Hi Jason. I've been using my CPAP for almost 2 years. When I got it the doctor had it set on APAP with the pressure set to 4 - 18. When I first started I had a horrible time. The pressure would go up in the middle of the night and wake me up. Every night. I thought it was just something I had to get used to. I started searching the internet to try and find some help. I watched many of your videos. In one videos you talked about switching from APAP to CPAP and working up on the pressure. So I set my machine to CPAP, turned off the ramp up and the EPR. I started low and week after week slowly increased the pressure. I'm now at 10.2 cm H2O and my AHI is 0 almost every night. I just wanted to say thank you for your videos! I would have probably given up on CPAP if it wasn't for you.

Interesting topic. For the past 11 months I've been APAP. Slowly over this time I minimized leaks, changed masks, dialed in pressure ranges and have had a good results reducing my AHI below 1.0, but still would have wake ups and restroom wake ups as well. Since this video was put up, I switched back to CPAP, and set my pressure the 95% over the course of two months of great data. I could see that my pressure curve was constant over this particular data set. So far, for the past week I haven't woke up in the middle of the night, not needing to hit the head. I have occasionally opened my eyes, in the night, but not at the same frequency as before...maybe this was the ticket. Awesome work Jason!

I am set at straight 8 now and the sleep has never been better. Thank you Jason!

Totally with you on fixed pressure. After I consulted with you I went to fixed pressure and am now at 7.6 and hoping to nudge up to 8. Sleeping wonderfully and my flow rate looks so much better. With mouth taping and using Bleep Dreamports leaks are a thing of the past. No longer needing daytime naps either.

Wow! I just tried constant pressure for two nights, with light exhalation relief, and I feel like a new man! This is amazing information! Thank you, thank you!

Makes perfect sense, which may be because I did the OSCAR session with you in November. Best $$ I have spent since starting CPAP.

I’m currently using 8-10, seems to be good. With my previous machine (one of those that is bad for your health) it came set 4-20, it would just push my mask off as the pressure went up. I spoke to the company I bought it from and was told not to change the pressures. It seems crazy not to customise your therapy.

I commented before on my APAP story and have never slept better. I purchased my APAP, heated humidifier, nasal pillows, and tubing without a prescription. No way I'd survive a sleep lab as my sleep position is side/stomach and based on your earlier videos, chose a nasal pillow. First night was magical, solid all night sleep, no waking up to urinate, no GERD issues and recorded prior to and after APAP. Low pressure is 5pps and have woken up the next morning to 6.5 to 7.0 pps with the high setting on 12pps (which I never reach). 3 years now, and have been very successful. ZZZZZZZZ!

I was on fixed pressure for years and was doing great, now been on auto for 6 months (range 6-20) and am sleeping like shit. This makes total sense! Might have a look at Oscar, see if I can figure it out.

Hey there! Been doing apap for 8 months and liked it, and felt better, but I was disturbed throughout the night by varying pressures. I sorta titrated myself. I was 5-15cmh20 but I found out within the first couple nights, that wasn’t cutting it for me. Experimented and found I like to start at 9cmh20 to feel like I can adequately breathe. My average after 7 months was 14.3. I worked down from there and found 10.8cmh20 is perfect. I’m sleeping 6-10 hours straight through on that fixed pressure. I also turned EPR down to 1 but might take it off completely soon. My events for 22 nights in a row are 0-.3. Thank you for this video!!! Made all the difference.

I'm so glad I finally switched to a fixed pressure! The doctor set me at a range from 5 to 16 and this was horrible. Over the last few months I dialed my pressure into a range of 10 to 12 and it was pretty good. Now I'm set at 12cm in fixed pressure and my sleep is perfect!!

I love using OSCAR, I learn so much about my CPAP sleep! Thank you for another great video!

APAP makes sense if you have a very narrow range slightly below and above your optimal setting. Will give you indication if your optimal has change and if you can lower or need to raise your pressures.

