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After 4 less then stellar nights trying to switch to apap on a new Airsense I decided to go back to what had worked for me with my previous machine. I set fixed pressure at 9.8 with epr set to 1. The attachment shows the results. Like night and day from the previous 4 nights .Although I would love to use apap it appears it is not in the cards in the short term. I may try again down the road with the for her mode and see if that might make a difference but for now I will stick with what gives me the best sleep quality. Just like with masks no one mode is suitable for all . Thanks for trying to help me out.
Good for you. If it works there is no need to change just for the sake of it. Some people have a tough time getting used to the pressure changes with APAP.
Although there is debate about whether to have a wide or narrow range for APAP. I have always used as narrow as possible such as 6-9 or 7-10.
If you ever feel that your therapy is not quite there at a fixed pressure you can always go to APAP with a tighter range as it will give you a mini titration of where the pressure needs to be.
01-25-2020, 02:17 PM (This post was last modified: 01-25-2020, 02:52 PM by jaswilliams.)
RE: A little guidance please
You have now made two changes at the same time and that upsets the scientist in me as we don’t know what caused your issue, can you try apap and EPR of 1 looking at your graphs. It could be the pressure changes causing your issues but it could also be the EPR
***Edit***
Just seen your stats on the other board I see you also did not have good stats with epr at 1 on apap so it looks like fixed pressure suits you best
Yeah the epr of 1 was not the culprit as it worked fine for me on cpap. What I plan to do when I get my bearings back after some sleepless nights is I may try reducing the fixed pressure slightly and see what happens. I was using 9.5 with the Respironics APAP machine and had been getting along fine at that. I decided to up that a bit to 9.8 on the Airsense just because I chose to keep the epr on at 1. On my previous machine I used cflex+ at 2 or 3. It would be interesting to me to see how much lower I could go on the fixed pressure without waking up the hornets. For now though I think I will leave well enough alone until I see a good trend going. I am pretty confident though that I could go to at least 9.4 before I notice anything different but then again who knows until you try it.
I have been on PAP for just over 6 years and based on everything over that time frame it is apparent to me that I react best to fixed pressure. I like to tinker so I may at some point try again using the for her mode with epr on but right now I will stick with this unless it goes off the rails. I was using the soft response setting after the first day but I don't now how much softer for her makes things. I think I read someone say that the for her is much like the Respironics. Anyway, thanks for responding.
I recently found out that you can set the EPR to operate only during the ramp cycle instead of having it operate all of the time. That may help if you decide to try the APAP again. I am not sure why having a wider range would be a problem since it should only go to a higher pressure if it senses continued obstruction or a hypopnea at the lower pressure. Mine was set at 4-14 and I was having apneas because the pressure didn’t go beyond the 14 which I apparently needed it to since it showed my highest pressure needed was 14 that night and my AHI was 11/hr. I raised my minimum pressure to 5 and my high pressure range to 20 and my AHI has been below 5 every night since. I also set the EPR to 5 in ramp only since I felt I was not getting enough air during ramp.0
Fixed pressure is something we often arrive at to minimize disruptions and events It's not surprising. While some of us do well with auto-pressure, almost all of us are better if the pressure does not fluctuate by more than 3-cm. One of the things I try to do when helping someone set a pressure is to minimize that fluctuation.. Fixed pressure is the least fluctuation, and you will find many doctors prefer it, and prescribe it as well.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
My sentiments exactly. I think too many people get told that because they have an apap machine they should be using the apap mode. As with everything PAP related, whatever works best for YOU is what you should go with. Since going back to fixed pressure all my results have been great. The only crap I see now is when I wake up and it's too early to get out of bed and I try extending my sleep time and end up with a lot of awake junk. If I get really bored and decide to give apap another shot I would do as you say and narrow the range so that the min is closer to what works on fixed pressure and the max is narrower. That would allow me to probably turn off epr. I have always thought what was the use of using apap mode if you have a very narrow range but its seems like a lot of people do it. In my mind it seemed like you were taking away the biggest benefit of apap mode by limiting the machines ability to go higher. Having said all that, I am not that bored yet. I prefer getting my sleep again.
There are many cases where limiting pressures works well for users. I have, as have others, guide users that have APAP to a very narrow range or even fixed pressure because they needed it. My pressure is set for 11-25 PS=6, My EPAP max 11.8 for the night. IF i had a pressure issue I could really limit it to a fixed pressure and be very comfortable. For me and others how high the pressure is set at has little to no meaning because the actual pressure never gets near the setting.
I handle high pressures extremely well. With low pressures (below 10) I feel like I'm not getting enough air so I rip my mask off. If you follow these forums at all you know a lot of people have an issue with the removal of the mask. I was one of them. My original Rx was for a dumb brick of a CPAP with a pressure of 19, it was heaven, for me an instant awakening when without I was driving off-road, and not in a jeep!!!,
Point is everyone is different and there are always 2 issues, getting effective therapy and having enough comfort to get that effective therapy.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
(01-27-2020, 12:06 PM)bonjour Wrote: There are many cases where limiting pressures works well for users. I have, as have others, guide users that have APAP to a very narrow range or even fixed pressure because they needed it. My pressure is set for 11-25 PS=6, My EPAP max 11.8 for the night. IF i had a pressure issue I could really limit it to a fixed pressure and be very comfortable. For me and others how high the pressure is set at has little to no meaning because the actual pressure never gets near the setting.
I handle high pressures extremely well. With low pressures (below 10) I feel like I'm not getting enough air so I rip my mask off. If you follow these forums at all you know a lot of people have an issue with the removal of the mask. I was one of them. My original Rx was for a dumb brick of a CPAP with a pressure of 19, it was heaven, for me an instant awakening when without I was driving off-road, and not in a jeep!!!,
Point is everyone is different and there are always 2 issues, getting effective therapy and having enough comfort to get that effective therapy.
Excellent summary. Well said.
DaveL
compliant for 35 years /// Still trying!
I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea.
