Apap/cpap

[Jeff S]

Hi!
I was diagnosed with OSA 6 years ago, after 10 years without a decent night's sleep. I also have cataplexy, which the sleep doc at the time said "I don't want to go there". I was fine for over 5 years, but then started not sleeping well. As my original sleep doc had moved out of state, I found a new one who gave me a new study. He gave me a BIPAP instead of my barely functioning CPAP. I could not sleep with it at all-when the pressure dropped it woke me, or more correctly didn't allow me to sleep (it had a spread of 8-16). When I frantically called the next morning for a technician, the BIPAP was exchanged for an APAP, also with a setting of 8-16. The doc wanted me to come for another study, which I had last night. The tech said that I now needed 9-14 (I have lost weight in the interim), which, he said, was equivalent to straight CPAP of 12. When I asked further questions, the tech confided that "no one in the office knows a thing about APAPs" (!!!!!!), but they had changed my settings anyway. When I got home, I saw that the starting pressure was still 8. I assume nothing had been done. The machine is a Remstar Auto A-Flex. User adjustments have been disabled. My question is, is there anyway of making the adjustments myself (going through the sleep clinic and/or provider will take weeks!), or preferably, to change it to straight CPAP of 12? The user manual says it can be done, but I have searched in vain to unlock the secret. Can anyone help?

[James @ Intus]

It's an auto machine. If you need 12, the machine will go to 12. Setting an APAP to a fixed 12 makes it a CPAP. It's like buying a Ferrari and only driving 10 mph with it all the time. Use it to its potential I'd say. If it was 8-16 and they wanted to set it 9-14, that's such a small difference you'd barely notice it.

In all this, you haven't actually said whether you get on with the APAP or not. The whole point of an Auto-CPAP is that you don't have to worry about the pressure settings.

Sure, it *can* be changed. Many US CPAP website have published the 'secret' button sequence to unlock the clinician's menu. But from what you describe, I highly doubt you'll be better off tinkering. Leave it and see how you go. If you set it at 12 you may deprive yourself of a pressure of 15 which you may need at times. If you set it at 12, you will keep getting 12 even when you only need 8.

We don't encourage people telling others publicly how to change pressures. I suggest you seek that info elsewhere or do get back in touch with your clinic. The least they can do is analyse the machine's data card to see what your average pressure is so you can then make an educated decision on the pressure needs.