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An '''Automatic Positive Airway Pressure device (APAP, Auto-PAP, AutoCPAP)''' automatically titrates, or tunes, the amount of pressure delivered to the patient to the minimum required to maintain an unobstructed airway on a breath-by-breath basis by measuring the resistance in the patient's breathing, thereby giving the patient the precise pressure required at a given moment and avoiding the compromise of fixed pressure.
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== Overview ==
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An Automatic Positive Airway Pressure device (APAP, Auto-PAP, Auto-CPAP) adjusts the pressure delivered based on the current needs of the patient on a breath-by-breath basis.  The primary goal of auto-titration is to provide the minimum pressure necessary to maintain an unobstructed airway over the course of a night, thereby increasing patient comfort. 
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In some cases, an APAP is used as the primary means of [[titration]] once a patient has been diagnosed with [[obstructive sleep apnea]] through a [[sleep study]]. 
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== How an Auto-CPAP Functions ==
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An APAP uses a range of pressures predefined in the clinician settings, relying on real-time feedback from the patient such as airflow limitations, snoring, apnea, hypoapnea or a combination of these variables. <ref>Asp, Kevin.  What is APAP Therapy?  A comprehensive breakdown.  https://www.aastweb.org/blog/what-is-apap-therapy-a-comprehensive-breakdown;  February, 2017.</ref>  Once the APAP begins to  detect one of these physiological events, the algorithm will begin working to respond and treat the patient.  If the machine detects a flow limitation, or obstructive event, it will begin raising pressure to maintain the patency of the airway until it determines that an effective treatment pressure has been reached, or the machine has reached its limited or functional maximum pressure. <ref> Berry, Richard MD, Parish, James M MD, Hatse, Kristina M PhD, The Use of Auto-Titrating Continuous Positive Airway Pressure for Treatment of Adult Obstructive Sleep Apnea. Sleep, Vol 25, No. 2. 2002. </ref> If the machine detects a clear airway event, the machine will ''maintain the current pressure'' in order to prevent causing further clear airway events.  If no events are detected over a set period of time, the APAP will begin reducing pressure to attempt to return to the minimum effective pressure. <ref> Ibid </ref>
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== Advantages of APAP over fixed CPAP ==
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*''Patient Comfort:'' The primary goal of an APAP is to maintain the lowest minimum effective pressure to maintain airway stability, which is often lower than an effective single [[CPAP]] pressure.  This results in greater patient comfort. 
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*''Pressure Requirements:''  Patient needs can vary over the course of the night because of sleep stage, sleep position, health, diet, or weight related factors that can render a single [[CPAP]] pressure less-effective or even ineffective. <ref> Nolan GM, Doherty LS, Mc Nicholas WT. Auto-adjusting versus fixed positive pressure therapy in mild to moderate obstructive sleep apnoea. Sleep. 2007;30(2):189–194 </ref>
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*''Data-Capable:''  Most, if not all APAP machines are data capable and can be accessed using either proprietary software or [[sleepyhead]].  A list of data-capable machines can be found at [http://www.apneaboard.com/forums/Thread-CPAP-Machine-Choices-read-this-before-you-accept-a-new-machine. Data-Capable Machines]
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*''Increased Compliance:''  APAP use may increase patient compliance, particularly at higher pressures. <ref> Ibid </ref>
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*''Decreased Sleepiness:'' APAP use may decrease day-time sleepiness more effectively than fixed pressure [[CPAP]]. <ref> Vennelle M, White S, Riha RL, Mackay TW, Engleman HM, Douglas NJ. Randomized controlled trial of variable-pressure versus fixed-pressure continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) Sleep. 2010;33(2):267–271 </ref>
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== Popular APAP Manufacturers ==
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*Resmed
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*Philips Respironics
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*DeVilbiss
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*Fisher & Paykel
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----
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[[Category:CPAP technology]][[Category:Medical terms]][[Category:APAP]][[Category:CPAP data]]
 
[[Category:CPAP technology]][[Category:Medical terms]][[Category:APAP]][[Category:CPAP data]]

Revision as of 03:53, 3 March 2017

Overview

An Automatic Positive Airway Pressure device (APAP, Auto-PAP, Auto-CPAP) adjusts the pressure delivered based on the current needs of the patient on a breath-by-breath basis. The primary goal of auto-titration is to provide the minimum pressure necessary to maintain an unobstructed airway over the course of a night, thereby increasing patient comfort.

In some cases, an APAP is used as the primary means of titration once a patient has been diagnosed with obstructive sleep apnea through a sleep study.


How an Auto-CPAP Functions

An APAP uses a range of pressures predefined in the clinician settings, relying on real-time feedback from the patient such as airflow limitations, snoring, apnea, hypoapnea or a combination of these variables. [1] Once the APAP begins to detect one of these physiological events, the algorithm will begin working to respond and treat the patient. If the machine detects a flow limitation, or obstructive event, it will begin raising pressure to maintain the patency of the airway until it determines that an effective treatment pressure has been reached, or the machine has reached its limited or functional maximum pressure. [2] If the machine detects a clear airway event, the machine will maintain the current pressure in order to prevent causing further clear airway events. If no events are detected over a set period of time, the APAP will begin reducing pressure to attempt to return to the minimum effective pressure. [3]


Advantages of APAP over fixed CPAP

  • Patient Comfort: The primary goal of an APAP is to maintain the lowest minimum effective pressure to maintain airway stability, which is often lower than an effective single CPAP pressure. This results in greater patient comfort.
  • Pressure Requirements: Patient needs can vary over the course of the night because of sleep stage, sleep position, health, diet, or weight related factors that can render a single CPAP pressure less-effective or even ineffective. [4]
  • Data-Capable: Most, if not all APAP machines are data capable and can be accessed using either proprietary software or sleepyhead. A list of data-capable machines can be found at Data-Capable Machines
  • Increased Compliance: APAP use may increase patient compliance, particularly at higher pressures. [5]
  • Decreased Sleepiness: APAP use may decrease day-time sleepiness more effectively than fixed pressure CPAP. [6]


Popular APAP Manufacturers

  • Resmed
  • Philips Respironics
  • DeVilbiss
  • Fisher & Paykel


  1. ↑ Asp, Kevin. What is APAP Therapy? A comprehensive breakdown. https://www.aastweb.org/blog/what-is-apap-therapy-a-comprehensive-breakdown; February, 2017.
  2. ↑ Berry, Richard MD, Parish, James M MD, Hatse, Kristina M PhD, The Use of Auto-Titrating Continuous Positive Airway Pressure for Treatment of Adult Obstructive Sleep Apnea. Sleep, Vol 25, No. 2. 2002.
  3. ↑ Ibid
  4. ↑ Nolan GM, Doherty LS, Mc Nicholas WT. Auto-adjusting versus fixed positive pressure therapy in mild to moderate obstructive sleep apnoea. Sleep. 2007;30(2):189–194
  5. ↑ Ibid
  6. ↑ Vennelle M, White S, Riha RL, Mackay TW, Engleman HM, Douglas NJ. Randomized controlled trial of variable-pressure versus fixed-pressure continuous positive airway pressure (CPAP) treatment for patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) Sleep. 2010;33(2):267–271



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