You are not a crack pot. I have been on auto CPAP for 16 years. It was at 5-15 but have since raised it to 10-15 over the last few years.

You're my favorite crackpot papper person with great insight. Your adoring fans have missed you the past week.

i agree with you on this, fixed pressure worked the best for me, also not needing apap means i could get the cheaper cpap machine not needing apap

I have an Airsense 10 APAP and that I have been using for 2 years now, it was from a home study. It was set at 4-20 which was a joke, I saw I believe one of your videos about pressures and decided I needed to change it. I went from 4 to I think 11 and quite honestly I think it was still too low. I used OSCAR and it appeared that most of the time the machine was at 20 cm H2O and what I noticed is that when I was sleeping soundly the pressure would steadily drop, it would flag a event and then slowly climb back up. Just my opinion, it wasn't doing it's job. I saw another of your videos and you said to just make it a CPAP so I compromised and kept it as an APAP and made the minimum pressure 18.5 cm H2O. Also looking at my nights in OSCAR I could swear that the machine is flagging wrong but I also can be reading things incorrectly. Throughout my usage the machine claims I usually get AHI's between 4 and 10 with every so often a really bad night between 10 - 20. I am going to an in lab appointment next week. With my pressures at around 20 cm H2O I want a human to help with the study ... I may need bilevel or a bilevel fixed at a higher pressure. Or maybe the machine has me fooled and it is throwing false positives and I really am getting a better night sleep than the machine is analyzing. Of course with high pressures comes leaks ... have that mask plastered to my face!

Thanks for another great video. I've been on CPAP for 13 months now. Of course the MD prescribed a 4-20 setting, to which the RT added a ramp. I was getting less air with the machine than without! Ditched the ramp the second night and raised the minimum pressure to 7 the third night. First call with my RT and she's really upset that I did those changes, saying it needed to be cleared with the MD first! Asked me to not touch anything again. I never felt the need to, as I've been sleeping well and my AHI has been under 1 pretty much since the start. I've seen you video on how we shouldn't rely on AHI number to assess treatment success and, now you are saying that letting the range to 20 might be a bad decision. You have provided more value in 2 free videos than my RT in 4 calls and 3 sit-down visits included in my paid service subscription... You are now forcing me to re-evaluate whether my treatment is really doing fine but I can't rely on my RT for it. I'm tempted to contact your company.

Thank you for all that you do to help us Jason! After wrestling with 5-20 for a few months, I listened to you. Went to PS 5 10-18 so my therapy is provided in a tight range of 15-18. That and going to very “high trigger” setting with my Aircurve 10 VAuto results in AHI averaging less than 1. Best, Rob

I was put on 5-15 and I'm suffocating and losing sleep! I'm irritable AF and my ears are killing me!

Had a Foam station 2 the flex options were giving me issues.(the foam was delicious by the way). Noticed while laying on my side when pressure would drop I could actually feel my airway collapse (not totally but you get the point).

Very 50 shades of gray aesthetic. Now I know why my apap annoys me. Thank you.

Great video legend! Keep it up brother. Always make me smile, giggle and occasionally laugh the fuck out loud Bahahahahaha. I don't like cpap at all haha but you make some good points man. Much love. Nick

Fascinating that the APAP's are so slow in reversing pressure boosts even when sleep irregularities are detected __after__ boost. Are there CPAP machines that are more reactive and better at tracking disturbances/need to correct apneas? FYI my Resmed pressure was adjusted downward by sleep specialist remotely once initial pressure setting was determined to be causing problems and excessive leaks.

I apparently have a great provider because after I got my machine, we had several calls (telemedicine) over the first couple of months and gradually raised the starting pressure to 9cm; my AHI is consistently under 1. Pressure varies from 9-13 most nights.

Hey Lanky, how should one determine a static pressure to set to? Use the average pressure from the last 30 or 90 days? I have constant issue where I am woken up at 3-330 AM everyday and can't return to sleep once up. Trying to fine tune my resmed in hopes this may help!

fixed pressure dialed in during an in-lab sleep study is the gold standard for most people I feel.

