What is APAP or AutoPAP?


AutoPAP – also known as “APAP”, “auto-titrating CPAP”, “auto-adjusting CPAP”, or “self-adjusting CPAP.”

A CPAP machine is set for one continuous pressure. An AutoPAP automatically adjusts, on a breath-by-breath basis, to deliver the minimum pressure needed to keep the upper airway open during sleep. This allows the device provide you with your ideal pressure over the entire night.

An AutoPAP differs from a CPAP in that an AutoPAP uses algorithms to sense subtle changes in the user’s breathing and deliver only the amount of pressure necessary to keep the airway open.

An AutoPAP automatically varies the pressure to prevent and/or correct sleep disordered breathing events – apneas, hypopneas, air flow restrictions, and snores.

Computer software is available for AutoPAP machines, which will allow a user or clinician to download the recorded data into a PC. This data can be put in report form to track treatment results.

The CPAP pressure setting determined in the sleep study may be too high once you settle into therapy.

1. In the sleep lab, you may have experienced more REM sleep (dreaming) for the first time in years, a REM rebound effect requiring a higher pressure. On PAP therapy after your sleep patterns return to a normal amount of dreaming, your pressure may be too high.

2. Untreated sleep apnea may cause swelling in the mouth and throat, requiring a higher pressure setting in the lab. After PAP treatment, the swelling may go down, requiring a lower setting.

3. If you had nasal congestion the night of your study due to allergies, a cold, chemical sensitivity, cool air, or air flow from the CPAP machine, a higher pressure setting would be required in the lab than your usual requirements.

REM (dream) sleep and sleeping on your back require higher pressure settings because of more apneaic events. If you slept poorly and didn’t experience REM or sleep on your back, the technician had to guess what settings you might need. The technician may estimate a pressure that is actually too high or too low.

It’s true that your current titrated setting, if accurate, may not require an APAP. But what about next month or next year? If your weight goes up, you will probably require a higher setting; if it goes down, a lower one. If you start feeling tired again, you may need a different pressure setting. Another sleep study is an expensive way to fine-tune pressure requirements, and has the risk of your not sleeping normally in a lab setting. With an auto-titrating machine and software in the comfort of your own home, you can determine whether the lab’s titrated pressure is indeed your best pressure, or experiment to find your best single pressure setting (for CPAP mode) or range (for APAP mode), working with your doctor.