I used an APAP for 2 weeks and eventually found myself fatigued and requiring non-elective naps. These were the first naps I had taken in almost 2 years since getting my CPAP. Then, I adjusted the APAP to a constant pressure and I immediately felt refreshed like the "old days" on CPAP.  

My CPAP pressure setting is 10 and on most mornings, I found the APAP pressure at 8.  At first, I thought this was a good thing... needing less pressure. As it turns out, the original 10 is what I require.

Does the APAP "react" to a need for a pressure change?  If so, does that mean that I would begin an episode, partially awakening, and the pressure would change to what I needed?  

In any case, the old saying, "If it ain't broke, don't fix it." comes to mind.

Has anyone else had the same problem.


_________________
As a Christian, you may be the only bible someone ever reads.

TedG954 wrote:

I used an APAP for 2 weeks and eventually found myself fatigued and requiring non-elective naps. These were the first naps I had taken in almost 2 years since getting my CPAP. Then, I adjusted the APAP to a constant pressure and I immediately felt refreshed like the "old days" on CPAP.  

My CPAP pressure setting is 10 and on most mornings, I found the APAP pressure at 8.  At first, I thought this was a good thing... needing less pressure. As it turns out, the original 10 is what I require.

Does the APAP "react" to a need for a pressure change?  If so, does that mean that I would begin an episode, partially awakening, and the pressure would change to what I needed?  

In any case, the old saying, "If it ain't broke, don't fix it." comes to mind.

Has anyone else had the same problem.

One question comes to mind.....do you know what range your APAP was set at ? I suspect that it may have been at the full range of 4/20 cmsH2O.

If that was the case then the algorithim may have been slow in getting the required pressure to you in time. APAP performs best at a tight range.........in your case, no more than 8/12 and maybe even tighter.

It can be a problem, and has been reported here before (I think). Quite a lot of APAP users reset their machines to straight CPAP.

Personally, I think CPAP (if you can handle it) gives the best therapy, but APAP certainly has a place in the compliance arena.

Best of luck.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

The APAP was set at 4 to 10.


_________________
As a Christian, you may be the only bible someone ever reads.

I had my APAP replaced, the old one was set at 4-20, the new one at 5-10. (Titration was for 7, although I felt that the titration was a disaster with no normal sleep that night. Actual 97% pressures were 6.5--11.6) I suddenly found myself napping in the mornings, putting my head down at 9:00 a.m. and waking up at 10 or 11, and guessed that the 10 was not enough pressure for the times when I was in bad position or breathing badly and that I needed the flexibility to go a little higher even though most of the time I was well under 10 cm.
I wasted time trying to play the dumb game to which most of us OSA pt.s are condemned, called the DME who say no adjustments without a prescription from the sleep lab that ordered the machine, sleep lab says we never told them to set it from 5-10 why should we correct it, sleep doc says lab should handle it, lab says doc should handle it, doc says no prescriptions without office visit, office visit is canceled cos doc needs a day off etc. In the meantime a helpful online informant told me how to adjust the setting and I reset it to go up to 12 and things are more or less back to normal.
When I eventually had the delayed office visit, the doctor asked if everything is OK, and I said meekly "Just fine, though it was a hassle to get the APAP adjusted." And he said; "Anytime we can help, don't hesitate to call we will do whatever you need!"
So, consider playing with the APAP settings.


_________________
Arthur
Sleeping with a curvaceous blonde autoPAP (Resmed autoset). Surviving, and in small ways doing better. Maybe there will be that big surge of energy, and easier weight loss one day. Hope springs eternal.....

I had my APAP replaced, the old one was set at 4-20, the new one at 5-10. (Titration was for 7, although I felt that the titration was a disaster with no normal sleep that night. Actual 97% pressures were 6.5--11.6) I suddenly found myself napping in the mornings, putting my head down at 9:00 a.m. and waking up at 10 or 11, and guessed that the 10 was not enough pressure for the times when I was in bad position or breathing badly and that I needed the flexibility to go a little higher even though most of the time I was well under 10 cm.
I wasted time trying to play the dumb game to which most of us OSA pt.s are condemned, called the DME who say no adjustments without a prescription from the sleep lab that ordered the machine, sleep lab says we never told them to set it from 5-10 why should we correct it, sleep doc says lab should handle it, lab says doc should handle it, doc says no prescriptions without office visit, office visit is canceled cos doc needs a day off etc. In the meantime a helpful online informant told me how to adjust the setting and I reset it to go up to 12 and things are more or less back to normal.
When I eventually had the delayed office visit, the doctor asked if everything is OK, and I said meekly "Just fine, though it was a hassle to get the APAP adjusted." And he said; "Anytime we can help, don't hesitate to call we will do whatever you need!"
So, consider playing with the APAP settings.


_________________
Arthur
Sleeping with a curvaceous blonde autoPAP (Resmed autoset). Surviving, and in small ways doing better. Maybe there will be that big surge of energy, and easier weight loss one day. Hope springs eternal.....

Poster Ted G writes...Does the APAP "react" to a need for a pressure change?  If so, does that mean that I would begin an episode, partially awakening, and the pressure would change to what I needed?  

Yes and Yes.

I use an APAP (AFLEX) and I was lucky enough to learn that leaving the pressure range wide open is (for some) an invitation to therapeutic failure.


