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Sleep Study followup
Oh yeah, I had a sleep study a couple of weeks ago....

Last Friday I went in to find out the results. It turns out I have mild sleep apnea -- meaning I stop breathing in my sleep only 9 times an hour. This Thursday night, I'm going back in to sleep with CPAP masks on and sleep study techs waking me up periodically to have me try a different mask and/or adjust the pressure of the CPAP machine.

The Friday after that (June 1st) I go in, discuss the results one more time, and get a prescription for a CPAP machine.

I must admit, the financing of the machine is one of the more interesting bits about this, but I won't bore you with the details (unless asked).

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It might be, it also might be that folks aren't as precise with language as they could be.

My mom recommends I get an automatic CPAP machine, which from my googling is the same as an APAP machine.

From what I've seen, two definitions for "CPAP" are "Continuous Positive Airway Pressure" and "Constant Positive Airway Pressure". It appears that Constant PAP, APAP, VPAP/BiPAP, etc are all Continuous PAP systems. It does appear that APAP is the most advanced of the Continuous PAP systems, and is certainly more sophisticated than the d/dt PAP=0 machines. (Hmm, I can get away with "d/dt PAP=0 readily enough for "Constant PAP", but limPAP=PAP doesn't really work for "Continuous PAP". Then again, perhaps "getting away with" either may be stretching it).

So maybe when my doctor is scheduling me for a titration for a CPAP machine, he means "Continuous" and would be happy with CPAP, VPAP, or APAP.

I dunno. I'll ask the technician tomorrow night.

APAP senses your apnic events and adjusts the pressure on the fly to the minimum that will reduce them to an acceptable level. The goal is to use the lowest pressure possible for comfort. Some people love 'em, some hate 'em.

CPAP, even the odd c-flex variants, always leave the max pressure the same. It is set in accords with the polysomnogram results and is not user adjustable (Hah. Right.)

The VPAP seems to be functionally equivalent to a BiPAP. These units are generally not used for obstructive sleep apnea. They are used when an individual is dxed with central sleep apnea. OSA is when the soft tissues of your mouth and throat fall closed during sleep and obstruct your airway. The pressure acts like a pneumatic splint to prevent this. CSA is a neurological issue where the brain doesn't send or the body doesn't receive a command to breathe. The BiPAP (and VPAP) are not constant pressure, they deliver two pressures, one low one to allow expiration and a higher one to allow inhalation. They are one step away from a ventilator. I doubt you will get one, I can't imagine why you might need one if you have 'pure' OSA. There is a mixed variant that seems to consist of the features of both CSA and OSA, but you haven't mentioned that...

Oh sure, now everyone wants a CPAP machine. I was sleeping with a CPAP like WAY before it was cool.

DH here, Bu-

I can't imagine she meant an APAP. She's never used or even seen one in her life. I suspect she was describing the Remstar line with C-Flex, which eases transition to using CPAP for some. That is what we use, though we have switched ours to straight CPAP. It does NOT change the set pressure on the fly like an APAP does. One argument, the only halfway compelling one for me, for an APAP would be that some people find it easier to accommodate to. I use straight CPAP set to a high level (19) and I'm really comfortable with it. It took some time but now I crave the feeling of being inflated. Quite restful. I even use it when I nap, mostly.

The most important factor isn't the C or the A in XPAP, it is the interface. You must have one that you find comfortable. Expect to try out a bunch. After you find out a pressure call us and we'll talk... we may have some suggestions. We've tried them all, pretty much. Get the sizes and exact mask/interface names of the interfaces you try from the sleep lab so we can see if we have spares so you might be able to try on more interfaces than you might if you just get a new one every 6 months or 1 yr as insurance allows. With your facial hair, the only serious contender is a nasal interface. You may also need a chin strap to keep your mouth closed. You certainly MUST have a heated humidifier... do NOT accept a 'pass through' or cold humidifier.

Like I said, give us a call. I predict that you will find yourself feeling much better after you start CPAP. Both of us have. Just because you have 'only' 9 apnic events/hr doesn't mean you don't need some aggressive intervention... the question is what is your min/max/and average O2 saturation on room air. You'd be surprised how failing to breathe drops the old O2 sat...

Later, BB and etc.


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