Sell more machines. There is a shortage of sleep docs, so the auto titrating machine was introduced to get primary care docs involved. Seems so easy, set a pressure window and let the machine adjust based upon how you are doing. Wrong.

APAPs are reactive, so you have an event and the pressure increases. Then over 30 min or so without an event the pressure will decrease, until you have another event, and it will increase. Why let your body have those events in the first place? Set the pressure needed to resolve the events.

This also doesn't take into account that APAPs suck at identifying hypopneas and RERAs. Your machine might be saying "hey, you are amazing" and you feel like crap because you are having a bunch of events that the machine missed.

Getting your machine dialed in on the setting needed to resolve events and allow you to tolerate the pressure should be the goal, not let the lazy machine try to respond.