CPAP vs APAP | is APAP therapy a terrible choice?

[@claudiaw9246]

Thank you so much for explaining this so clearly! My initial prescription was for 5 to 16, but after a couple of weeks, my respiratory therapist set it to a steady 8.4 which made it much easier for me to sleep. I was suffering information overload at the time, so I didn't really understand what he was doing, only that it worked.

[@funraddoc]

Great video - well done.

[@lisaboisjoli3623]

Great video! My APAP was set 6 to 20. The 20 was just too high and I was getting noisy leakage. Turned it down to 18 and it is greatly improved.

[@garygullikson6349]

The "aussie" CPAP guy with cowboy hat has stated that the most APAP machines with the exception of the Lowenstein Prism 20A or the F&P Icon, do not act fast enough to control apena. The Lowenstein machine costs some $2300 and the F&P Icon is not sold in the US anymore. I am in contact with a sleep center that seems to be in favor of APAP/Auto CPAP, not conventional CPAP. Just completed the Night Owl home apnea test series preparatory to getting a CPAP/APAP machine, awaiting results. I have been a CPAP user for over 30 years, age 85, currently using an Airsense 10 with expired motor notice. Who should I believe ?

[@SaintGGod]

Aussie guy is correct. I've had two tests done and I have a Lowenstein.

[@gels1922]

EXCELENT VIDEO - Thank you

[@louisel.sinniger2057]

Thank you for this video. I am an RN who’s years were spent in the hospital setting how ever now I work semi retired in a nursing home environment. The frustrating thing for me is residents personal machines & their settings. If a resident has a newer complaint no one in our facility can assist them and neither can their families. The facility is not helpful as they go in “dumb mode”. I have expressed to the facility that we need professional outside assistance with this equipment but so far nothing. Outside of reporting this to the state I am not sure of the correct course of action. Any feedback would be helpful. I live & work in NYS

[@thecpapstore]

Hi there! First off thank you for sharing your experience as an RN. My partner is a nurse as well and I have tremendous respect for you. I am not sure how to help you with getting more help with the facility and state. Here in BC, Canada we have the same issue with the medical facilities gatekeeping basic knowledge. However, if you have specific questions that you get from your patients and staff, please write them here. I will be able to put together a long form video answering all of them which you can share with your staff. Let me know! - Tristan

[@louisel.sinniger2057]

@ well hello, this is a nice surprise. Wasn’t sure if my comment would be seen. Thank you. I have been a nurse 51 years. It’s been a whirlwind. Families & facility management don’t seem to have the interest in assuring their residents necessary equipment is in good working order. This seems to be the way now days. I don’t really get families that voice concerns which is just a shame. At the place I work I seem to be the only one that has experience working with this equipment because the staff are often calling me to “fix” the problem at hand. 🤷‍♀️ I appreciate your feedback though. I will keep you in mind

[@jps99]

My doc started me on the "4 - 20" range which resulted in air leaks on the high end, and a feeling of oxygen starvation at the low end. After a few pressure change requests to my doc, I ended up with a range of "9 - 15" which works well for me.

[@GlitteranGold]

Moderate sleep apnea here just got diagnosed and have been using a APAP machine for one week still tired as ever? What’s going on is it the wrong kinda machine for me?

[@nnndddccc]

Is there a guide on how to interpret the Oscar graphs to determine the ideal pressure?

[@ziadtarab86]

sleep apnea board- friendly experienced people willing to help. loads of information too.

[@sheldons231]

I actually changed my to 10 to 14. Most of the time, my 90% pressure was 10 but occasionally went to 12 or 12.5 and rarely 13, and my AHI is normally 0 and the odd time 1 and only a few time 2. So I think I got it dialed in. But I had to replace my DreamStation so I got a Lowenstein 20A as I hate ResMed, it keeps jacking up the pressure and waking me up. My Lowenstein is so much better than both Philips or ResMed it is unbelievable, but hard to find in Canada, so I went to Australia to get a German machine. Did look at a Dutch company but they don't have the modems for the machines.

[@sababa1022]

Ok. So how do you determine optimal cpap pressure? I’m currently on apap and averaging ahi in the low teens.

[@dtoro15]

The way i switched to CPAP and dialed in my pressure was by looking at my 95% pressure. Once you find that, try a pressure for 3 days and see what happens with AHI. Adjust until you feel confortable and AHI is at an acceptable rate for you. I use 10 CM CPAP, and my AHI is .2 average. I use a nasal mask.

[@sababa1022]

@@dtoro15 Thanks for the suggestion. I appreciate it.

[@phildimopoulos6010]

I've actually watched a few vids about this now, and really appreciate the info. What I may be struggling to grasp is if in APAP (mine is 6-12cm range currently, EPR 2), is there something wrong with it being at the lower pressure most of the night? Because the higher pressure isn't needed until the apneas occur, correct? I guess the flipside is that the machine doesn't catch half of the apneas throughout the night so having it at the 95% pressure (mine being around 11 during apneas) would eliminate that. Should I use a range of 9-13cm in this case? Or try CPAP mode at 10-11cm for a few nights, or 12 with EPR at 2? Just kind of spitballing, I'm not looking for an exact answer to MY question necessarily, just figured more people than just me were likely wondering.

[@thecpapstore]

Hi there, in regards to your first question, I think it is important to think of an APAP as reactive (not proactive). The 'higher pressure' is needed to stop the apnea from occurring in the first place. So if you have a lower pressure most of the night, but you are still having apneas causing your APAP to increase pressure, your therapy may not be as effective as it could be. Increasing pressure after an apnea has already occurred is like putting on your seatbelt and hitting the brakes... after a car crash. It doesn't make sense. Of course PAP therapy is not as black and white, but hopefully that example gives you more clarity. We can not give specific medical advice here (always consult a doctor), but I would say testing out what you suggested (in your 2nd paragraph) should definitely lead you in the right direction.

[@phildimopoulos6010]

@@thecpapstore excellent response, this honestly solidified what I was steering towards... my sleep tech was great, but I no longer go to the clinic since my trial ended so I'm just putting together the last few pieces of the puzzle. Thanks for the reply!

[@GlitteranGold]

Keep in mind I went to a sleep study place and my machine is set 5 to 20 if I sleep on my side it’s almost always a 5 pressure but if it’s automatic and not continuous like the CPAP that’s probably what the problem is. Since I have 27 episodes per hour every night. The APAP probably isn’t doing enough I got the ResMed air sense 10 for her age 25 female here.

[@thecpapstore]

what is the highest pressure it goes to in APAP mode?

[@GlitteranGold]

@ My machine can go up to 20 with pressure.

[@A.N.A8]

APAP is bad. CPAP all the way.