I saw my Sleep doctor for the first apointment last week, and he changed my therapy back to straight CPAP at 11cm. they had tried a APAP setting of minimum 5cm and max of 15cm for the last 3 weeks to see if it was more comfortable that straight CPAP. I went from sleeping 8 hours per night to a fragmented 6 hours, with an average for the three weeks of AI 1.6, HI 13.9 and AHI15.3.

last night the first night back on Straight CPAP i had a AI 0.1, HI 4.9, AHI of 5.0. and slept a some what continous 8 hours. Its partialy my fault as i had asked the Dr to try VPAP thinking it might be more comfortable. The Dr explained that during my sleep study, in the titration, as the pressure was increased past 11, my sleep became distrupted, and didn't progress beyoned state 2 sleep. the best pressure to eliminate apneas and enter deep sleep was at 11cm for me.

On the APAP setting, the pressure was occasionaly raising above 13 ( that was the highest pressure achived during titration ) and this was probably what was causing my lack of deep restful sleep. my AI, HI, and AHI were also higher at those pressures.

I don't go back to see him for another 4 months. although he said that if there were problems or questions, i could call for an apointment before that, or e-mail his office with questions. he felt as long as there were no issues that seeing him every 4 months for the first year should be fine. The DME will read my machine every 3 months and send him a report.

all in all, my experience from the sleep lab, the DME, and my Dr, and insurance company have been very positive. i should mention though that i am employed by a hospital that operates the sleep lab, the DME and the Clinic. they also operate a self operated insurance plan. I'm looking forward to the next couple of weeks of getting a good nights sleep.

I could have written your post above! I was on CPAP with a pressure of 10 for almost 8 years. I had lost some weight and the CPAP pressure was blowing my mouth open and waking me. So I went to the sleep doc and we talked about trying an APAP since I hadn't upgraded my machine in 8 years. We got an APAP and he set it with a pretty wide open pressure of 6 to 20. I was using the Swift LT and the machine was spending a lot of time up around 17 and blowing my mouth open even worse. I tweaked the numbers back down to between 8 and 12, 2 either side of my original titration of 10 and the leaks were not as bad, now was the mouth blowing open as much but the sleep was still not nearly as good. I got re-titrated a few days ago and still had a pressure of 10 as best for me. I put the APAP in CPAP mode with C-FLEX on 2 and slept much better the past couple of nights. I was still getting a little mouth opening and tried a chin strap but found that uncomfortable so I just tired a full face mask last night and that was great.

I'm still waiting on my software and card reader so I can really tweak things in! Congrats on going back to CPAP and getting some good sleep. Isn't it wonderful sleeping well?

Honestly, most of us here would say that Auto spread is FAR TOO WIDE. Most of us would SUFFOCATE at 5. The majority here claim that a spread of 3 is about all you want. Say, 11 to 15.

I have found I do better on straight CPAP, but I want to own an Auto for self-titrating when I find things changing and I want to figure out what's going on.

Try the straight CPAP for awhile, then experiment with a smaller spread, and see what your numbers do.

BTW, I'm here in Lakewood, WA, COPS capitol of the NW. (Waving)

Cheers,
Barbara

Methos1979 wrote:I could have written your post above! I was on CPAP with a pressure of 10 for almost 8 years. I had lost some weight and the CPAP pressure was blowing my mouth open and waking me. So I went to the sleep doc and we talked about trying an APAP since I hadn't upgraded my machine in 8 years. We got an APAP and he set it with a pretty wide open pressure of 6 to 20. I was using the Swift LT and the machine was spending a lot of time up around 17 and blowing my mouth open even worse. I tweaked the numbers back down to between 8 and 12, 2 either side of my original titration of 10 and the leaks were not as bad, now was the mouth blowing open as much but the sleep was still not nearly as good. I got re-titrated a few days ago and still had a pressure of 10 as best for me. I put the APAP in CPAP mode with C-FLEX on 2 and slept much better the past couple of nights. I was still getting a little mouth opening and tried a chin strap but found that uncomfortable so I just tired a full face mask last night and that was great.

I'm still waiting on my software and card reader so I can really tweak things in! Congrats on going back to CPAP and getting some good sleep. Isn't it wonderful sleeping well?

