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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
tomandlu
 
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meaning of Intellipap settings?

Postby tomandlu on Sat Oct 31, 2009 2:21 pm

I am wondering if anyone knows what the 'default' apnea and hypoapnea settings in the clinician's menu are for the Devilbiss Intellipap? Or, is there a document somewhere that explains these settings? Thanks.

I've been using an Intellipap for 4 months, and early on had HUGE improvement. Last few weeks I have been SO tired and sleepy, both when I wake up and in the middle of the day - just like before I was on my APAP. Getting in to see the sleep doctor is a 6+ month waiting list... :-( I bought the smartlink software but have not learned much from it - like this morning, as tired as I can remember being in months, and it only recorded a few hypoapnea events last night, and never increased pressure (setting the Dr. put me on is 5 cm min and 12 cm max; A few weeks ago when I got the software I bumped up the max to 15 cm because I've seen e or 4 nights a week where my max pressure ended up being >13.9). If I run w/the minimum setting the Dr. put me at (5 cm) it almost never responds; if I set it to a minimum of 6.5 cm, I get many more events and higher pressures during the night. Does this make sense to anyone? Suggestions?

_________________
Machine: IntelliPAP AutoAdjust Travel CPAP Machine with SmartFlex
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: IntelliPAP Integrated Heated Humidifier
Software: SmartLink Version 2 Software
Additional Comments: Rotate between a full mask, nasal mask and Swift-FX nasal pillows.

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katcw
 
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Re: meaning of Intellipap settings?

Postby katcw on Sat Oct 31, 2009 2:32 pm

Maybe it isn't the CPAP treatment that's getting you -- have you increased your carbohydrate intake lately? If I eat too much rice or pasta or something, it puts me right to sleep! :wink:

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timbalionguy
 
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Re: meaning of Intellipap settings?

Postby timbalionguy on Sat Oct 31, 2009 4:58 pm

The IntelliPAP has some interesting algorithms that are not well understood by users. I am wondering if the pressure your doctor might have given you is much lower than it should be. 5 cm/H2O is pretty low pressure, and it may be tha machine cannot accurately sense events at such a low pressure. But when you get just a little higher-- 6.5 cm, the machine suddenly 'comes to life'.

Since you seem to be the adventurous type, and higher pressures do not seem (from what you have written) to cause you distress, try a minimum setting of 8 cm. I bet you see improvement over 6.5 cm. If 8 cm works better, try raising it minimum pressure to 10 cm. The only caveat here is make your adjustments fairly slowly and gradually. Stop if you you see your AHI consistently below 5, or you see a sharp increase in NRI that lasts for more than a couple days (indicitave of pressure induced central apneas).

I also think you will find as you get closer to your 'titrated pressure', you will see the 'runaway pressure' thing less and less.

These are my experiences. Your mileage may vary.

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Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Humidifier: REMstar Heated Humidifier
Additional Comments: EPAPmin: 8, EPAPmax: 14, PSmin: 0, PSmax: 15, Max pres: 30, Backup rate: Auto. Switched machines 7-10-2010
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Autopapdude
 
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Re: meaning of Intellipap settings?

Postby Autopapdude on Sat Oct 31, 2009 6:19 pm

I agree, based on my experience with the Intellipap. Originally, I had it set on 6-15. It worked very well, but my AHI wasn't as low as I wanted (it would fluctuate between 2-4, and I would have a couple of NRIs). The optimum pressure for me is 8-14, with a bit of tweaking (my doctor said go for it---her original setting was a lower starting pressure). I think the closer you bracket your titrated pressure, the better it works, given its algorithm. My sleep lab titration was 11, and I have always responded to treatment at lower levels than that for years. As soon as I bumped it to 8, it became more responsive, and now maintains 8-8.5 as the 90%ile, and occasionally, I get a 9 or 10 in one night or so. My AHI has settled in between 1-2, and I feel rested, and have no NRI events. So, it seems to like a higher "low limit."

tomandlu
 
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Re: meaning of Intellipap settings?

Postby tomandlu on Sun Nov 01, 2009 8:53 am

Thanks all for your replies. Does anyone know how the settings (in the clinician's menu) - Apnea%, Apnea duration, Hypoapnea % and Hypoapnea duration? And, what the 'default' settings are?

