[CPAP] AUTO or not - Is the auto-CPAP machine inherently better than a CPAP?

[SuperSleeper]

I felt personally attacked in some responses and feel very sad that some of you feel so strongly it wasn't enough to state your case, but you felt you had to denigrate mine.

Personal attacks are against Apnea Board rules.

Zimlich if you feel someone has violated this rule and attacked you personally please PM me the link to the post and I will take appropriate Admin action if necessary.

If we're talking about someone attacking an idea you put forth that is not really a personal attack and is allowed here because this is an open discussion forum. Challenging another member's statements and conclusions is all part of the discussion.

Strong opinions exist on both sides of this issue. We have to grow a thick skin sometimes. As far as I can tell no one here is trying to beat down a fellow sleep apnea sufferer. We're all a bunch of CPAP users trying to help each other out. We need to keep in mind that when someone posts strong opinions in opposition to what we believe it is not necessarily an attack on us personally. They might be trying to help everyone out.

Thanks.

[SuperSleeper]

I have a straight, non-data CPAP that was almost as expensive as some APAPs. It serves my needs, I'm happy with it, and I paid a little extra to get something that met my requirements. So if you want to cover all the bases and pay a little extra for APAP or data, go for it! But it is not "always" the right answer, in this hosehead's opinion.

I agree if the machine meet your requirements and happy with it than no need to upgrade but let me ask this would you still get that machine if knew at the time you could get machine with data instead. You are one of the few people on this board who had instant success with CPAP therapy if i,m not mistaken but for the struggling newbies as i was a year ago what would you advise them in selecting their first CPAP. We can all have different opinion which is a good thing because i don,t learn anything from people who agree with me all the time and also i think it is far better to have different opinion and speak out than keeping silent which help no one. It,s basically like cars, i would not drive any car has no airbags but that does not mean car with no airbags are not good cars just cars with airbags are safer and can save lives.

[SuperSleeper]

This thread is very interesting. The distressing thing to me is the amount of animosity shown when someone has a dfferent opinion in some cases. We all are entitled to an opinion and this was not a thread to bludgeon anyone into submission over the question, and I felt that ended up being the case. I felt personally attacked in some responses and feel very sad that some of you feel so strongly it wasn't enough to state your case, but you felt you had to denigrate mine.

I agree it is interesting thread, thank for posting so newbies can make better informed decision when it come to choosing their first CPAP. While back i used to think people were attacking me personally but in fact i was new to the internet and they were just speaking their opinion as it is a public forum. I don,t think personal attacks exist on this board but it does exist on the other forum.

[SuperSleeper]

I have a straight, non-data CPAP that was almost as expensive as some APAPs. It serves my needs, I'm happy with it, and I paid a little extra to get something that met my requirements. So if you want to cover all the bases and pay a little extra for APAP or data, go for it! But it is not "always" the right answer, in this hosehead's opinion.

I agree if the machine meet your requirements and happy with it than no need to upgrade but let me ask this would you still get that machine if knew at the time you could get machine with data instead. You are one of the few people on this board who had instant success with CPAP therapy if i,m not mistaken but for the struggling newbies as i was a year ago what would you advise them in selecting their first CPAP. We can all have different opinion which is a good thing because i don,t learn anything from people who agree with me all the time and also i think it is far better to have different opinion and speak out than keeping silent which help no one. It,s basically like cars, i would not drive any car has no airbags but that does not mean car with no airbags are not good cars just cars with airbags are safer and can save lives.

zonk,

Yes, you remember correctly. My adjustment time to CPAP was around an hour :-) I was one of the lucky ones.

Truth to tell, I would probably opt for a fully data capable machine if I knew then what I know now. In fact (and it hurts me to admit this), I've been on the fence about getting myself an S9 Auto for a few months now. Of course, I'd be buying it out of pocket, because I want the toys, not because it is needed for my therapy. I've been very sucessful with my "dumb" machine. When I first got the machine, I think it would have been fair for me to pay the difference between my machine and an S9 Auto.

Although I had no clue about all of the machines and the options out there, I had 3 main things I was looking for back then:

1. The machine had to be durable and well built, because it was going to travel a lot.

2. It had to be easy to break down, pack up, and move because I had to take it to a fire station every third day.

3. It had to have a heated hose, because I knew about rainout.

That's about all I knew at the time!

[SuperSleeper]

This thread is very interesting. The distressing thing to me is the amount of animosity shown when someone has a dfferent opinion in some cases. We all are entitled to an opinion and this was not a thread to bludgeon anyone into submission over the question, and I felt that ended up being the case. I felt personally attacked in some responses and feel very sad that some of you feel so strongly it wasn't enough to state your case, but you felt you had to denigrate mine.

Hi zim,

I value your opinions and think you have made great points, in this and many other threads!

I think that this is a hot topic for many people because they have been misled or ill-served by either their doc or the DME, so it tends to get people's hackles up.

[SuperSleeper]

This thread is very interesting. The distressing thing to me is the amount of animosity shown when someone has a dfferent opinion in some cases.

Some people have made strong arguments, some not so strong. I agree that it's an interesting discussion, and I'm sorry you feel there's been animosity. Some people are rather straight-forward with their opinions, and are rather good at making their points. That is sometimes interpreted as a negative thing, but it can also be viewed as a positive thing. It's looked at in different ways in different cultures. For example, science-types have a culture in which this type of thing is admired, wheras art-types have a culture where it's considered boorish. Each culture had adopted its own perspective because, at least in part, those strategies are successful for advancement in that field.

