CPAP machine with built-in filtration

[Goofproof]

We breath dirty air all day long, that's true but many of us have congestion, especially at night. By having HEPA filters installed on the inlet side, the whole air circuit would be protected and maybe our congestion would be lessened. Oversizing the filter would cut down on fooling with the machine maintenance. Jim

[lindalq]

Btw Linda, Remstar auto may still be used by people (mine's my backup), but it's no longer carried by major dealers and doesn't have a lot of features newer machines do. It was called the "Tank" because it was reliable, did a good job, etc. etc. but is too large.

I was definitely surprised that you're unfamiliar with 'data' as it's the #1 desirable (well, maybe after the 'right' mask) feature of new machines. The PR S1 and S9 Autoset (Resmed) are state of the art in that respect. Go to the lightbulb at the top of these pgs you can read all about data, not the least of which is the latest build by 'Jedimark', a member here who wrote a really good program called Sleepyhead... that even has a Mac version - something the previous ones did not. Go to Pugsy and look under her notes for links to it.

Data tells us how long we slept, how many Apneas and/or Hypopneas we had overnight ("AHI"), how many and what type of leaks occurred, what flow rates were, if we snored, and a whole bunch of other stuff. Very cool!

Hi Julie,

Thank you so much for letting us know about REMstar Auto. We did not know that RESmed was going out of style. Was the main reason for not using Remstar auto because of its size? Are there any other reasons? The REMstar Auto seems like it have cool functions such as heated humidifier tubing, A-flex, ramp features and lots of other cool ones too.

When we asked for three major considerations when purchasing, a lot of people put data as one. However, they never clarified what data they wanted. Thank you for clarifying that. Perhaps you could answer some of our other questions/uncertainties regarding this:
- We thought only the physicians have access to these data, but from Pugsy's post, it seems like the Sleepyhead software allows users to see it too. It seems that Sleepyhead work with PR system one Remstar auto. Would this be correct?
- Just out of curiosity, what benefits are achieved by seeing these sleep data? Other than learning more about their own sleeping patterns. It seems like only physicians can change the therapy, or would we be wrong to assume this?

Thanks!

[lindalq]

You wanted an idea – well here is one – from another thread here:

If you can look up the vent rate for your mask and note the pressure used to determine that rate - then calculate the vent rate at your current pressure. What is the result?

At night my the amount of air I use averages some 6.5 liters per minute. However, a portion of my exhale will often reach over thirty liters per minute. If my vent rate is say 20 liters per minute then for a very short time air is being pushed back down the pipe. But then as I continue to exhale at a lower rate the air goes out the vent before inhale begins.

CO2 when increased in the blood tends to open up circulation. While part of me looks at the potential for a very low vent rate to not clear as much CO2 in the process of breathing with the mask and that the body would respond by increasing respiration which would make for a higher amount of not clearing CO2 at the same time the increased circulation tends to calm things down when in comes to breathing control so it would seem that a reasonable equilibrium might be found.

With EERS[1] the last bit of air exhaled becomes the first bit of air inhaled and the amount is consistent breath to breath. This tends to prevent hypocapnia during times of high air use (over breathing). But I suppose if the actual vent rate is too low it is possible that you could end up breathing a whole lot more resulting in a very large portion of the air being rebreathed. If that were the case simply making a bigger vent port would easily solve the problem.

[1]: Gilmartin G, McGeehan B, Vigneault K, Daly RW, Manento M, Weiss JW, Thomas RJ.
Treatment of positive airway pressure treatment-associated respiratory instability with enhanced expiratory rebreathing space (EERS).
Source: J Clin Sleep Med. 2010 Dec 15;6(6):529-38. Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Link: http://www.ncbi.nlm.nih.gov/pubmed/21206741


Ya know this suggest a potential vent system that could help many who intermittently over breath, which is suspect is all of us. Two vents. A small one near the entrance of the mask and a large one say some 150ml to 250ml or so down stream. So when the person is breathing quietly as one would expect at rest in bed there would be no rebreathed air. But if the persons breathing rose toward points where one could predict that hypocapnia would be a result the amount of rebreathed air would increase – to a point.

I think this could very much increase ventilatory stability while using CPAP.

I think that ventilatory instability is the greatest cause of people giving up on CPAP.

Hmm, interesting idea. We will definitely look into this. Thank you Todzo!

[lindalq]

Hi bwexler,

Thank you for your inputs.

The data we look at with Sleepyhead shows a series of graphs for the length of time we slept with events disbursed along the time line as the occurred. The current display technology simply provides an average over the full length of sleep. By looking at how the events were clustered or disbursed we can correlate them to arrousals for bathroom breaks or other events as well as pressure variations so we can fine tune machine settings.

How much can you fine tune the machine settings? Maybe we understood this wrong, but it seems like only physicians can change the settings on the CPAP machines. Would this be wrong?

