pressure not changing

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: pressure not changing

Post by palerider » Wed Sep 25, 2019 4:22 pm

biomed wrote:
Wed Sep 25, 2019 4:09 pm
palerider wrote:
Wed Sep 25, 2019 8:28 am
biomed wrote:
Wed Sep 25, 2019 7:56 am
palerider wrote:
Wed Sep 18, 2019 2:39 pm
Dog Slobber wrote:
Wed Sep 18, 2019 10:59 am


Breath-assist therapy??????
Some people have trouble with words, don't make fun of their disabilities.
"Breath assist" was the first description that came to mind. I believe if you Wikipedia under "CPAP", it, or a similar term, was used by the author, who appears to have the same verbal handicap.
Nope. Unless by "similar" you mean 'completely different'.

Also, the wikipedia article for cpap is utter crap.
Does anything please you?
Accuracy, truth, facts.

You should try it sometime.

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biomed
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Re: pressure not changing

Post by biomed » Wed Sep 25, 2019 4:58 pm

ragtopcircus wrote:
Tue Sep 24, 2019 6:50 pm
Btw, the EPAP waveform reported by the current released version of Oscar is incorrect for PR Dreamstation CPAP/APAP. It is reportedly the rolling average pressure over a 2 minute pressure. It is not EPAP. I don’t know whether that is the average commanded pressure or measured. The IPAP waveform appears to be, as already discussed, the commanded therapy pressure, not the actual pressure.
Thanks. That makes a lot of sense. I'd expect a rolling 2 minute average of actual breath-by-breath pressure to be fairly smooth. Of course, it depends if it's a rolling algebraic average or a rolling exponential average, like something time-averaged through a Resistor & Capacitor network.

I tend to freakishly use geometric means [ sqrt (A x B x C x D) ] instead of algebraic means [ (A + B + C + D)/4 ]. Can't tell the difference between mean and average values. I guess that's why I could never be a statistician.

You sound like a hardware or military techie, using "commanded" instead of "desired" or "programmed". I do the same.

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biomed
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Re: pressure not changing

Post by biomed » Wed Sep 25, 2019 5:11 pm

palerider wrote:
Wed Sep 25, 2019 4:22 pm
biomed wrote:
Wed Sep 25, 2019 4:09 pm
palerider wrote:
Wed Sep 25, 2019 8:28 am
biomed wrote:
Wed Sep 25, 2019 7:56 am
palerider wrote:
Wed Sep 18, 2019 2:39 pm

Some people have trouble with words, don't make fun of their disabilities.
"Breath assist" was the first description that came to mind. I believe if you Wikipedia under "CPAP", it, or a similar term, was used by the author, who appears to have the same verbal handicap.
Nope. Unless by "similar" you mean 'completely different'.

Also, the wikipedia article for cpap is utter crap.
Does anything please you?
Accuracy, truth, facts.

You should try it sometime.
You really do have a poor bedside manner.

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Pugsy
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Re: pressure not changing

Post by Pugsy » Wed Sep 25, 2019 5:13 pm

All right....enough with the bickering.
Get back on topic or don't say anything. Smoke is starting to come out of my ears.
Further comments that are off topic will be removed. This is the only warning.
Neither of you get the last word.....I do. :shock: :D

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biomed
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Re: pressure not changing

