[Equipment] New user - CPAP vs APAP

[janesleeping]

Thanks Trish. After reading the replies and some other equipment specs I think I'll buy the ResMed Air10 Autoset for Her. I'll post when it is a done deal.
This forum is valuable when dealing with such unknown technical health matters, especially if one isn't getting enough sleep!
Thank you.

Hi janesleeping,
WELCOME! to the forum.!
Get an APAP if you can, for the reasons mentioned in the above posts and Much success to you with your CPAP therapy.
Good luck with getting the machine that you really want and that will meet your needs.
Hang in there for more responses to your post.

[PsychoMike]

In Canada, for instance, the pressure needs need to deviate by at least 4 cmh2o positionally, or REM vs non-REM to be considered for an Auto PAP.

Actually, it will depend on who's paying...if you have insurance coverage from work, there is no requirement for the 4 cmh20 difference....it's whatever the doctor prescribes. In terms of public healthcare, I believe it varies a bit province-to-province, so check what the local health regs are. Some will start you on a CPAP, but if compliance is an issue, they will permit an upgrade (in some cases independent of the 4 cmh20 as well).

[janesleeping]

Hi Daria
Thanks. I have opened a can of worms! I think my insurance will only pay what is remaining after the ADP pays. Not sure have to check. I have ADP downloaded to take to Dr to see if I am eligible. I don't think I am. The worst part is that the ADP will not even assist with the CPAP amount if I chose an autoset CPAP that has both fixed and auto pressure settings. I think the government is too far behind the technical advances in the devices. I am going to persist and hope. DME advisor agrees with my request and understanding of the situation. DME advisor has extended my loan period 2 more weeks while I work on this.
I am not trying to get more money or trick the system - I only need what will be the best therapy option for me without all the back and forth and repeat sleep studies. Jane

[PaytonA]

Sometimes it is necessary to trick the system in order to get what is the most appropriate for our health. sometimes the "guidelines" are well behind the technology and in order to get the correct therapy, one must trick the system. Not saying that is what you are doing Jane, just that sometimes it is necessary.

Best Regards,

PaytonA

[DariaVader]

I think GMSMapNut nailed the process to follow to get one

In Ontario, 4 cm variance is required to get ADP to pay for 75% of the cost of APAP. That must be documented by the sleep study results. In my case, the doctor ordered specific, APAP oriented study and I just made the cut. If your sleep study was not APAP oriented than, I'm not sure if you can get the funding... maybe, just maybe, that's what the doctor was telling you.
Also, remember that one can get the funding only once every five years. If you accept CPAP now, ADP may not cover APAP before 5 years are up. I'm not sure. You have to check on that.

As for APAP vs CPAP, IMHO it's no brainer. APAP is better - it can treat with normally lower pressure and increase it only when higher is required.
I used to be at 13.4 CPAP. Now, with APAP, 90% of the time I'm at 10.5 or less with similar results.

I looked up - the change is possible.

Quote from: http://www.health.gov.on.ca/en/pro/progr...manual.pdf

505.01 Clients who have received ADP- funded respiratory Devices and continue
to meet the general (see the ADP Manual, Policy 300, Eligibility Criteria
for Program Benefits) and Medical Eligibility Criteria (see Part 3,
Applicant Eligibility Criteria for Respiratory Equipment), are eligible to
re-apply for Funding either during or after the designated minimum funding
period has expired, if there is:
 a documented change in the Client’s medical/respiratory status and
the ADP funded respiratory Device no longer meets the Client’s
basic respiratory needs, as defined by the ADP; or
Respiratory Equipment Policy and Administration Manual
September 2012
27
 damage due to normal use and wear, and the Client confirms that
the respiratory Device is no longer under warranty and the cost of
the repair is more than one third of the original purchase price.

[Possum]

If I had the choice, I would op for an APAP, which many seem to consider the Cadillac of sleep apnea treatment, particular for pressures on the higher end. Whenever I eligible for a new machine, I will push for an APAP.

[janesleeping]

Hello again
My journey continues....
I have completed a 2 week trial of CPAP at 12.
Followed by a 2 week trial of CPAP at 14 that lasted 1 night. Could not tolerate fixed pressure at 14.

Then a 2 week trial with APAP 5-15 -
Apnea Index: 6.6 Hyponea index: 1.5 AHI: 8.0
Obstructive: 4.0 Central: 2.5 Unknown: 0.0
Median Pressure: 9.4, Maximum pressure: 13

Next APAP trial 7-17
Apnea Index: 5.4 Hypopnea Index: 1.0 AHI: 6.4
Obstructive: 3.2 Central: 2.5 Unknown: 0.0
Median Pressure: 9.7 Maximum Pressure 13.1

I really don't know how to interpret these stats but I think I fall under the required 4 pressure variance to be eligible for the APAP through government assistance.

I am going to buy an APAP anyway but want to know if the results are acceptable. I started at 48 AHI - I don't know the breakdown of Central and Obstructive. Does CPAP therapy eliminate AHI altogether if set properly? Do I need a different PAP therapy?

I couldn't figure out how to use sleepyhead. No card in the Loaner machines.

Last machine ResMed AirSense 10 AutoSet for Her.

Any advice?

Janesleeping

[eseedhouse]

You need to get the AHI down below 5.

Your trials suggest you are getting close and need to fine tune the therapy. Whatever machine you buy make sure it is fully data capable and at least an APAP machine, not a simple CPAP. You may end up needing a constant pressure but, if so, the APAP machine can be set to do that. If you need variable pressures then you have the machine to do that.

If you fail on the APAP then there are further steps available to you but there are good chances you will be fine on APAP.

Once you get your machine make sure it comes with an SD card and download SleepyHead and check your numbers and graphs each day. After awhile you will begin to see patterns and that will help you titrate your therapy to where you need it. Make sure you learn how to adjust all the settings yourself at home and not need to have the DME or Doctor do it for you.

And although the numbers and graphs are vital for you, so also is how you are feeling. If you have the best numbers in the world but still feel bad you need to make sure that this is addressed and not ignored.