Also, what do you think of additionally incorporating a LCD screen that allows you to quickly view/scan your previous night's sleep pattern the next morning?

[Goofproof]

The benefits of having full data from a xpap machine is about the same as having a steering wheel included when you buy a car. Both allow you to steer your purchace where you need to go.

When's the last time you bought a new car that had no steering wheel and was factory set to only make right turns. Most xpap users are smart enough to drive, they want the steering wheel they over paid for. Jim

I think this lindalq troll has gone far enough, no one with avg intelligence, can be this poorly informed. Leg pulling over.

[lindalq]

Hi Jim

We breath dirty air all day long, that's true but many of us have congestion, especially at night. By having HEPA filters installed on the inlet side, the whole air circuit would be protected and maybe our congestion would be lessened. Oversizing the filter would cut down on fooling with the machine maintenance. Jim

So just to confirm, you're saying that by having an inlet filter, it might mitigation the congestion that commonly occurs in people using CPAP?

What do you mean by oversizing the filter would cut down on machine maintenance? Is there currently a problem with the machine maintenance due to the dirty air??

[Todzo]

SleepyHead is open source and I believe new developers would be welcome. I would like to see the outputs consolidated into an indication of obstructive vs breathing stability related events. That would take some true system development. If you have some math and SW people you are in.

[Goofproof]

Yes, Yes, changing the filter every 3 weeks and washing the outer filter is a little much, how would you like to do that to your furnace, a/c, engine on your car.

[lindalq]

The benefits of having full data from a xpap machine is about the same as having a steering wheel included when you buy a car. Both allow you to steer your purchace where you need to go.

When's the last time you bought a new car that had no steering wheel and was factory set to only make right turns. Most xpap users are smart enough to drive, they want the steering wheel they over paid for. Jim

I think this lindalq troll has gone far enough, no one with avg intelligence, can be this poorly informed. Leg pulling over.

But who's in the driver seat? your doctor or yourself? When we looked into the video tutorial for REMstar auto, it mentioned that users bring the SD card to their physicians, and we assumed that only physicians have access to these data and the video mentioned about only the physician is allowed to change the data. From your response, it seemed like this is not the case.

Apologies for being poorly informed. We are not end users and all we've been able to do is look at are the specs for the REMstar, and then brainstorm problems with it or base the problems on user feedbacks. Some of these are not common sense to us because we have never touched the machine and we can only base our response on what we learned from the web. We are sorry for asking numerous questions to you trying to understand all these features when we don't have a machine to test all these functions with. We are trying to learn something that's common sense for you, who probably have been using the machine for a few years already. Apologies again. We really are trying to learn about CPAP and finding improvements in it.

[Goofproof]

Maybe your time would be better spent, in finding something you know about, then brainstorm on it.

Like the storms that came thru here Sunday, your Brainstorm seems to be a ill wind that has blown out, thankfully causing less damage.

[lindalq]

Maybe your time would be better spent, in finding something you know about, then brainstorm on it.

Is that not why we're trying asking for user input here? Instead of just brainstorm impractical design features to implement? So should we have just gone with built-in filtration we originally brainstormed instead of some design changes we learned so far such as wireless transfer of data, better LCD display for the CPAP machine, or even improving the inflow filter you suggested?

[Todzo]

The benefits of having full data from a xpap machine is about the same as having a steering wheel included when you buy a car. Both allow you to steer your purchace where you need to go.

When's the last time you bought a new car that had no steering wheel and was factory set to only make right turns. Most xpap users are smart enough to drive, they want the steering wheel they over paid for. Jim

I think this lindalq troll has gone far enough, no one with avg intelligence, can be this poorly informed. Leg pulling over.

But who's in the driver seat? your doctor or yourself? When we looked into the video tutorial for REMstar auto, it mentioned that users bring the SD card to their physicians, and we assumed that only physicians have access to these data and the video mentioned about only the physician is allowed to change the data. From your response, it seemed like this is not the case.

Apologies for being poorly informed. We are not end users and all we've been able to do is look at are the specs for the REMstar, and then brainstorm problems with it or base the problems on user feedbacks. Some of these are not common sense to us because we have never touched the machine and we can only base our response on what we learned from the web. We are sorry for asking numerous questions to you trying to understand all these features when we don't have a machine to test all these functions with. We are trying to learn something that's common sense for you, who probably have been using the machine for a few years already. Apologies again. We really are trying to learn about CPAP and finding improvements in it.

Currently the usability numbers for CPAP (the industry uses oppressive terms such as compliance or adherence) are so low (I have seen a study as low as 17% still able to use CPAP for more than 4 hours a night at the one year mark) that there is much room for improvement. Diligent monitoring, I do believe, would catch many of the problems before they became a deal breaker for the patient.

If the patient has the right tools and is taught to use them it takes the burden off the medical care system and also helps the patient with real life feedback in much the same way that monitoring blood pressure of blood sugar do.

