Krickets?

[Nocibur]

So, who's gonna buy a Kricket?

https://kricket.com/

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[Pugsy]

OMG it's that time already. I had heard about the KPAP last year and that it would be coming out this year.
I didn't think so soon.

We won't have any spare money to experiment with this new machine.
The bills are rolling in for hubby's heart attack and it seems I have a problem still yet as well. HGB is dropping instead of rising and that's not good. We are still sorting that out or at least trying to sort it out. They want to do another upper GI endoscope to see if the ulcer is still bleeding and I don't have that at the top of my to do list.

[Nocibur]

The bills are rolling in for hubby's heart attack and it seems I have a problem still yet as well. HGB is dropping instead of rising and that's not good. We are still sorting that out or at least trying to sort it out. They want to do another upper GI endoscope to see if the ulcer is still bleeding and I don't have that at the top of my to do list.

I think it's time for a new hobby.

So yeah, V-Com with another 3.0 cmH2O drop (in this case, @10.0 chH2O CPAP):

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[Pugsy]

I think it's time for a new hobby.

Ya think??

Now when they have a KPAP that has a button to fix my pain issues....then I might get excited.

[Nocibur]

Now when they have a KPAP that has a button to fix my ...

Ah, yes! The Magic Button!

Now while this thing looks pretty clever, if you look at their Efficacy study:

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sleep quality doesn't really change. However, their study group seemed to be (aside from OSA) normal people.

Now, if they can take a group of TWAs, with like 50% sleep efficiency, and get that up to at least 75%, then they got something.

Cause the lesson of Sleep 101 is:

CPAP discomfort is a problem only when you're awake. It makes no difference once you're asleep.

With that in mind, I think the old mantra will be updated to include:

KPAP doesn't fix bad sleep.

At any rate, won't be long till we find out!

[Nocibur]

Although y'know, there might be some good pricing when it becomes available. Just to get the word out.

[Nocibur]

I wonder if you just put 2 V-Com inline would that result in the same effect as a KPAP.

THAT would be an interesting head-to-head comparison!

Although oddly, in an interview, Dr. Noah said the V-Com 2.0 cmH2O drop represented the ideal configuration. Now it's more?

Seems to 2.0 cmH2O was a comfort measure not requiring FDA approval. More than that, different story.

Oh well, better get ready for the next "Storm of the Century".

[McSleepy]

Please indulge my ignorance (caused not by laziness or lack of fundamental knowledge, but by lack of time ), but I hope you can save me some time - as you seem to have looked deeper into this new technology - and tell me how KPAP is better than bilevel CPAP. Everything I could find is about how it uses some convoluted approach to make constant CPAP more comfortable; but how about bilevel - it's what it has already been doing for ages? If it's just a cheaper way to achieve the benefits of bilevel (likely, looking at how small the machines are), then - case closed. But when they mentioned somewhere that they "instead of using pressure as feedback" did... something else(?), it got me really excited: in order to solve the dichotomy of "high pressure needed by severe OSA + airway restrictions" versus "leaks and discomfort", the algorithms need to look at airflow (in addition to pressure), thus factoring higher vital capacities, and other differences in breathing morphology. And, yes - a more advanced algorithms that the simple bilevel "inhale - IPAP, exhale - EPAP". Otherwise this is going to be nothing more than a KPAP demon hunter.
McSleepy

[Nocibur]

... tell me how KPAP is better than bilevel CPAP...

Improves patient compliance, reduces air leaks and (maybe probably) prevents TECSA by reducing tidal volume.

[Nocibur]

But when they mentioned somewhere that they "instead of using pressure as feedback" did... something else(?), it got me really excited

You'll need to post that reference.

vital capacities, and other differences in breathing morphology.

Again, need to be more specific, as vital capacity does not have anything to do with the stuff here (maybe with restrictive lung disease, but that's not the subject matter we're dealing with).

[McSleepy]

... tell me how KPAP is better than bilevel CPAP...

Improves patient compliance, reduces air leaks and (maybe probably) prevents TECSA by reducing tidal volume.

What makes you believe that? At least to me, bilevel was a major factor in improving compliance. Why would KPAP be better?

McSleepy

[McSleepy]

But when they mentioned somewhere that they "instead of using pressure as feedback" did... something else(?), it got me really excited

You'll need to post that reference.

vital capacities, and other differences in breathing morphology.

Again, need to be more specific, as vital capacity does not have anything to do with the stuff here (maybe with restrictive lung disease, but that's not the subject matter we're dealing with).

I can't quite find the source, it was a search. The role of vital capacity has everything to do with the ability of the CPAP machine to fill the lungs to the satisfaction of the patient, and thus - compliance, and has a lot to do with UARS: regulating pressure - at the source, not the destination - is a problem for some (like me), as what only matters is the pressure at the pharynx (trying to keep it open), and the amount of air in the lungs and (especially for me) - how fast that happens. Just ask anyone with UARS. Thus, if only regulating the pressure at the output of the machine, the result would be subject to multiple factors, and for some morphologies, the difference will be significant (I understand those cases are relatively rare). This is why this news is kind of getting me excited; and while it seems like in this iteration it will not be useful to me (as their solution seems to be to reduce the pressure while inhaling!), it seems promising that someone is working on it.

McSleepy

[Nocibur]

... tell me how KPAP is better than bilevel CPAP...

Improves patient compliance, reduces air leaks and (maybe probably) prevents TECSA by reducing tidal volume.

What makes you believe that?

The data show it does.

And besides, David White supports it, and I pretty much believe anything he says.

[Nocibur]

[The role of vital capacity has everything to do with the ability of the CPAP machine to fill the lungs to the satisfaction of the patient...

No really, it doesn't. Vital Capacity consists of Expiratory Reserve, Inspiratory Reserve and Tidal Volume, and only Tidal Volume (and FRC, in a big way, which is part of why CPAP works) are involved in CPAP.

[Nocibur]

The role of vital capacity has everything to do with the ability of the CPAP machine to fill the lungs to the satisfaction of the patient, and thus - compliance, and has a lot to do with UARS: regulating pressure - at the source, not the destination - is a problem for some (like me), as what only matters is the pressure at the pharynx (trying to keep it open), and the amount of air in the lungs and (especially for me) - how fast that happens. Just ask anyone with UARS. Thus, if only regulating the pressure at the output of the machine, the result would be subject to multiple factors, and for some morphologies, the difference will be significant (I understand those cases are relatively rare). This is why this news is kind of getting me excited; and while it seems like in this iteration it will not be useful to me (as their solution seems to be to reduce the pressure while inhaling!), it seems promising that someone is working on it.

Yeah, I'm not understanding your point(s), so I can't offer much of a response other than above.