For the CPAP manufacturers – a few suggestions

[watergauge]

As an engineer, I am impressed by this discussion! I'm used to the normal exhalation noise (mask port), but not when it hits the bed sheet or pillow, but would still like to hear it less (could it exhaust further from the head?) I do not experience machine fan noise coming up the air tube, but there must be some. My machine is in a bedside cupboard on a heavy steel base, itself on a cloth pad (to cut out conducted vibration to the cabinet), so it's virtually inaudible.
Cheers,
WG

[robysue]

Before I actually tried the compressible air space which also notably reduces noise and vibration I probably would have said the same thing that you did. We tend to mask the noise that we hear all the time. It becomes “part of the background”. However I do believe it also becomes part of the stimulation of our central nervous system as well.

Todzo, I think the noise is making it difficult for us to communicate. <g>

I'm not familiar with any machine other than the ResMed S-9 I've been using for almost two years, but it does NOT make ANY noise. ...

What! Are you telling me you cannot even hear the air spewing from the vent port!!!!

Noise created by air spewing from the vent port is a mask design problem, not a machine problem.

I've used a Swift FX for over 3 1/2 years. And the exhaust flow is the MAJOR design flaw in this mask. If it's not (silently) hitting my arms and chest making me feel cold, it's blasting against the covers and making a racket that I'd swear would wake the dead. But that exhaust noise has been independent of the machine I've used and strongly dependent on where and how the mask and the bed covers are arranged with respect to each other. It got so bad in the beginning that I finally started using a homemade, unauthorized diffuser designed by another forum member here just so I could get some sleep.

Hubby's new Eson nasal mask with the built-in exhaust flow diffuser on is virtually silent no matter how close it is to bedcovers, his chest, his pillow etc. And if you put your hand even an inch or so away from the diffuser? You can't feel a cold (or hot) blast of air either. Why more masks don't have a diffuser built into the exhaust vent system to tame that noisy exhaust is beyond me. I'm really looking forward to trying out my AirFit P10 when it arrives in the mail any day now ...

[Todzo]

So soon I hope to build my first prototype CPAP muffler/Compressible air space unit. With all that nasty noise and vibration out of the way I hope to then be able to do some decent phono spirometry.

From what I have read so far it is possible to gauge air flow, airway shape and constriction, and certain aspects of airway and lung health simply by the sound of the air which moves through it.

One microphone, one airway, one other way to monitor.

[Todzo]

Unfortunately, there are too many people who want "high tech" solutions (like, "there's an app for that") for simple problems which are solvable with "low tech" solutions. Or, said another way, they don't want to try using the "gray matter" that's holding their ears apart to solve their own problems. They want others to solve it for them.


Den

.

I realy do believe that machines should serve men and not men machines. Yes I really do want my "app for that". You bet I do!!!

[Todzo]

It would also be nice to have auto-downloading to a center where the data is made available on the web to the person and doctor(s) and flagged if problems are indicated.

Better yet, if they would add a web cam, for live streaming.

So what if someone did hack my CPAP data. My bank account is still safe.

You might do well to place a bit of post it note over your computer camera and microphone, however.

[sewsleepy]

As someone who lives in a very damp climate where my hose would never dry out on it's own, I have a big suggestion: a dry cycle. If you could hit a button and the machine ran dry warm air through the tubing for say 20 minutes every morning, it would be so helpful.

[Todzo]

As someone who lives in a very damp climate where my hose would never dry out on it's own, I have a big suggestion: a dry cycle. If you could hit a button and the machine ran dry warm air through the tubing for say 20 minutes every morning, it would be so helpful.

Excellent idea!!!

[StuUnderPressure]

As someone who lives in a very damp climate where my hose would never dry out on it's own, I have a big suggestion: a dry cycle. If you could hit a button and the machine ran dry warm air through the tubing for say 20 minutes every morning, it would be so helpful.

The ResMed S9 does just that already.

It is called a "cool down" cycle, but does help in drying out the moisture in the hose.

It's length of running can be up to an hour, but I find that it generally runs 45 minutes or less - depending of course on how much cooling it has to do.

It starts automatically & shuts itself off when it is done.