How does it detect REM?

Have you done a video on how to choose fixed pressure number from the Oscar data from auto sessions?

My home tests (2x) and sleep lab tests were exactly the same, except the lab had broken AC (76 degrees), a 1970s nightmare bed with broken springs and feathers sticking out of the pillow and woke me up after 5 hrs.... At 6 am, then they told me there was no time for titrating /cpap. (At a major city hospital attached to a big university). I'll take the home study thanks.

???? How do you turn off FOT on both a S-9 apap & another S-9 which is a cpap only. I looked in settings & searched web. ???

totally agree with you opinion & I begin change it to CPAP beginning with 6 pressure

I'm confused. I have the air sense 10, and I get all of this. However, nobody ever tells us which settings to put it on so it is now CPAP and not APAP. I have the white machine and it is on the 'for her' setting. Does it mean I have to take it off that to make it into a CPAP?

So glad I found this video today. I had an at home sleep study which determined I would need a CPAP machine, so I was never formally assessed for a fixed pressure (titrated?). From the APAP sleep results that my sleep physician read later, it was determined that the average pressure was 10.4. So when I changed the setting to CPAP (because I was still feeling tired in the morning and I had heard that people get better results with CPAP), I was surprised by how strong the pressure was - I didn't get a wink of sleep. So I went back to my auto setting with an EPR of 2. But with these auto settings, I was still waking up tired. Now I have found this video and I think that my perfect pressure is definitely less than 10.4. I think I will start at 6 and work up from there. Does that make sense?

Hi Jason. Thank you. I totally agree with you. I started on november and went great with auto cpap 4-12, with 95% at 7. And my skin problems came back with winter. Move a lot, sometimes it awakes me and my airsense 11 went crazy. Always at 12. OA is diagnosed but it's not. I wish I could change to CPAP. But I'm in France and can't change it on myself... need to go to the doctor each time. Thank you for your videos. Helped me a lot in choosing my mask and underderstanding many things. Great job.

5:27 How can you tell it's REM? Is it because of the flattened amplitude?

I get it Auto CPAP doesn’t work. When the doc set me up on 12 to 18 cm my mask would blow off at 16 so I hacked the setup and changed it to 13.5 to 15 and have been sleeping like a baby. Usually stays below 14 but pops up when my sinuses are all clogged up and keeps my AHI below 1.5. So I Would say a narrow, very narrow range of Auto CPAP works.

I'm a month in and very much starting to agree iwth you nOw, I have a tracheostomy which adds another variable but I tried auto and have never fallen below 9.8 events per hour. I'm getting rid of the tracheostomy but what a process this has been.

OMGosh. So described me with the cave and monster thing. Am going to switch it up off auto and if I’m better- yippeee. If not, I’m scheduling an appointment.

If the algorithm stinks a cookie cutter prescription for an APAP setup is horrible in most cases. I'm at a base prescription of 17 for CPAP which is pretty high and in an APAP I had to make my settings 15-20. By closing the gap I sleep great every night. I typically hover around 15-16.5 every night and now I'm sleeping 8 to 9 hours without having to wake up to pee. I'm looking to ditch the Phillips dream station one and get something with a better algorithm. Maybe a Resmed?

I don't like auto-cpap mostly because I went for so many years with a fixed flow. I do like the data.

Thank you for this. I've noticed lately that I've been having problems sleeping through the night. My initial prescription was for both APAP and CPAP settings. 8-14cm for APAP and 10cm for CPAP. Taking your suggestions into account, I modified them just a bit. While I didn't change my machine (3B Luna II) to CPAP mode, I did reduce my max APAP setting from 14cm to 10cm (matching the setting for my CPAP Rx). Since doing so, the quality of my sleep has improved greatly and I am finding myself sleeping through the night. I have since made the same change to my ResMed AirMini so it's ready the next I travel. Thanks again!

