Ramblings about CPAP to APAP?, and stuff.

[holden4th]

My transition from CPAP to APAP was what convinced me that PAP therapy would work for me. Almost 18 months down the track I'm still looking for sleep nirvana but at least I'm a hello of a lot better off than before therapy. The odd night or two when I fall asleep before putting on my mask reminds me of this very strongly.

[Podd]

It has been good to actually feel in control and monitoring my sleep patterns, sort of adds to my resolve, my sleep clinic is absolutely rubbish though.
I had been concerned for many years that CPAP wasn't as effective as it could be, (For Me that is.).
I did suspect that my pressure would need 'Tweaking', but I was having problems at my set pressure of 14cmh20, then Periorbital Edema was the final straw for me, I thought I might need a slightly higher pressure as I wasn't sleeping to well, but was reluctant to 'crank' up the pressure as I didn't want to look like a 'Chameleon' with bulgy puffy eyes any more.
I wrote a letter to the 'head honcho' explaining how I had gotten to where I was, I offered to attend another Sleep trial but also hinted that APAP might be the way to go, as I might also get the benefits of lower pressures as well.
A week later the NHS caved in and wanted me to collect a new APAP machine, I was really pleased.
The first sleep disturbed night made me look in detail at the settings of the machine and I started 'Tweaking' the settings for my Apnoea as they were obviously wrong.
I had Severe Obstructive Sleep Apnoea, but now I was plagued with high pressures and Hypopneas, but in saying that the Resmed S9 performed brilliantly and most only lasted around 14 secs, so no big deal, just an annoyance.
I started to look at why these were occurring and have come to the conclusion, the high pressures were causing the Hypopneas, this is something that can occur in 10 to 15% of people with Apnoea, this is disputed by some, but lowering the pressure by as little as 1cmh20, I don't get them, put it back up and I do.
Now, I am wondering whether there is some criteria in the Resmed Algorithm that causes this anomaly and they are still happening, it just doesn't record them.
But that aside, I am having the best nights sleep I have had in many years, the other night I had an AHI of 0.3, by any standards that's impressive.
It does vary slightly though, 0.7 is about the norm, still really good though.
I am curious if a person without any trace of Apnoea was made to use APAP, just what would the graphs show as they should be perfect, has anybody ever done this?
Rather oddly my Sleep Clinic asked me if I wanted to keep my old machine, mystified I said no, then I saw the prices on ebay, bummer......

[PaytonA]

Congrats on getting to where you are. From what I read it took some real effort. Way to go.

Best Regards,

PaytonA

[Podd]

Thank you for your comments Paytona, they were appreciated.
Almost without exception people take sleep for granted, except people with sleep problems that is!
To us, it's something we must work at, some it just takes longer than others.
Swopping to APAP after many years of CPAP, sure made me aware of stuff even I took for granted.
I know I will still have Apnoeas, Hypopneas and what ever else, but for the most part, my machine takes care of them before they become a problem.
For that I am grateful.

[Podd]

Yayyyyyyy!, With an AHI of 0.28, I'm chuffed to bits, I had 1 Hypopnea and 1 Apnoea, I think one was 10 seconds and one was 12 seconds.
For those who are interested, here are my settings, please remember the Upper Pressure caused all sorts of problems for me.
My Lower APAP setting is 13cmh20, (My breathing becomes erratic below this.)
My Upper APAP setting is 16cmh20, (Even slightly above this Hypopneas become a concern, probably not an issue though.)
The more astute of you will notice the 3cmh20 range, this is the EPR range on a standard CPAP machine, although on this APAP it's set at 2 as I prefer it.
My average pressure has increased, albeit very slightly, it's only 0.5cmh20 though.
I started this posting with a few concerns regarding not just my new machines settings but my old one as well, I ended up with a deeper understanding of my condition, how my body responds to changes and this caused a few surprises along the way.
So medically, do I believe the change to APAP from CPAP was justified?
Probably...........