Post by biomed » Fri Sep 27, 2019 1:58 pm

palerider wrote:
Tue Sep 24, 2019 5:07 pm
biomed wrote:
Tue Sep 24, 2019 2:45 pm
palerider wrote:
Wed Sep 18, 2019 2:43 pm
biomed wrote:
Wed Sep 18, 2019 11:57 am
it to the sim card
One is amazed that someone who alleges to be so technical as yourself, doesn't know the difference in a SIM card and a SD card. :roll: :lol: :lol: :lol: :lol:
I'm trying to be respectful, not a smart**s. All those plug-in thingies look the same to me. The difference is - I'm a hardware "puke" who can tell you exactly what's in them.
Apparently not, if you don't know the difference in a SD card and a sim card.... given that they're completely and totally different in shape purpose and content.
biomed wrote:
Tue Sep 24, 2019 2:45 pm
I retired from a major semiconductor company that made them.
Not much rubbed off, eh?
biomed wrote:
Tue Sep 24, 2019 2:45 pm
palerider wrote:
Wed Sep 18, 2019 2:23 pm
Your allegation is inconsistent with Philips Respironics own documentation on the subject.
If you'd provide a link where Philips engineers, not sales types, document servo behavior to be significantly different from what I've casually observed, I'd be grateful.
You'll notice the pressure drop shown at settings of 1, 2, and 3. and notice, that this is a *Philips Respironics* chart.
Image
Dear palerider,

Thanks for the plots. They're exactly what I needed - much more informative than the confusing BS scribbles I've seen on YouTube.

Since my Dreamstation has no actual pressure output, I've finally resorted to a 1 millisecond Motorola piezo pressure sensor IC and oscilloscope, but it's a pain to record the data. I don't know Philips' algorithm, but it looks like back-pressure relief with an added derivative. If I'm at my prescribed 10 cm Inhale and breathe naturally, I see the the left-hand waveforms at flex 1, 2 or 3. If I'm at 3 and puff hard, as a test, the leading edge momentarily dips to as low as 6 cm.

Since I'm 2.5 months into my 13 month Medicare eval/rental, I've taken your sage advice and asked my DME provider for a ResMed AirStart 10 APAP. I'm glad I went that route and came to this forum, rather than simply buying something, uninformed.

Thanks again.

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palerider
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Re: pressure not changing

Post by palerider » Fri Sep 27, 2019 2:16 pm

biomed wrote:
Fri Sep 27, 2019 1:58 pm
taken your sage advice and asked my DME provider for a ResMed AirStart 10 APAP.
I have NEVER recommended an airstart machine, and I never will.

You're just not paying attention.

Once more, with feeling

Resmed AirSense 10 Autoset.

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Re: pressure not changing

Post by biomed » Fri Sep 27, 2019 11:22 pm

palerider wrote:
Fri Sep 27, 2019 2:16 pm
biomed wrote:
Fri Sep 27, 2019 1:58 pm
taken your sage advice and asked my DME provider for a ResMed AirStart 10 APAP.
I have NEVER recommended an airstart machine, and I never will.

You're just not paying attention.

Once more, with feeling

Resmed AirSense 10 Autoset.
Actually, your only advice to me was "Get a Resmed". You certainly didn't give bad advice. You simply didn't mention a model.

If my equipment choice is poor, it isn't cast in concrete. I chose the AirStart because I'm a novice and it appeared to have features and performance similar to the Dreamstation, lest I run into a brick wall like "What is this patient's medical or financial justification for the AirSense 10 Autoset?"

Remember, my DME provider and I are dealing with Medicare.

I haven't yet received a reply from my him.

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Re: pressure not changing

Post by palerider » Sat Sep 28, 2019 2:16 am

biomed wrote:
Fri Sep 27, 2019 11:22 pm

Actually, your only advice to me was "Get a Resmed". You certainly didn't give bad advice. You simply didn't mention a model.

If my equipment choice is poor, it isn't cast in concrete. I chose the AirStart because I'm a novice and it appeared to have features and performance similar to the Dreamstation, lest I run into a brick wall like "What is this patient's medical or financial justification for the AirSense 10 Autoset?"

Remember, my DME provider and I are dealing with Medicare.