Hi, I recently had my bipap machine break down while I was in rehab. The people here brought in a cpap machine set up for apap, and I don't like it. It obviously doesn't react the same. When I exhale, it feels like I am fighting it. It's not as bad as a cpap, but I don't like it at all, but I have to put up with it, because I have to wait until next year to get a new bipap machine through Medicare. Oh well. I just wanted to say something about my opinion about apap.

I'm on bipap and this describes exactly what I feel every night. I'll just start to fall asleep at decent pressure but not long after I get jolted out of sleep with the pressure incredibly high and I end up awake and thinking about my breathing to get it to lower the pressure so I can fall back asleep... and within minutes it's doing it again. It's frustrating because my AHI is usually less than 2, often less than 1 so why is it constantly blasting me awake with extra pressure?? I feel worse than before I got the machine and I'm struggling to get 4hrs. I can't get back in to do my initial check up that's supposed to be 31-90 days after you start until it's actually like 2mo late because of how baked up the dr is. I feel like I'm not going to make it that long! 😢

Hi friend, i get how the APAP increases the preasure or why, but what makes it decrease it again?. I tried the APAP mode with the lower preasure programed kind high (the preasure i´de use with CPAP mode) and the max preasure 2 or 3 cmH2O more and i think it helps. What you think about that?

I think apap is great if you have a severe case. Since switching to Resmed airsense 10 autoset, my ahi has gone from over 10 to consistently 3 to 5 nightly. But my pressures are a lot higher than most.

Going to fixed pressure, at your suggestion, made a huge difference. Thx.

Is*

Now I'm going to ask a dumb question I've been wondering about for awhile. Is APAP different from a CPAP ramping up pressure? I had to turn the ramp function off because I felt like I was suffocating trying to get to sleep. I prefer feeling like I've strapped a leaf blower to my face. (Just kidding my pressure isn't that high)

Great info, my actual sleep tech/sleep doctor is terrible. Just gave me a pressure of 7 to 10 when starting. Ive increased base pressure to 10 and max to 16 and my ahi has gone down under 1. But leaks and i do wake up alot. Gonna need to get oscar and figure ouf myself if i meed more or less pressure

Thanks Jason so helpful as a new pap user

Love your videos! I used the old sleepyhead software years ago and got my auto foam station set between 10-14, lately it seems I’ve been feeling sluggish again, I don’t have a home pc to install Oscar on, but looking at the data on the machine it’s saying ahi average is 2, and it’s going up to my 14 on the high side, when it gets up to 14 it wakes me up, so should i try bumping my low up to 10.5?

I have just started this week and I have COPD. I'm set at 6-12 and had to turn off ramp due to starving at 4 cu. My OSCAR 95% is 11.2 cu with AHI below 1 so far this week. I'm thinking I need to go to at least 8 cu.? By the way, how do you scroll the graphs in OSCAR to compare the flow rate and pressure?

thanks for making this video.

Been using APAP on min 10 max 16 EPR 2. As far as AHI I say below 1 which is great! But I still feel tired during the day and struggle getting going for the day. Will switching to one steady pressure help with this? If so, what pressure do I go to on cpap mode according to looking at my data in Oscar?

just looking at the algorithm. i have been a neurofeedback practitioner in the past and seen infinintely sexier automatic algorithms than this....why not for a start return to a a baseline depending on ahi (why does baseline have to crank up every time. also what the eeg algorithm did was detect signs early of an event...i imagine there would be more chance of doing it with a higher dimensional space to optimize in. in short, i think its not apap that sucks, its the algorithm. btw i did have good results when i switched from cpap to apap.. i think the window is too large still. went 10 to 20 (a lot of cpap techs seem pretty bodgy). set epr to 3. my friend who is an electrical engineer chose those variables. event detection in biosignals is more about control theory (would ideally be nonlinear control theory) than medicine...once you get to the machine. you are going to shift sleep stages...why not optimise for each sleep stage by detecting signs of onset.