I'm a newbie to CPAP therapy, so please forgive me if I have this wrong, but this is my summary of this topic. APAP's are data-capable machines. If we are to compare them to CPAP machines, we can compare them to data-capable CPAP's or to much simpler CPAP's. The price difference between the APAP and the CPAP can be huge if we look at simple CPAP's, but insignificant if we look at data-capable CPAP's.

APAP's adjust their own pressure based on the data they collect. CPAP's can have their pressure adjusted, but that adjustment must be done by a person. Thus the APAP pressure will vary from night to night, even hour to hour, based on the machine's interpretation of the patient's needs. CPAP pressure won't be adjusted anywhere near that often.

What I've learned is that the people who use APAP's seem to know a lot about PAP therapy. I'd be interested in learning from them specifically what their APAP is doing for them that their CPAP won't. In other words, if you picked a specific pressure and put your APAP in CPAP mode at that pressure, how would that affect the quality of your therapy? Of your life? Would you have more obstructive apneas, more clear-airway apneas, or what?

[SuperSleeper]

I'm a newbie to CPAP therapy, so please forgive me if I have this wrong, but this is my summary of this topic. APAP's are data-capable machines. If we are to compare them to CPAP machines, we can compare them to data-capable CPAP's or to much simpler CPAP's. The price difference between the APAP and the CPAP can be huge if we look at simple CPAP's, but insignificant if we look at data-capable CPAP's.

APAP's adjust their own pressure based on the data they collect. CPAP's can have their pressure adjusted, but that adjustment must be done by a person. Thus the APAP pressure will vary from night to night, even hour to hour, based on the machine's interpretation of the patient's needs. CPAP pressure won't be adjusted anywhere near that often.

What I've learned is that the people who use APAP's seem to know a lot about PAP therapy. I'd be interested in learning from them specifically what their APAP is doing for them that their CPAP won't. In other words, if you picked a specific pressure and put your APAP in CPAP mode at that pressure, how would that affect the quality of your therapy? Of your life? Would you have more obstructive apneas, more clear-airway apneas, or what?

I can take a stab at that.

Once set to CPAP mode, an "APAP" will do exactly the same thing as a CPAP- a constant pressure regardless of what is happening with the patient. So, there should be no difference in apneas, and no difference in therapy if an APAP is set to CPAP mode, if all other things are equal.

What does an APAP do that a CPAP won't? An APAP will adjust the pressure within the parameters that have been set. If the machine is set to deliver a pressure between 10-14, it will select the pressure within those ranges that eliminate obstructive apneas, and change that pressure within the range as needed.

Whether or not this is a good thing depends a lot on the doc and on the user. Some users find changing pressures to be disruptive. For example, I can't stand using ramp- every time the pressure increases I wake up. I suspect I wouldn't like APAP either because of this. Some researchers find increased arousals with APAP. Others report increases in central apneas- some people appear to be sensitive to pressure changes. Finally, some people feel that APAP is just not usually needed. If CPAP eliminates apneas...we're good.

On the other side of the fence: Some users like APAP, stating the the machine will keep the pressure as low as possible while eliminating apneas. They feel that the machine will adjust to changing conditions, such as sleep positions, that might change the amount of pressure needed to reduce apneas. Many also feel that a single night in a sleep lab cannot reflect the true conditions that will be experienced at home, and an APAP can adjust to those changing conditions. Some researchers feel that APAPs lead to increased compliance, since the machine can reduce the pressure that the person experiences and they feel that the patient will be more comfortable and more likely to continue therapy.

Regarding having more apneas, either OSA or central, that is hard to know. People seem to react differently. Some people get increased centrals as pressure is increased or changed. Some people experience increased centrals on BiPAP. Others do not. Some people get low AHIs at pretty low pressures, while others have severe obstructions unless their pressure is quite high- some in excess of 20. Some can't live without exhalation relief. Others cannot tolerate EPR.

Hope that makes sense...

[SuperSleeper]

APAP's are data-capable machines. If we are to compare them to CPAP machines, we can compare them to data-capable CPAP's or to much simpler CPAP's. The price difference between the APAP and the CPAP can be huge if we look at simple CPAP's, but insignificant if we look at data-capable CPAP's.

Not all APAP machines are data capable, for example S9 Escape Auto is not full data capable while S9 AutoSet and S9 Elite (CPAP) are full data capable, usually i use ResMed S9 for price comparison because i find Philips Respironics names confusing. CPAP machines comes in all sort of prices you can choose one to suit your budget for example you can pick the popular DeVilbiss IntelliPAP AutoAdjust/SMARTFLEX and Heated Humidifier for $425 which is auto and data capable.

[SuperSleeper]

Not all APAP machines are data capable, Without the capability to collect the data, how can the APAP make good decisions as to what pressure to select?

The machine does not have to collect and store data in order to respond to respiratory events, etc.

[SuperSleeper]

It,s basically like cars, i would not drive any car has no airbags but that does not mean car with no airbags are not good cars just cars with airbags are safer and can save lives.

My S9 AutoSet did just that, it saved my life. It is not about which machine is better than the other because basically it is just a glorified leaf blower and most CPAP machine would do job adequately. Whether insured or not for a struggling newbie as i was a year ago the choice of machine is important as finding the right mask in complying with the therapy. IMHO the S9 AutoSet can improve compliance, have by far the best LCD screen data and yes it cost a little more but what price can one put on HEALTH .