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pulmonary hypertension
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pulmonary hypertension

I have had sleep apnea for probably about 20 years but have only started using cpap within the last 8 months.  After 25 years of smoking I quit about 9 months ago and am concerned about COPD but my spirometry was pretty normal.  I then I learned that pulmonary hypertension is sometimes a result of sleep apnea and can have very similar symptoms to emphysema.  Would this show up on a regular chest x-ray because I had one of those not long ago?  Would this affect spirometry the same as emphysema?   If not, how would one go about getting it diagnosed?

Also, what advantages are there to using an apap over a cpap.  The cpap has not been great and based on what I've told my ENT about my troubles with it, he thinks that the apap may make the difference.

Thanks in advance for your help.
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Yes, pulmonary hypertension can occur in longstanding untreated obstructive sleep apnea, but it's rare and more common in severe cases. If you have no symptoms (like shortness of breath, leg swelling, etc.) then I would focus on treating the sleep apnea for now. The diagnosis of pulmonary hypertension is a clinical one where multiple tests such as EKG, echocardiogram, CXR, and others may be used alone or in combination. Talk to your doctor about it if you're still concerned.

As for aPAP vs. CPAP, it's not a matter of which is better, but which is the right one for your needs. The vast majority of people are able to use CPAP without any problems. It really depends on the specific problems you are having with your CPAP. You should address all these issues first before trying a fancier, more sophisticated xPAP model. Ultimately, the only way to know is to try it. There is some concern that the aPAPs may undertitrate your pressures.
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