The common wisdom developed empirically by many apneic posters on another forum is that it's a good idea (for many) to set the lower pressure fairly close to the titrated pressure; and, to keep the APAP pressure range fairly tight.  In this way, you are not relying on the software to sense an event before adjusting.  I know this happens because my higher AHI at lower low range pressures shows this plainly.

In my case (and I neither recommend following, or not following, my example) my original dx was 5-20 cm.  Using daily data reporting feedback via SmartCard, I (very gradually) adjusted the range to (ultimately) 9-11 cm.  My titrated CFLEX pressure was 8, so to get the best therapy (in my individual case) I actually had to set the lower level to just above my titrated CPAP pressure.  

I spent a successful 1.5 years on straight CPAP before buying an AFLEX auto.  For me, using the autopap set to a very tight range, I have the best setup.  When my pulmonologist saw my results, he was quite pleased, and had no problems with me tweaking my pressure (your doc may have a different idea.)

Regards all - - Woof



.

TedG954 wrote:

The APAP was set at 4 to 10.

The range is quite wide. Setting it to 8/11 would give better results...............however if you can take full CPAP it might be best to leave it at 10.

Daniel.


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

TedG954 wrote:

I used an APAP for 2 weeks and eventually found myself fatigued and requiring non-elective naps. These were the first naps I had taken in almost 2 years since getting my CPAP. Then, I adjusted the APAP to a constant pressure and I immediately felt refreshed like the "old days" on CPAP.  

My CPAP pressure setting is 10 and on most mornings, I found the APAP pressure at 8.  At first, I thought this was a good thing... needing less pressure. As it turns out, the original 10 is what I require.

Does the APAP "react" to a need for a pressure change?  If so, does that mean that I would begin an episode, partially awakening, and the pressure would change to what I needed?  

In any case, the old saying, "If it ain't broke, don't fix it." comes to mind.

Has anyone else had the same problem.

have you tried an APAP minimum pressure of 10, with a maximum APAP pressure set at 12 or 13? That is what I do. My  CPAP titration pressure is 10, but  I run my machine on APAP mode, minimum my  titration pressure and my maximum at 13. Typically my pressures go up to 11 or 11.2 about every night, with periodic excursions when Im really worn out  or taking certain medications to 12 and above.

Ive tried going back to straight CPAP  at my titration pressure of 10 and it just doesnt work. I begin waking up a lot and urinating a lot at night and just dont feel good during the day. Went back to APAP mode...

I also tried (recently) APAP  mode with a reduced minimum pressure of 9, with a maximum of 12. Thats kind of what you describe. I found that DID NOT WORK!

My method is rather unconventional, but it works well for me and allows my pressure to adjust nightly to small changes. For example if I worked out really hard during a day, Ive found my pressure needs increase more than normal. Ditto if I take any sedating  medications. Ditto if Im kind of tired and run down...pressures tend to climb with me.

I like my APAP mode!

Fred


_________________
"We don't need socialized medicine, what we need is insurance reform."


Resmed S8 Autoset Vantage, HumidAire 3i, Resmed Quattro ffmask

While the info in this post is very informative, please be careful to follow the guidelines regarding information about pressure changes.  Yes it is your therapy, but it is prudent to include your doc in your therapy, and when its not working, simply tweaking the pressure might not be the answer.

If your titrated pressure was 10 cms, it makes no sense that the APAP was set w/a pressure range of 4 cms to 10 cms. Very few people can breathe comfortably w/a mask on at 4 cms of pressure. It would make MUCH more sense to set the pressure 1-2 cms below your titrated pressure and 1-2 cms above your titrated pressure.

Some sleep labs titrate your pressure to that which stops all events and then set the scripted pressure at 1-2 cms above that pressure w/EPR or C-or A-Flex at 1-3 cms under that scripted pressure. Other sleep labs set the scripted pressure at the titrated pressure that stops most or all events.

Some patients need some form of expiration pressure relief for exhaling. Thus the development of EPR and C- and A-Flex, others do better acclimating to xPAP therapy w/the use of a Ramp feature starting out at a lower pressure building up gradually as you drift off to sleep to your titrated pressure. And some few individuals need a set exhalation pressure AND a set inhalation pressure.

The reason your reported pressure was usually 8 cms is because 1] the reported pressure is only the pressure AT OR BELOW which you spent 90%-95% of the night (depends on which brand of APAP you were using) and w/your lowest pressure set at 4 cms, you obviously spent some time well below your titrated pressure as the APAP responded to your needs.

Some people do better w/the narrow pressure range, others do better w/o the constant fluctuation of pressure.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Thanks for the responses.  The last week on straight CPAP has been fine. I think I'll stay on a set number. The APAP option will always be available, but for now 10 will suffice.


_________________
As a Christian, you may be the only bible someone ever reads.

some machines do not work with some headgear............ breeze headgear does not work on Respironics autos...... I ahd a machine adn the card showed that I was at 6 all the time and was feeling terrible... I called Respironics adn they told me it will not work...........so got a different machine adn worked ok

Say what? What the devil does the headgear have to do w/the xPAP pressure?? That doesn't even make sense other than maybe it is not as stable in holding the nasal pillows in place and thus affects leaks. But even that could be true of any mask and headgear.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

keegan62 wrote:

some machines do not work with some headgear............ breeze headgear does not work on Respironics autos...... I ahd a machine adn the card showed that I was at 6 all the time and was feeling terrible... I called Respironics adn they told me it will not work...........so got a different machine adn worked ok

Headgear....................I think someone was pulling your leg  

Headgear relates to the mask, not the machine.

Daniel


_________________
The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)