Thoughts about the future of wide open 4–20 setting/detecting optimal APAP pressure

[palerider]

Hah! Too Funny, you actually took the bait and had to try to prove your AHI is lower than mine! What a putz, you've been pwned!!

Perhaps you should stick to things you're competent at, like designing battery backup systems, and leave the lame attempts at insults to people that don't actually have any talent, because you're not very good at coming up with a creative insult.

You're right - you are the master of the lame insult!

If you actually had any *experience* with more than one brand of machine, then your opinion about which machine was better might be worth considering.

Don't try to help people treat their apnea. Leave that to people who have *experience*, not just opinion.

Stick to what you know...

batteries.

I'm happy to defer to your knowledge about how to set up a battery backup system on a boat, or a house, to be prepared for extended power outages.

[CapnLoki]

If you actually had any *experience* with more than one brand of machine, then your opinion about which machine was better might be worth considering.

There you go with your lack of understanding - I never said one machine was better that another. I merely suggested that the different properties might mean that one machine was not the best for everyone, all the time and that this might be worse for the large number of users who aren't getting help from the forums. In particular, does an aggressive algorithm cause some people to give up? I posted a link to a paper that clearly supports my claim the some machines "overshoot" but you haven't commented on that at all.

You seem to think this insults your manhood and you had to post your chart to prove "yours is better than mine." In fact, that would be a bad night for me, so does that mean my DreamStation is three times better than your S9?

[Pugsy]

Come on guys....do I need to put you two in a boxing ring and let you duke it out with me being the referee?

Please don't make me have to get the dreaded ruler out and start slapping hands..

Please try to tone down the heat in the "heated" discussions...thank you. A little heat is one thing but starting a raging wild fire is another. I am starting to feel more heat than I am comfortable feeling.

[palerider]

If you actually had any *experience* with more than one brand of machine, then your opinion about which machine was better might be worth considering.

There you go with your lack of understanding - I never said one machine was better that another. I merely suggested that the different properties might mean that one machine was not the best for everyone, all the time and that this might be worse for the large number of users who aren't getting help from the forums. In particular, does an aggressive algorithm cause some people to give up? I posted a link to a paper that clearly supports my claim the some machines "overshoot" but you haven't commented on that at all.

Actually, I did, you're making up all the alleged deficits you keep trumpeting. Just there's no mention your other allegations, there's no mention of 'overshoot' in the paper.

What there *IS* mention of is that the Respironics machine *DID NOT ACHIEVE ADEQUATE PRESSURE TO ALLEVIATE BREATHING ISSUES*. Why aren't you harping on a real fact?

More than five residual obstructive events per hour were observed with devices B, D, F and G. Breathing normalisation (defined as the avoidance of any obstructive event: apnoea, hypopnoea or flow limitation) was only achieved with the A1, A2 and C devices.

A1: AirSense 10, standard setting;
A2: AirSense 10, response setting;
B: Dreamstar;
C: Icon;
D: Resmart;
E: Somnobalance;
F: System One;
G: XT-Auto.

So, it *directly states* that the Dreamstar, Resmart, System One and XT-Auto failed to reduce AHI below a level of 5, and that only the Airsense 10 and Icon actually normalized breathing.

I see no reason to comment further on your nonsense.

You seem to think this insults your manhood and you had to post your chart to prove "yours is better than mine." I fact, that would be a bad night for me, so does that mean my DreamStation is three times better than your S9?

Nope, you implied that my therapy was substandard, I simply pointed out that you're full of crap.

It had nothing go do with what you allege yours is, that 'competition' is purely in your mind.

[Gryphon]

My personal preference... I have no detailed data to back it up, is that I prefer the "Feel" of the ResMed product. Both with the CPAP, APAP, and now my Bi-level, the shifts from inhale to exhale feel more natural and to my liking then my experiences with Resperonics equipment.

My first machine ever was a resperonics that I used for years, and My second In-lab test like 3 years ago was with a Resperonics machine controlled by the sleep tech and the shift from inhale to exhale was driving me nuts with that machine. I didn't know anything about "Ti-Min and Ti-Max" settings at the time, or even if the in lab tech could have changed them so I could finally fall asleep with out the machine jarring me awake with pressure changes mid-inhale. My AirCurve lets me adjust those settings and I'm all the more happy for it now that I know what they do.

Now... I understand that the Dream Station systems allow for Direct DC power connection, which when running the machine off of a battery would be a vastly superior setup from a power management standpoint. If I had to build out a "SHTF" set up, or something for back woods camping, I would have to deal with my dislike for the breathing algorithms of the Dreamstation and use it, as the ResMed would use up too much power. Though I don't think that "Power Use" equals pressure... I just think it uses up more power because it can't support DC input with out some sort of converter which wastes energy.

If one machine is better then the other when it comes to use at home? Meh. I'd rather keep my AirCurve and be happy.

In answer to the original question... I think a machine that see's a constant jump from 4 initial pressure to say 10... night after night after night... would be really stupid for it not to at least start at like 2 under average.... or at least give you the option to allow for that sort of "Smart adaptive change" I don't want my machine to think for me, but there lots of people out there who don't know any better and have lazy doc's who get sent home with machines given to them right out of the box with no settings or optimization at all. They think the Magic Auto Fairy will make everything right with the world and then don't follow up to find out that 4-20 is not working for a lot of people, which means the machine is making them feel like crap, which is the opposite effect we want and they give up in frustration and throw the thing in the back of a closet to rot.

I'm all for smarter things... just so long as it still has a steering wheel I can grab hold of and use when I think I need to, if I chose to educate my self and take hold of that steering wheel. I feel as though I should always have that right, and would be against a smart machine that "Did everything for me, hidden in mystery" as long as I know what it's doing and why, and can change what it does based on my understanding of what I need, I'm happy.

Rest well,

Gryphon