. It was called something like air break I think. It allowed one to alter the firmware to convert regular APAP machines to bi-level and I think even ASV. But it seemed quite technically challenging. Maybe the project could get going again.
RE: CPAP, APAP or ASV
Just researched the firmware subject and found that the forum declines to address that. I understand that and didn't intend to venture into off-limits territory. So, never mind on that topic, but I sure hope others will give input on what Krakow and the others discussed in the videos cited by super pilot.
RE: CPAP, APAP or ASV
I hope so as well. I sure have been suffering fragmented/disrupted sleep as of late. Was actually thinking of approaching the VA about this.
Kind of tired of having low events but tired as if I have a high events rate. My therapy thread seems to have sputtered out. I suppose I'm in that area of others not really being able to improve my numbers through my machine settings. And it is just being on the machine period combined with outside things effecting my not getting restful sleep. I do feel like I'm regressing.