[Todzo]

As someone who lives in a very damp climate where my hose would never dry out on it's own, I have a big suggestion: a dry cycle. If you could hit a button and the machine ran dry warm air through the tubing for say 20 minutes every morning, it would be so helpful.

The ResMed S9 does just that already.

It is called a "cool down" cycle, but does help in drying out the moisture in the hose.

It's length of running can be up to an hour, but I find that it generally runs 45 minutes or less - depending of course on how much cooling it has to do.

It starts automatically & shuts itself off when it is done.

Kinda sounds like cool wet air rather than warm dry air.

I would think you would need to add a heater to the circute and perhaps bypass the humidifier to obtain the desired effect. But nice to know it does that. Thanks!

[Todzo]

I use nasal pillows. They were hard to get used to.

First my nose really took about a week to get used to all the pressure in the new places.

Second, I think the fact that the actual opening into my nose was much smaller than my nose opening means the air velocity was faster and so the systems in me designed to use the feel of the air rushing past them (nose hairs and skin I suppose) took some time to re-calibrate to the new situation.

So what if we took some dental alginate mixed for face casting and indeed cast my nose area. Then use the cast to make a very accurate connection to my actual nose which covers a good portion of the nose. I think you could make the air inlet space pretty close to the nose natural inlet size normalizing air volumes in the nasal area. Making a seal would require very little physical pressure because it is already the right shape I would think. The support of the nostril outside would help keep the pressure from flaring the nostril perhaps as well.

I think the inlet to the assembly could be from both sides to reduce the hose size making the connection off face. The vent air could be routed back down by some thin tubes run along the larger inlet tubes and the actual vent outlet off bed. Comfort, easier to get used to breathing wise, no vent noise, I really gotta try this!!!

[Todzo]

From what I read dynamic CO2 therapy[2] is held back by issues of reliability in the control systems. Yes I suppose this would be hard to do.

EERS[1] tends to be hard to control. Use too much and hypercapnia is likely. Too little and apneas form.

So what if you vented at many points along the tube. Say 15 liters per minute at the 400 ml mark, then 5 liters per minute at the 300 ml mark, then 2 liters per minute at 250 ml, 200 ml, 150 ml, and 100 ml. Then 1 liter per minute at 50 ml and 0 ml. The size of the vents would be set to the CPAP pressure to be used.

One could analyze the flow wave forms of the person to determine the optimum spread of the venting process to cover the range from normal breathing (no re-breathed air or very little) to moving toward central apnea over breathing (much carbon dioxide rich re-breathed air). This spread of holes could be transferred to a flexible plastic strip and added to a small section of hose plugged into the non-venting mask.

Perhaps the vented air could be directed to a separate hose so the holes never got blocked and the vented air bothered no one.

[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

[2]: Dynamic CO2 therapy in periodic breathing: a modeling study to determine optimal timing and dosage regimes
Yoseph Mebrate, Keith Willson, Charlotte H. Manisty, Resham Baruah, Jamil Mayet, Alun D. Hughes, Kim H. Parker and Darrel P. Francis
J Appl Physiol 107:696-706, 2009. First published 23 July 2009; doi: 10.1152/japplphysiol.90308.2008
Link: http://www.ncbi.nlm.nih.gov/pubmed/19628721

[SleepingZ]

A VERY BASIC SUGGESTION

The power supply or black adapter between the little wire coming out of the Remstar and the regular wire that goes into the power outlet - well, that thing is very heavy. It reminds me of the adapter I had for my first laptop about 10 years ago.

Now, the adapter for my Macbook Air is about one-sixth the size and weight.

Respironics, get with the program and make these adapters a lot lighter, so they will be much easier to carry on vacation... After all, the price of the System One with humidifier here in Canada far exceeds the price of a great laptop!

Hoping that this issue matters to other folks too!

[SleepingZ]

One other thing: why can't manufacturers make CPAP machines look really nice. When I look at the Phillips Respironics S1 with the hose attached, I can't help but wonder if this black box thing wouldn't better belong under the hood of a car?
Wouldn't there be a way to disguise these CPAP machines into something that better suits a bedroom? In worse case scenario, come with a choice of big decals to support your favorite sports team?