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Re: Re: Re: CPAP lovers

Posted by Kevin (in Walla Walla) on August 09, 2002 at 08:36:21:

In Reply to: Re: Re: CPAP lovers posted by Peter on August 09, 2002 at 04:33:32:

Peter,
I get to try all the new equipment as it's released, both clinical and home use. I also have very mild apnea - RDI of about 6. As an experiment I used the Virtuoso, Tranquility, ResMed AutoSet T, GoodKnight 418P, and the big ResMed Clinical system. I used each system for at least a week, sometimes several weeks. Each with the manufacturer recommended mask, and each with the same min/max settings.

The 95th percentile low leak pressure (the pressure we'd send you home on) was different for each system. Anywhere from 6 cm to 14 cm. I'm now going back and trying each system with a variety of different masks and looking at how the pressure requirements change.

Most of the published research on Auto-Titrators has been funded by the manufacturers, and there may be an inherent selection bias. There was a paper presented at the 2001 APSS (go to www.apss.org.abstracts.htm. Download and go to paper 153.J - Evaluation and Comparison of Two Autotitrating CPAP Machines) In this study up to 44% of patients had to be taken off the AutoSet T because it was failing to adjust pressure during a monitored study.

Just remember - just because an auto-titrator says you're being adequately treated, doesn't mean you are. We had a patient we titrated in the lab to 19 cm. The referring doc didn't agree with our findings and put him on an auto-titrator. After a week it showed he "needed" 8 cm. After a month at 8 cm he still felt sleepy. The doc put him on a different auto-titrator for a week, and it showed he "needed" 12 cm. After another month a 12 cm he still felt sleepy. The doc finally referred him back to our center for a retitration. It showed he needed 19 cm, just like we had found months earlier.

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