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Chip McDonald
Unread post  Post subject: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Thu Aug 09, 2018 3:10 pm

Joined: Sat Jul 28, 2018 3:32 pm
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Ok, so what I've deduced so far: different brands have different approaches to pressure relief. But while I've looked at different literature from manufacturers, it's very... non-technical.

In other words, I see references to people talking about Resmed's EPR on CPAPs, but then their APAP algorithms, both with vague allusions to "aggressiveness" and timing. I saw one person citing Phillips as being "less aggressive", and other people complaining of being woke up from some machines.

1) What are some of the basic *subjective* takes on the different brand's approaches?

2) with auto machines, do some have adaptive approaches based on anticipating timing, just reacting to pressure? I saw that Respironics I believe reacts to snoring somehow as a precursor?

3) For a company like Resmed, are they just rehashing the same algorithm for each generation? Is the S10 APAP superior to the S9 for instance?

4) How specific do the machines "adapt"? Are they modifying pressure on a millisecond scale, millisecond reaction base, X number of events across a time base?

5) Do they alter the "wave form" of the reaction - like a triangular pressure increase versus a more sine or sawtooth, or do they create a full ADSR-modified "push" of air?

6) Do they interpret the ADSR character of breathing, or just peak-peak timing?


All of this seems like a very ripe field for A.I. / machine learning, I haven't seen mention of it but... SURELY a company is working on/using ML for their auto curves?



I hope this isn't to obtuse, I'm from a musician/audio recording background and tend to want to know a bit more than just "it raises the pressure if it thinks you're having a central".


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diamaunt
Unread post  Post subject: Re: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Thu Aug 09, 2018 5:37 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Chip McDonald wrote:
Ok, so what I've deduced so far: different brands have different approaches to pressure relief. But while I've looked at different literature from manufacturers, it's very... non-technical.

In other words, I see references to people talking about Resmed's EPR on CPAPs, but then their APAP algorithms, both with vague allusions to "aggressiveness" and timing. I saw one person citing Phillips as being "less aggressive", and other people complaining of being woke up from some machines.

https://www.youtube.com/watch?v=-gie2dhqP2c
https://www.youtube.com/watch?v=4GW97Xk06N8
https://www.youtube.com/watch?v=lzCCgNLya_g

  1. Resmed is better.
  2. They react to breathing anomalies.
  3. Depends, big change between s8 and s9, mostly physical packaging changes between s9 and air10.
  4. No, nothing in your body requires that kind of response. APAPs work on minutes, though they monitor breathing waveform around 7ms. ASV machines do react breath by breath.
  5. CPAPs do neither. bilevels deliver pressure differences in different ways depending on what they're trying to do.
  6. neither, they work on the *shape* of the waveform. .

If they are, they ain't sayin.

Cpaps apaps and normal bilevels *never* raise the pressure if you're having a central.

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Chip McDonald
Unread post  Post subject: Re: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Fri Aug 10, 2018 8:52 pm

Joined: Sat Jul 28, 2018 3:32 pm
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diamaunt wrote:
  1. Resmed is better.
  2. They react to breathing anomalies.
  3. Depends, big change between s8 and s9, mostly physical packaging changes between s9 and air10.
  4. No, nothing in your body requires that kind of response. APAPs work on minutes, though they monitor breathing waveform around 7ms. ASV machines do react breath by breath.
  5. CPAPs do neither. bilevels deliver pressure differences in different ways depending on what they're trying to do.
  6. neither, they work on the *shape* of the waveform. .



Thanks for the conciseness!

Quote:
Cpaps apaps and normal bilevels *never* raise the pressure if you're having a central.



I thought the purpose of FOT as a feature was to do that, a central requires more pressure and FOT allows the apap (try) to differentiate between the two?


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diamaunt
Unread post  Post subject: Re: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Fri Aug 10, 2018 9:13 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
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Pressure Setting: 18/13-25/19

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Chip McDonald wrote:
diamaunt wrote:
Cpaps apaps and normal bilevels *never* raise the pressure if you're having a central.



I thought the purpose of FOT as a feature was to do that, a central requires more pressure and FOT allows the apap (try) to differentiate between the two?

Did you watch the videos?

Centrals don't require more pressure... more pressure can, in a minority of people, cause *more* centrals. You could have a pressure of 30cm (a few specialty machines go that high) and it wouldn't make a bit of difference when having a central.

The purpose of FOT is to try and tell whether your airway is open or closed, if it's closed, pressure gets raised after the apnea ends in order to try and prevent the airway from closing.

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Chip McDonald
Unread post  Post subject: Re: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Sat Aug 11, 2018 8:46 am

Joined: Sat Jul 28, 2018 3:32 pm
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diamaunt wrote:
Did you watch the videos?

Centrals don't require more pressure... more pressure can, in a minority of people, cause *more* centrals. You could have a pressure of 30cm (a few specialty machines go that high) and it wouldn't make a bit of difference when having a central.

The purpose of FOT is to try and tell whether your airway is open or closed, if it's closed, pressure gets raised after the apnea ends in order to try and prevent the airway from closing.


No, it was 11 last night and I was in bed - my wife has already had to sit through 10^27 apnea videos so I didn't want to disturb her, although I just watched them.

I see now, thanks, sorry for the redundancy - reading too much about what may not even matter. I don't even know if I'm having centrals, but I'm OCD, anxious and I'm literally dying waiting for my titration next week!


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diamaunt
Unread post  Post subject: Re: Breakdown of Different Brand Algorithms / Strategies?  |  Posted: Sat Aug 11, 2018 12:35 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 1804
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Chip McDonald wrote:
I'm literally dying waiting for my titration next week!

We're ALL literally dying. We've all got a fatal disease called life.

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