Many of us know that we never would have made it had we not learned to see and use our own CPAP data several times a week. It is what should be but not what currently is considerd "standard practice". This very much needs to change.

Probably some good lawyer will figure out that his or her client has OSA which was not monitored diligently, that if this had been done the deadly accident would not have happened, and the sleep clinic has deep pockets. Perhaps then things will change. Hopefully they will change much before the deadly accidents!!!!

[lindalq]

Hi Todzo,

Currently the usability numbers for CPAP (the industry uses oppressive terms such as compliance or adherence) are so low (I have seen a study as low as 17% still able to use CPAP for more than 4 hours a night at the one year mark) that there is much room for improvement. Diligent monitoring, I do believe, would catch many of the problems before they became a deal breaker for the patient.

If the patient has the right tools and is taught to use them it takes the burden off the medical care system and also helps the patient with real life feedback in much the same way that monitoring blood pressure of blood sugar do.

Many of us know that we never would have made it had we not learned to see and use our own CPAP data several times a week. It is what should be but not what currently is considerd "standard practice". This very much needs to change.

Probably some good lawyer will figure out that his or her client has OSA which was not monitored diligently, that if this had been done the deadly accident would not have happened, and the sleep clinic has deep pockets. Perhaps then things will change. Hopefully they will change much before the deadly accidents!!!!

Thank you for bringing this to our attention.

We realized that CPAP definitely have a terrible steep learning curve and we were thinking of solutions to reduce this.Thank you for bringing the usage of data as a way to increase the usability of CPAP into our perspective. Most websites only talked about different tricks for getting used to the mask.

Do you think it might have helped if the CPAP machine had a LCD that allowed you to check the previous night's sleep pattern when you wake up the next day? such as AHI or sleep quality report? Would this have assisted you in dilligent monitoring of your CPAP usage and thus provided a better learning curve?

[Todzo]

Hi Todzo,

Currently the usability numbers for CPAP (the industry uses oppressive terms such as compliance or adherence) are so low (I have seen a study as low as 17% still able to use CPAP for more than 4 hours a night at the one year mark) that there is much room for improvement. Diligent monitoring, I do believe, would catch many of the problems before they became a deal breaker for the patient.

If the patient has the right tools and is taught to use them it takes the burden off the medical care system and also helps the patient with real life feedback in much the same way that monitoring blood pressure of blood sugar do.

Many of us know that we never would have made it had we not learned to see and use our own CPAP data several times a week. It is what should be but not what currently is considerd "standard practice". This very much needs to change.

Probably some good lawyer will figure out that his or her client has OSA which was not monitored diligently, that if this had been done the deadly accident would not have happened, and the sleep clinic has deep pockets. Perhaps then things will change. Hopefully they will change much before the deadly accidents!!!!

Thank you for bringing this to our attention.

We realized that CPAP definitely have a terrible steep learning curve and we were thinking of solutions to reduce this.Thank you for bringing the usage of data as a way to increase the usability of CPAP into our perspective. Most websites only talked about different tricks for getting used to the mask.

Do you think it might have helped if the CPAP machine had a LCD that allowed you to check the previous night's sleep pattern when you wake up the next day? such as AHI or sleep quality report? Would this have assisted you in dilligent monitoring of your CPAP usage and thus provided a better learning curve?

If the software were made to analyze what happened in the night and flag events that look harmful - notify the patient, the sleep clinic, the doctor, the visiting nurse - as appropriate - well - you have someting the entire industry needs about twenty years ago. A worthy goal I should think!!!

[knightlite]

Improving the options on cpaps -- make all lights user controlled, make humidity setting lockouts.
I constantly hit the dial on my resperonics when turning on/off , I would like to disable the dial setting.
Make an optional low water alarm light .
People with allergys might benefit from having a super air cleaner on their intake .
Some people go thru a tub of water in a night , can you make a auto top up unit that would last several days-up to 4 or so , even a tube to go into a gallon of distilled water .. A better check valve to stop reverse water flow into blower unit would be nice .
Give me a usb connector so my lap top will be my big screen and let me do my settings from there , let me download right there or have wifi input .
In the future== a blood o2 reading , blood sugar reading . Many diabetics go too low at night and they need an alarm or pump turn on . All this depends on new tech readings from a device that will be accurate and stay put each night. Low o2 could bring on external oxygen .
I feel that any machine that is attached to you for 8 hours a day has the potential to be ungraded to do all kinds of monitoring for health problems --all that is needed is the easy non invasive probes that will be developed . Certainly wifi heart monitoring is one of them . With the immense amount of digital storage coming along a doctor could zoom thru your unit and pickup many clues about your health problems . I could even envision a unit to electrically de-stimulate your brain to stop insomnia.
Much of this will be driven to reduce medical costs at expensive facility's . If we survive ACA.