[CPAP] APAP replacement

[John J]

Let me preface by saying I am a sleep professional as well as CPAP user. I have a PhD and I tend to analyze, well everything. When I see posts extolling the benefits of autoPAP and none of the caveats, I become concerned. All the auto machines rely on information they get from you through your mask. If you are not using one of the masks specifically recommended by your machine maker, your machine may be receiving false information that it then uses to determine the need for pressure changes. Most of the auto machines rely on an average or spot check of your breathing. That means you continue to have OSA to some extent, how much depends a lot on the variability of your breathing which in turn may vary due to position and/or sleep stage. If you do not have a sleep physician or respiratory therapist regularly review the data from your machine you may still be at an increased risk for heart attack, stroke, metabolic syndrome etc. Most of the "scientific" literature regarding the efficacy of autoPAP compared to CPAP rely on very low subject numbers, often less than 50. Do you really want to subject your health to information that is limited to what happens with a small number of people. Also, most research limits their study subjects to those that do not have many of the co-morbidities you see with sleep apnea. If you suffer from one of those then the machine you are using has not been verified to successfully treat your OSA.

First, thank you very much for your post. I am a brand new CPAP user and I have also worked on sleep study analysis, however I am Not an RPSG tech. My co-worker is a very experienced RPSG. I believe you have made an excellent point. Based on everything I've learned, an auto CPAP can NOT substitute for a quality Titration Study. O2 sats and internal pressures can vary considerably with even 1-2 'degrees' of pressure change. I feel that people should really consult with a good sleep physician/pulmonologist. For whatever it's worth, I think it is well worth it. Hopefully it is affordable to you. Good luck everyone