From APAP to CPAP

[xaid]

Hi guys.

I have watched many experts on you YouTube who prefer CPAP over APAP. They suggest that CPAP is a better cure for hypoapnias and RERAs.

First, is that true? What is the reason that adaptive algorithms are not working as they should?

Any advice on how to choose  the best setting when changing from APAP to CPAP? Also, what numbers other than the AHI shall we look at to make sure that the therapy is going well?

[jlsmithseven]

They probably work as they should, however if you are a light sleeper like me all the pressure changes can wake you up. Since narrowing down my pressure ranges within 1cm of each other my sleep has gotten much better. You just need to find a range that allows the algorithm to work, just not at such a hefty change rate. I go by how I feel , but my AHI has been under 2 since I've change it. It was around 4-7 before I did.

[Narcil]

i think the idea is to use your 95% APAP pressure when switching to CPAP. that's what i plan to try.

in my eyes, apap algorithm are mostly reactive, therefore cpap has the potential to stop events altogether.

[Deborah K.]

For most people, Apap works better because it does react to breathing changes.  We don't breathe the same all night long. When I used an Apap machine I pretty often had 0.00 AHIs. That's the very best one can do. Some feel better on Cpap, and it's okay to use it if they get their best results.  When using a ResMed machine it is better to use Apap mode with the highest and lowest pressure set to the same number.  In this way, the user can still see how flow limits are doing and adjust EPR as needed.  I don't think flow limits show up on Dreamstation machines.  If that is correct it won't matter whether Apap or Cpap is used by a Dreamstation user.

[PeaceLoveAndPizza]

Once when asked about how long a man’s legs should be, Abraham Lincoln responded, “Long enough to reach the ground.”

Similarly, both CPAP and APAP can be used to treat sleep apnoea. In my experience, APAP is better for most as it will adjust to the breathing impairments as they occur. With CPAP it is only a fixed pressure, which in my experience needs to be set to the 95% or higher of pressure to resolve most events. 

Regarding the YouTube “experts”, anyone can hang up a shingle and call themselves such. Just because someone has a slick video does not make them experts in anything other than producing slick videos. There are some very good ones, but you need to be careful and remain vigilant.

[xaid]

They probably work as they should, however if you are a light sleeper like me all the pressure changes can wake you up. Since narrowing down my pressure ranges within 1cm of each other my sleep has gotten much better. You just need to find a range that allows the algorithm to work, just not at such a hefty change rate. I go by how I feel , but my AHI has been under 2 since I've change it. It was around 4-7 before I did.

Thanks for your advice.
I experience many arousals and do not feel well-rested during the day although my AHI is less than 1. When I look at my OSCAR charts I found lots of variable breathing events.

[xaid]

i think the idea is to use your 95% APAP pressure when switching to CPAP. that's what i plan to try.

in my eyes, apap algorithm are mostly reactive, therefore cpap has the potential to stop events altogether.

Have you tried to narrow the min-max pressure instead of using fixed pressure?
Although my AHI is less than 1, my OSCAR charts show lots of variable breathing events!

[40plus]

For most people, Apap works better because it does react to breathing changes.  We don't breathe the same all night long.  When I used an Apap machine I pretty often had 0.00 AHIs.  That's the very best one can do.  Some feel better on Cpap, and it's okay to use it if they get their best results.  When using a ResMed machine it is better to use Apap mode with the highest and lowest pressure set to the same number.  In this way, the user can still see how flow limits are doing and adjust EPR as needed.  I don't think flow limits show up on Dreamstation machines.  If that is correct it won't matter whether Apap or Cpap is used by a Dreamstation user.

Wait a minute, huh?

Is APAP where max and min is the same number different than CPAP at a fixed pressure? If so, how can that be? 

APAP at min 13, max 13, surley cant go above or below 13. The same is true for CPAP at 13. So what is the difference?

(im using resmed airsense 11)

[xaid]

For most people, Apap works better because it does react to breathing changes.  We don't breathe the same all night long.  When I used an Apap machine I pretty often had 0.00 AHIs.  That's the very best one can do.  Some feel better on Cpap, and it's okay to use it if they get their best results.  When using a ResMed machine it is better to use Apap mode with the highest and lowest pressure set to the same number.  In this way, the user can still see how flow limits are doing and adjust EPR as needed.  I don't think flow limits show up on Dreamstation machines.  If that is correct it won't matter whether Apap or Cpap is used by a Dreamstation user.

Dream station shows "Flow limitation" as an "Event Flag", not as a dedicated detailed chart. I do not know this would would help me adjusting the pressure.
Although my AHI is less than 1, when I look at my OSCAR charts I found lots of variable breathing events and few flow limitations.