What are your thoughts when a patient goes to the doctor and he orders a sleep test where the mail to you a clip on the finger device for one night. Then you mail it back in and you get diagnosed with Sleep Apnea and they push you into a rental CPAP with a downpayment monthly rental and deductible. Then they leave you on a 4 to 20 setting. I could not breath at 4 and 20 made my lungs hurt so I got into the machine settings and did a 7 to 14. My prior readings were in general 5 events per hour at the spread setting but then went down to an average of 2 per hour over the next 8 months. They kept trying to bombard me with hundreds of dollars in supplies on a rotational automatic basis and I felt like they might be billing me and the insurance. That's a lot to cover and might make a great video but mainly I'm wondering what your opinion is in being diagnosed with a through the mail clip on finger device and one night of sleep which happened to be a night that I worked late and slept only 7 hours. My lungs and chest were hurting all day so the change in settings helped that issue but I wonder now if I was even correctly assessed to start with or did I just get sucked into a Mafia system?

My dr set my pressures at 5-15 but I couldn’t breathe. I played with it A LOT and found that I’m really only comfortable when starting at 10.8. Heavy, right? But any lower and I’m not comfortable at all. So, it’s set at 10.8 to 20 and my average is somewhere in the 12 range. I sleep great. No leaks, very low AHI numbers (under 1 per hour) and I pretty much don’t wake up till my alarm goes off. Sometimes on a night when I don’t have to wake early I’ll go 10-12 hours nose breathing like a sweet little baby. Should I change it from APAP to CPAP and set my pressure at like 11.5? Am I ok to keep it the same? I really like it. Thanks for any answers! Been pap-ing for 8 months and no follow up appointment with dr for another 3 months.

Thanks!

Does this apply to people with severe central SA? (70 episodes per hour, 65 oxy). My ASV seems to work for me. I can’t remember what the settings are (I do know how to hack into it) but after two months maybe I need to adjust?

Ok I like what I hear. Got my Dreamstation 1 (sans foam) set as a bi level automatic whatever between 7.5 and 12. Ahi typically under 2. But everynow and again I wake with my mouth open despite a facemask and a loud noise of air escaping. How easy is it to set to a single pressure and what would you advise me to start at? PS may your next birthdays be memorable for the right reasons.

Why not everyone on ASV. If cost was no issue would this be feasible?

Thanks to you I now sleep well! Thank you!

As a mother, haven’t had a good night’s sleep since before he was born. Appreciate your videos. Still trying to learn to keep the mask on my face and not throw it on the floor. One of these days it’s going through a window.

Jason is not a crackpot.

Thanks

Hi there, recent new viewer to your channel. Are you speaking of the same thing as an "ASV" machine? I was Rxed with one due to complex SA with desaturation caused by centrals with increased CPAP or BIPAP pressures as Dxed with three in lab sleep studies (as I understand it). How do I interpret your comments in this situation. I am just not sure if your video is about ASV machines. Thanks!

Hey lanky My sleep dr just ordered a auto titrating Figured I'd come on and do some research to find out what it's all about and stumbled across your video here How long after i start it would you suggest i have a consultation with you to review my data? Thanks

Howdy, Jason. I was originally on a pressure of 14 with my Foam Gate machine - and I felt terrible. Changed sleep doctors - she tried APAP with me instead (still on DS1) - and my AHI went much lower. Last September I got a ResMed Airsense 10 Autoset for Her (which was already set to APAP) and now my AHI is consistently under 1.0 but have been tired lately. BTW - I also grind/clench my teeth and wear a mouth guard. I have my yearly sleep doctor check up next week - should I ask her anything specific about which application (APAP, CPAP or Bi-Level) I should be on?

My Air Sense 10 is only CPAP, so I can't play with Auto stuff ...