Thanks Methos, its nice to hear that i wasn't the only one with these kind of results on APAP. i had hoped it might be a little more comfortable that straight CPAP. Last night, the first back on straight CPAP, I didn't even need the 'ramp up'. just went straight to 11cm, didn't feel uncomfortable at all. On APAP, at the lower pressures it felt like i was having to 'suck the air' thru the mask.

Have to mention that i like your avitar, thats a BMW R1200C isn't it? I had a 1999 1200c until 2 years ago when I bought a R1200gs. now i am trying to figure out how to pack my CPAP and a battery on it so i can still take it camping.

While some people do, indeed, do better on straight CPAP than Autopap, I think one of the main reasons some have trouble with APAP is setting the minimum pressure too low. Not that the max pressure is too high.

As long as leaks are well under control, I don't think setting the maximum pressure wayyyy up high at the top matters much -- for most people. For most, the autopap is not going to use the upper pressures anyway. It's the minimum pressure that should be the workhorse, imho -- set high enough to prevent most apneas right from the get-go:

Results: 1st night with Auto A-Flex (topic started by TSSleepy)
Two nights graphs posted using pressure range 4 - 20 and 10 - 20
http://www.cpaptalk.com/viewtopic.php?p=348963#p348963

November 2008 Just got an APAP (topic started by turbosnore)
http://www.cpaptalk.com/viewtopic.php?p=319619#p319619

October 2008 Turning off Aflex and Cflex (topic started by DoriC)
http://www.cpaptalk.com/viewtopic.php?p=307265#p307265

September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
http://www.cpaptalk.com/viewtopic.php?p=294319#p294319

Wulfman, DreamStalker, and ozij explain why autopaps make changes slowly.
December 2008 Why adjust APAP. Isn't it auto? (topic started by oxygenium65)
http://www.cpaptalk.com/viewtopic.php?p=323218#p323218

Agreed RG! Especially for those going from CPAP to APAP who are adjusted to the sounds and pressure of CPAP. I'd probably start out with a short range like 2 points on each side of the CPAP pressure and adjust based on results, but the docs don't follow you close enough to do it like that.

I would say the same as above. When I started I was prescribed a pressure of 14 on CPAP. When I bought my APAP Iset my set my pressure to 12-19 and the pressure always went to 19 in the first hour and stayed there through the night. I never felt as rested either. I beginning to believe APAP's aren't as smart as we would like them.

Section1 wrote:I would say the same as above. When I started I was prescribed a pressure of 14 on CPAP. When I bought my APAP Iset my set my pressure to 12-19 and the pressure always went to 19 in the first hour and stayed there through the night. I never felt as rested either. I beginning to believe APAP's aren't as smart as we would like them.

I have found that my IntelliPAP will tend to do the 'max pressure' thing if the minimum pressure is set too low. The pressure seems to need to be about 1 cm below or at your titrated pressure. Try 13-19 or 14-19 sometime, and see if you get different results.

I can tolerate both, but I found I get better numbers at a single pressure. You might also look for that now that you've switched back.

I think RG nailed it! The low pressure is too low and it takes the APAP too long to raise it to the titrated pressure that aborts events.

I was titrated at 10 & CPAP was set to 11. 20 months & 53# lighter, sleep doc loaned me an APAP which showed 95thcentile pressures from 6.9-9.8 when set wide open (4-20, and boy was 4 tough but 20 mins relaxation techniques got me calmed down enough to breathe OK at 4) -- loved sleeping with APAP; my pressure needs are quite volatile and changing pressures do not appear to effect my sleep. We re-set my CPAP to 9 in July. Got my APAP 12 days ago and we set my pressure range 6-15 doubting that I'll ever need 15 but it's there just in case. 6 is comfortable and my numbers are great so far (<3), so I'll leave my low pressure at 6. When I get a card reader and can review detailed reports, I might increase my low pressure based on what the reports show.

I think a lot of my problems with the wide open pressure was a combination of the low pressure and also large leaks at the higher pressures. I've got a full face mask now so I can tame the leaks, and I also have the software and card reader so now I can do some experimentation once I learn what all those numbers and other things mean. Any pointers to threads that may discuss dissecting and understanding the Encore Viewer reports is greatly appreciated!

As for the bike, yes, it's a BMW R1200C Phoenix. It's an '01 that I found last year with only 3k miles on it. I love it. I just wish we had a longer riding season. The GS's are nice bikes. I also love the R1150RT's and the R1100RS. But the C 'fits' my body and riding style best.