I haven't yet received a reply from my him.
wiki/index.php/CPAP_models

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ragtopcircus
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Re: pressure not changing

Post by ragtopcircus » Sat Sep 28, 2019 7:57 am

biomed wrote:
Wed Sep 25, 2019 4:58 pm
ragtopcircus wrote:
Tue Sep 24, 2019 6:50 pm
Btw, the EPAP waveform reported by the current released version of Oscar is incorrect for PR Dreamstation CPAP/APAP. It is reportedly the rolling average pressure over a 2 minute pressure. It is not EPAP. I don’t know whether that is the average commanded pressure or measured. The IPAP waveform appears to be, as already discussed, the commanded therapy pressure, not the actual pressure.
Thanks. That makes a lot of sense. I'd expect a rolling 2 minute average of actual breath-by-breath pressure to be fairly smooth. Of course, it depends if it's a rolling algebraic average or a rolling exponential average, like something time-averaged through a Resistor & Capacitor network.

I tend to freakishly use geometric means [ sqrt (A x B x C x D) ] instead of algebraic means [ (A + B + C + D)/4 ]. Can't tell the difference between mean and average values. I guess that's why I could never be a statistician.

You sound like a hardware or military techie, using "commanded" instead of "desired" or "programmed". I do the same.
Yes, I am an electrical engineer with almost 30 years of product development experience, including hardware design, ASIC design/verification, and embedded firmware. I also have some amateur experience with tuning fuel-injected engines (and the difficulties of accurately characterizing complex airflow).

So yeah, I do look at this through the lens of product development and embedded control - both how they probably designed it, how I would have designed it as a commercial product, and what I would do differently for personal use.

I would love to be able to put an open-source version of the ResMed firmware on the Dreamstation hardware (possibly with a different CPU than either) and tweak a few things.

My understanding of exactly what the Dreamstation is reporting and doing for exhalation is still evolving as I study the data and filter out some misinformation.

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Re: pressure not changing

Post by ChicagoGranny » Sat Sep 28, 2019 9:15 am

biomed wrote:
Fri Sep 27, 2019 11:22 pm
If my equipment choice is poor, it isn't cast in concrete. I chose the AirStart because I'm a novice and it appeared to have features and performance similar to the Dreamstation, lest I run into a brick wall like "What is this patient's medical or financial justification for the AirSense 10 Autoset?"

Remember, my DME provider and I are dealing with Medicare.
AirStart is a bad choice. Medicare will not be a problem with regard to getting an AutoSet instead of an AirSense. Medicare pays by HCPCS code which is identical for either of those two models -
E0601 Continuous airway pressure (CPAP/APAP) device
Your DME might be a problem. Many, many DMEs are concerned with their margins over the patient's best interest. Watch out for yourself. Forum members can advise you before you take delivery of a machine.

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Re: pressure not changing

Post by biomed » Sat Sep 28, 2019 6:17 pm

ChicagoGranny wrote:
Sat Sep 28, 2019 9:15 am
biomed wrote:
Fri Sep 27, 2019 11:22 pm
If my equipment choice is poor, it isn't cast in concrete. I chose the AirStart because I'm a novice and it appeared to have features and performance similar to the Dreamstation, lest I run into a brick wall like "What is this patient's medical or financial justification for the AirSense 10 Autoset?"

Remember, my DME provider and I are dealing with Medicare.
AirStart is a bad choice. Medicare will not be a problem with regard to getting an AutoSet instead of an AirSense. Medicare pays by HCPCS code which is identical for either of those two models -
E0601 Continuous airway pressure (CPAP/APAP) device
Your DME might be a problem. Many, many DMEs are concerned with their margins over the patient's best interest. Watch out for yourself. Forum members can advise you before you take delivery of a machine.
Thanks for the input.

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palerider
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Re: pressure not changing

Post by palerider » Sat Sep 28, 2019 7:22 pm

ragtopcircus wrote:
Sat Sep 28, 2019 7:57 am
I would love to be able to put an open-source version of the ResMed firmware on the Dreamstation hardware
That would be interesting... but I'd bet you'd lose the ability to differentiate between central and obstructive apneas.

The dreamstation blower is at least twice the diameter as the Resmed one, and I don't think it'd be able to vary it's speed like the Resmed does (1cm 4hz pressure variation) to test for airway patency during an apnea.

Resmed's blower is a variable frequency three phase motor, Respironics uses a rather different system.

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