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Re: What is my APAP thinking?

Posted by Bird Watcher on March 30, 2006 at 07:18:17:

In Reply to: What is my APAP thinking? posted by eyedoc on March 30, 2006 at 06:26:00:

Since you are new to APAP's I can tell you that the ResMed machines are set up internally to react faster to events compared to auto CPAP's from Puritan Bennett or Respironics. For some people, the ResMed way of doing things is just the ticket to better sleep while others don't do well with the algorhythm. ResMed meachines are not adjustable in this sense, and are only adjustable to how high they can go (limit settings).

If you have it starting at 4 now and it rapidly climbs to 12, I would suspect that it is mis-reading you and the limits should be re-set to something like 6-10 cm and see how you do. You would necessarily have to give up the machine. You may do better with less aggressive limits. What was your original pressure you got from your sleep test(?) or did the doctor set you up on the machine and allow it to find the pressure?

I also understand that this machine has a mode, called ERP, that is a straight CPAP mode but relaxes the exhale pressure slightly, like a Respironics C-FLex feature. Using this mode may be an option for you if you know what your proper pressure should be.

There is really no adjustment or factor called a 'duty cycle' on these machines. Duty cycle is an electrical engineering term that refers to on and off time of a pulse waveform. These machines are more akin to the concept of a photo sensor in the cockpit of an airplane, whereby the stronger the (analog) light hitting the instrument panel, the stronger the guage backlighting. When the outside light gets dimmer, the backlighting goes dimmer, helping the pilot's eyes. Auto-CPAPs are constantly sensing your breathing and reacting with higher pressure if it sees an abnormal situation, and then backing off when the event is resolved. Each manufacturer has it's own algorhythm and each manufacturer sets it's parameters to what waveforms are considered abnormal.

Respironics' Remstar Auto has the advantage in this field because their auto mode can be used with the C-Flex feature.

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