Cpap legend! Btw I need a new ocar review please 👨🏻‍✈️😎😀

CPAP VERSUS AUTO CPAP AaaaaaaaaRRRRHHHHHH. I HAD TO WATCH THE ROAR 10 TIMES...MADE MY DAY...

people need to take control of their own therapy, learn to use oscar. Not only the data but take into consideration how you are feeling the next day. After seeing one of lankys older videos on this i tried fixed for a few months and didn't notice any difference for me personally. Maybe i'm just not sensitive to the pressure changes.

Could you please clarify Editing Jason's 3rd point, " They are reactive, not pro-active. Meaning you need to have an Apnea or Hypopnea, before they're going to increase...." ResMeds will increase pressure on both Snores and Flow Limits, thus preventing Apneas and Hypopneas. But yes, this is still reactive.

You still crack me up, I don't care how stupid people say you are, or "just get to it, you're not even funny!" except, you are funny. No one else is making breathing machines funny, I mean...c'mon.

Hi Jason, why is it so hard to find the provider settings for my Transcend 365?! Can you help?

Are there any consumer EEG devices? I wanna see if I am waking up when my flow rate gets funky?

how can I get in touch with you? let me know... Best Jake.

you don't leave APAP settings at 5-20 forever, unless if patient has severe sleep apnea initially. Once patiernt used their APAP initially and gathered enough data to interpret then, the APAP should be re-calibrated to the desired pressure settings. CONSULT A SLEEP DOCTOR! One data you presented (with post-arousal events) cannot be used to generalize the whole picture of APAP. You need to conduct a research with plenty of samples then, you can conclude.

i wish my Luna G3 info would work with Oscar

Interesting Jason. I got changed to auto BiPAP about a year ago. Overall, my sleep is better, but I do occasionally wake up once in a while. I wonder, is my Auto Air Curve 10 doing this same bullshit? The little bastard has a mind of its own. I'll have to download OSCAR and find out. I must say, BiPAP therapy has definitely been wonderful. Seems like I do better with BiPAP than I did with CPAP.

What's the solution?

Hackles duly raised. Fully triggered

I am confused because I have a Fisher & Paykel machine which has two settings, auto and CPAP Is Auto the same as apap? I have always had my machine set to auto. My initial pressure setting was 10 but after I lost weight I experimented and finally got it down to 8.5 but then put it up again to 9. What I don't understand is that if my machine is set to Auto, 4 to 20, then why would it make a difference when I change my pressure? If the machine is sensing what pressure I need and that that might be anywhere from 4 to 20, then why do I get different AHI readings depending on what I have set the pressure to? Doesn't the machine just decide for itself what pressure to have if it is set on auto?

great info but low audio quality. sometimes you are talking very very low and other times you are clapping and shouting...thanks for that lol

You lost me at 2:50……

Did you delete my comment? Why?

Thumbs down is highly inaccurate because some people push it just to make others miserable. Thumbs up actually takes some effort and thinking, like yeah this dude knows what hes talking about. In terms of that, I would love to give a thumbs up to this video, but the problem I have is the pressure I need 9.6 just seems a bit too high. I have a starting pressure of 7, with Auto Ramp starting at 8 and my range up to 12. For the past year though my 95% pressure was 9.6 so I would love to keep it as one level, but can't because of the pressure being too much. I have Dreamports and Mouth Tape.

Hot damn, you're SUPER spicy today!

You can add an extension to chrome to see the dislikes. You currenty have one dislike.

Jason your still a crackpot lol..just kidding..love your videos...

Your videos are very informative and educational, but I find the theatrical and cartoons unnecessary in dealing with serious issues. I fully understand if your aim is to make a serious disability light hearted in your videos, but as a fellow sufferer it’s not a fun ailment. And I certainly don’t think your a crackpot far from it, as most sleep labs do not give you adequate information if any at all.

Shave! Yuch...

KZfaq dropped the dislike counter because biden was getting thousands of dislikes on every video 😂😂😂