Why CPAP and APAP machines.

[OMyMyOHellYes]

If a manufacturer stopped making them, he'd simply loose the sales to the manufacturer that kept on making such. It would take all major manufacturers to agree to stop making CPAPs and that would not be legal in many countries.

That's kind of what a lot of folks thought when American Airways started charging checked bag fees. Nobody else would do that and American would soon be flying with empty planes.

[cate1898]

Welcome to the forum cohngr! Sounds like you are doing a good job in familiarizing yourself so that you will make an informed purchase!

As the only difference between an Auto CPAP machine and a fixed pressure CPAP machine is the software, it stands to reason that the only reason that straight CPAP machines are sold is to line the pockets of the companies that make them.

[trish6hundred]

Hi cohngr,
WELCOME! to the forum.!
You can set an APAP up to do straight CPAP if you need to, so the APAP is the better machine to get.
Much success to you with your CPAP therapy.

[cohngr]

Thanks again everyone for your invaluable input!!!
Paul, if you still following, my mask is made by someone called BMC and the model is an iVolve.
I will be looking at more mainstream one when I make decision what machine to get.

Cheers
Grant.

[Weird Tolkienish Figure]

Same reason they still make analog hearing aids? Some people got used to them, used them for years, and now prefer them.

That's my guess.

[DeepBreathing]

Paul, if you still following, my mask is made by someone called BMC and the model is an iVolve.
I will be looking at more mainstream one when I make decision what machine to get.

The thing with masks is that they are a very individual matter - every face is different, which is why there are so many makes and model of mask out there. If you find your BMC is satisfactory then you might want to stick with it even though it's not made by a mainstream company. BMC are not an entirely unknown company and have been involved in patent law suits with Resmed - both claim to have won.

[Dawei]

Grant, just wanted to mention one more point about CPAP vs APAP machines. In the US, there remains a prejudice by doctors against APAP and in favor of CPAP, according to a respiratory therapist at my DME. How much of this doctor bias is driven by equipment mfgrs/marketing and how much is from medical concerns is a question I can't answer. Since the vast majority of pts. who start PAP therapy fail to stick with it, CPAP is probably easier for providers to prescribe. Meanwhile, the RT I was talking with expressed the wish that docs would all write for APAPs, since these machines can function in both modes, and going this route would relieve DMEs of having to stock both types of machines.
I'm sure my experience was not unique in battling to get my doc to move me up from CPAP to APAP. Even after he agreed to write a scrip for APAP, he made the point that there is no clinical evidence indicating APAP provides better therapy over CPAP.

David

[cohngr]

Hi David and Paul

Thanks again for most interesting and constructive comments. I'm learning so much from reading all the posts in this forum.... My normal work is taking a bit of a dive!! :-)

[Napmeister]

My experience after a two week trial with a S9 Apap:

I had lower AHI numbers on a fully data capable S9 Elite which is a Cpap machine. Have heard this explained like this:

Once you figure out the pressure needed to keep your passage open, that is all you need for therapy to get air past your flapper valve (medical term used by plumbers) and into your lungs.
No more pressure and no less, the magic number for your throat, Utopia. Anything else (APAP) means pressure fluctuations. Some brains don't mind that constant change but others are disturbed by the fluctuations or changing rhythms.

For me, my brain/system seems to like the constant pressure but if I had to choose a new machine, would probably buy the Apap for the option availability but set it to Cpap mode and experiment further if seeking better AHI numbers.

Summing up, buy the Apap and experiment with Cpap, you just never know till you try. Understanding and watching your data (SleepyHead or equivalent software) capable machine is the smartest thing anyone can do.

[Dawei]

Napmeister--I'd agree that your best bet would be an APAP. As you pointed out, that would give you the choice of CPAP or APAP at any time. As for the explanation you heard about the straight CPAP being better because it supplies the single, constant pressure that is needed to keep your airway open, this, to me, is an over-simplification and therefore misleading. In my experience, that single, fixed pressure necessary to keep my airway open has been found to change both short-term and long term. (I've been on the hose for more than 9 years). The CPAP pressure found in both my first and a few years later, second sleep study titrations changed over time, increasing several points on both occasions. I also see changing pressure needs at times from night to night. And if a machine is blowing a fixed pressure at me which is higher than what's needed to keep my airway open that night, or that point in time, I don't like it at all. It's uncomfortable, and it becomes a leakage problem, since my pressure needs often get up close to the top of the scale, near 20cm.
As for AHI, like pressure, mine changes over time. I'm coming to the idea that my AHI can be connected to my of state of mind at bedtime--to things like anxiety level, with my AHI changing in step (higher anxiety resulting in higher AHI and vice versa).

David