Posted by Bird Watcher on October 22, 2007 at 19:43:11:

In Reply to: Minimum pressure for REMstar AUTO posted by jiveonlive on October 22, 2007 at 18:58:32:

You wouldn't want to use an auto-cpap without knowing that you can do fairly well with just a straight CPAP. That's where some people miss the boat at trying to understand what autos do and don't do. Autos are for people who can do okay with CPAP but are looking for better results, not for people who can't tolerate CPAP at all or get no relief with just CPAP.

Any auto CPAP box can be used in straight pressure mode or auto mode. The newer Respironics models also have the flex exhale relief feature.

In addition, keep in mind that auto mode may not be good for persons with severe aprnea, meaning that if you have an extremely high RDI or AHI without the pressure and you'd have a significant O2 desaturation in your blood stream during sleep without pressure. The theory behind this claim is that if you need pressure all the time to keep your airway open, why use a device that's programmed to decrease the pressure?

Autos are for those with mild to moderate apnea or UARS type disturbances, but again, not if straight CPAP can't work at least a little for the same condition.

Having said all that, if you know what your beneficial CPAP pressure is, also known as a titration, that is the place to start with an auto. You wouldn't want to start WIDE OPEN 4-20 cm and let the machine try to figure everything out, because it's not that smart - believe me! It will be jumping around too much.

Using an auto? Start maybe at 2 cm below your titration and 2 cm above for three nights. See how you do, allowing the machine to do it's thing in that range. Don't make any changes for a least a few nights. It takes the body a while to stabilize on settings. If the upper or lower limit are too high, you may have air swallowing going on and be bloated in the morning, or, you may rip the mask off during the night. If the upper and lower limit are too low, you will slowing slide back into a condition of not treating the apneas, in which case you'll still think that you slept the night but won't have good energy the next day.

With the Respironics models that have the flex, using that feature can throw another aspect into therapy. Try not using the flex at first. Make one step, if necessary, at a time on the flex setting if having trouble breathing out against the pressrue. Don't automatically use steps 2 or 3 because someone else said that it should work better for you that way. This is a patient adjustable setting!

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