Will APAP Fix This

[rooy1960]

Good morning and happy Wednesday!

I'm doing well with AHI's consistently below 1.0.  I was wondering if switching to APAP will help decrease OA's in my case? Here are last night's numbers:

http://imgur.com/a/696mZ

Thanks!

[DeepBreathing]

If it ain't broke... if last night was typical and if you feel rested then don't change anything.

[SuperSleeper]

I agree with DeepBreathing.  I would love to have AHIs consistantly below 1.0.    

That said, it's still best to continue monitoring your AHI every so often.  Just because you're below 1.0 this week, does not necessarily mean you'll remain there in the future.  To many variables can change - your activity level, your weight, your food intake, the amount of sleep you get, your sleep environment, stress levels, medication changes, etc.

I would leave it as-is, but check it every so often.  If it starts creeping up, then you may wish to consider changing something or switching to auto-mode. But if you do switch to auto, make sure you start off with the upper and lower limits set pretty close together (definitely not "wide-open" from 4-20 cmH2O), but perhaps set to a range around 10-14 (assuming your current pressure is 12). Then adjust as need be from there.

[TASmart]

I agree with the two above answeres. But it's easy enough to try - set your machine in APAP mode, with pressures say from 10 to 14. See what happens. I am a bit more of an experimenter than some I guess. My results are always worse with either the APAP mode or the EPR, I seem to do the best with just straight CPAP.

[Gideon]

These numbers are as good as it gets. IF and WHEN your AHI runs consistently higher and only then, I'd consider APAP with a range of 10-14 to start. Expect that to change. It's purpose is to titrate to a new value.

Some people do better with straight CPAP, your numbers say you may be one of them.

On second thought I'll suggest going to APAP now, set the range to 12-12. From a therapy point of view it makes no change, you are doing extremely well. it is to add a "Flow Limit" Stat, which is a precursor to OA events. Again this does not change your excellent therapy.

[rooy1960]

I agree with DeepBreathing.  I would love to have AHIs consistantly below 1.0.    

That said, it's still best to continue monitoring your AHI every so often.  Just because you're below 1.0 this week, does not necessarily mean you'll remain there in the future.  To many variables can change - your activity level, your weight, your food intake, the amount of sleep you get, your sleep environment, stress levels, medication changes, etc.

I would leave it as-is, but check it every so often.  If it starts creeping up, then you may wish to consider changing something or switching to auto-mode.  But if you do switch to auto, make sure you start off with the upper and lower limits set pretty close together (definitely not "wide-open" from 4-20 cmH2O), but perhaps set to a range around 10-14 (assuming your current pressure is 12).  Then adjust as need be from there.

Thank you for your input. I look at my numbers first thing every morning and will continue to do so. Sleepyhead and coffee: best way to start the day. And, boy, you're not kidding about variables.  I figured out just two nights ago that if i put my hair in two braids, my mask fits better and thus fewer leaks. It seems to be an adventure in constantly solving for variables 

[rooy1960]

These numbers are as good as it gets.  IF and WHEN your AHI runs consistently higher and only then, I'd consider APAP with a range of 10-14 to start.  Expect that to change.  It's purpose is to titrate to a new value.

Some people do better with straight CPAP, your numbers say you may be one of them.

On second thought I'll suggest going to APAP now, set the range to 12-12.  From a therapy point of view it makes no change, you are doing extremely well. it is to add a "Flow Limit" Stat, which is a precursor to OA events.  Again this does not change your excellent therapy.

I'm extremely pleased with how well my therapy is working. I'm only 16 days in, but I think I'm trying to (unrealistically) achieve zero events (the perfectionist in me), and I thought maybe having APAP would accomplish this. For now, I will be grateful for how easily I've adapted to CPAP and how well the therapy is working. Thank you for your always edifying advice.

[rooy1960]

I agree with the two above answers. But it's easy enough to try - set your machine in APAP mode, with pressures say from 10 to 14. See what happens. I am a bit more of an experimenter than some I guess. My results are always worse with either the APAP mode or the EPR, I seem to do the best with just straight CPAP.

After reading a little more about how PAP works, I realized that my previous thinking was seemingly wrong about therapy.  I mistakenly thought that my machine (in APAP mode) would detect reduced air flow and prevent OA's with increased pressure. Once the airway closes completely, any PAP doesn't "blow" it open, right?  The point is to keep it open?

[rooy1960]

If it ain't broke...  if last night was typical and if you feel rested then don't change anything.

Thank you, and point well-taken.

[justMongo]

After reading a little more about how PAP works, I realized that my previous thinking was seemingly wrong about therapy.  I mistakenly thought that my machine (in APAP mode) would detect reduced air flow and prevent OA's with increased pressure. Once the airway closes completely, any PAP doesn't "blow" it open, right?  The point is to keep it open?

Exactly so.