Background: I never had a titration study. The night I did my study I didn't get into the 'interesting stuff' until after 2 am, at which point they wouldn't wake me up to put me the CPAP. In the morning the DR came in and said I should be good to go on an APAP, with settings 5cm min and 12cm max. When I had my two month appointment I didn't get any of my questions or concerns addressed as the PA said his only job was verify compliance for insurance. I've tried to get back in to see the DR and it is a 6 month wait. The DME vendor is neither knowledgeable or helpful.

My apnea%, duration, hypoapnea% and duration are all set to the max in their range - given that I doubt those settings are default. I would like understand how the affect the algorithm. Any info anyone has (or a link to the clinician's manual!) is greatly appreciated.

Thanks,

Luanne

_________________
Machine: IntelliPAP AutoAdjust Travel CPAP Machine with SmartFlex
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: IntelliPAP Integrated Heated Humidifier
Software: SmartLink Version 2 Software
Additional Comments: Rotate between a full mask, nasal mask and Swift-FX nasal pillows.

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ozij
 
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Re: meaning of Intellipap settings?

Postby ozij on Sun Nov 01, 2009 11:01 am

Advanced Submenu
Apnea %
The absolute value below which the respiratory flow must fall to be considered as an apnea.
Range: 0-20%, increments of 5.
Default: 10%
Apnea Duration
The number of seconds the respiratory flow must remain below the apnea percent to be detected as an apnea.
Range: 6-150 seconds, increments of 2
Default: 10 seconds
Hypopnea %The percent which the respiratory flow must fall from its normal value to be considered as a hypopnea.
Range: 30%-70%, increments of 5
50%
Hypopnea DurationThe number of seconds the respiratory flow must remain below the hypopnea percent to be detected as a hypopnea. Range: 6-150 seconds, increments of 2
Default:10 seconds


Any change of Apnea % from 10% towards 50 will only affect the relative numbers of apneas vs hypopneas recorded. It will have no effect on the way therapy is given, the algorithm responds to both apneas and hypopneas in the exactly the same way. Note that apneas are defined as The absolute value below which whereas hypopneas are measured from the opposite side of the scale, by fall from the normal value. An apnea will be considered an apnea on this machine only if the respiratory flow falls more than 90% from the normal.

If you want to make the machine twitchier you have to make the "fall from normal" for hypopneas smaller. By telling the machine to start responding at e.g. a 30% fall from normal (that's the most responsive), and not wait till the fall is 50% you make it very twitchy. (And I don't recommend changing the sensitivity at all -- let alone making large changes --unless you really really know what you're doing).

I doubt your time for events is at the end of its ranges -- (note the numbers) and I would be even more careful about fiddling with that.

O.

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Machine: S9 AutoSet™ CPAP Machine
Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Software: Updated version of ResScan. First machine (5 years) was PB420E. Tried others including Autoset S8 II
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tomandlu
 
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Re: meaning of Intellipap settings?

Postby tomandlu on Mon Nov 02, 2009 8:21 am

Thanks for the information O!

>I doubt your time for events is at the end of its ranges -- (note the numbers) and I would be even more careful about fiddling with that.
And yes, you are right - my settings are not all at their max; they are (were):
Apnea% - 20%
Apnea Duration - 30s
Hypopnea% - 70%
Hypopnea Duration - 60s

I changed the settings to all-default last night, and perhaps it is only the placebo effect, or my hopefulness, but I feel less tired this morning. Please don't misunderstand - when I started my APAP therapy I found HUGE, GIA-NORMOUS improvement from the very first morning after use. I was absolutely amazed at how much more rested, less tired, less sleepy I was... I quit having 'dreams' with my eyes open. It has just been for the past few weeks or month that I would say... I haven't felt as rested as I think I could be.

Again, thanks for the help on understanding the settings.

Luanne

_________________
Machine: IntelliPAP AutoAdjust Travel CPAP Machine with SmartFlex
Mask: Quattro™ FX Full Face CPAP Mask with Headgear
Humidifier: IntelliPAP Integrated Heated Humidifier
Software: SmartLink Version 2 Software
Additional Comments: Rotate between a full mask, nasal mask and Swift-FX nasal pillows.


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