IntelliPAP Auto 19, M Series Auto A-Flex 11

[BrianD]

Hi All,

I rarely post to these boards but read them regularly. I find them extremely valuable as I have been disillusioned by the accepted traditional system. Don't get me wrong. I really like my sleep doctor and speak with him regularly. But the system around the treatment is somewhat broken for some and boards like this allow people to share ideas and learn from each others collective experience. Kudos to DeVilbiss for their active and direct approach. Just in principle, I want to go out in the future and purchase their machine to support their enlightened approach. Although, I would probably wait a bit until all the constructive feedback has been addressed.

All of the other companies out their should be following suit in a similar fashion to DeVilbiss, instead of being worried about the potential liability of talking with patients directly. Companies need to realize and accept that ultimately we (the patients) are the customer and that they must communicate with us in a two way exchange of knowledge and experience.

BrianD

[bonjour]

well I just pulled the trigger on the IntelliPAP Auto, in part based on the challange, and what was said here.
Having been titrated twice ay 19cm I wanted SW that can detect events. I was debating between the RemStar m-series and this and the kicker was that the vendor actually reads and responds here. I should have it Friday.

Fred

[dieselgal]

Bonjour I think you will be happy with your Intellipap. I started using mine during the trial and have not gone back to my auto. In fact I was just thinking the other day that if something were to happen to mine I would absolutely go for it again. Something about it just fits so well with my breathing.
Good luck and I hope you come back and give us a glowing report!

[mindy]

I'm curious - has anybody who has used the Intellipap been at a pressure that high (19)?

Mindy

[Guest]

what a scientific, fact-based comparison this was.....NOT.
I'd like to see what clinical proof Devilbiss has? So basically the presumption is that a doctor will prescribe this unit based on subjective noise levels??? Come on. I can't believe they are getting you guys to drink their Kool-Aid.

[bonjour]

I love it (NOT) when someone posts a negative comment as "guest" so we have no idea.

Fred

[mindy]

I love it (NOT) when someone posts a negative comment as "guest" so we have no idea.

Fred

Unfortunately it's not uncommon. I'm finding that ignoring comments like that is the easiest way to avoid high blood pressure!

Mindy

[Guest]

ignoring comments like what? I['m simply asking for the clinical proof that supports the IntelliPAP's auto algorithm. Show me something that proves a DOCTOR would recommend this product. It's nice that a few users find it to be a good product and enjoy the color or ease of cleaning..... That's great. Unfortunately, this is a medical device where you should base your decision on fact and efficacy of treatment.

[-SWS]

ignoring comments like what? I['m simply asking for the clinical proof that supports the IntelliPAP's auto algorithm.

FDA approval supports the IntelliPAP AutoAdjust and its algorithm as a medical device. And the FDA requires clinical proof for all approved medical devices.

Show me something that proves a DOCTOR would recommend this product.

We have countless instances on the message boards of doctor-recommended PAP modalities, settings, and even machine types/models being either suboptimal or completely wrong. So that begs the question how doctor recommendation of an FDA-approved medical device impacts what just occurred with this focus panel: people favorably measuring their AHI and performing subjective quality-of-sleep assessments (as well as providing other useful feedback that is not so directly related to efficacy).

By the way, the medical community has always relied very heavily on subjective quality-of-sleep evaluations. That includes subjective following-day wakefulness, energy, and even cognition-based assessments. Those same types of patient-provided subjective evaluations proved very useful here IMO. And, in fact, one product-challenge participant resumed his previous M-Series treatment based solely on his own subjective daytime assessments. So you can clearly see that same type of subjective-assessment criteria at work even with this highly informal panel of product-challenge participants.

That's great. Unfortunately, this is a medical device where you should base your decision on fact and efficacy of treatment.

Well, as already mentioned, the central fact pertaining to your first objection is that this algorithm is FDA approved as a viable medical device. And these participants assessed their efficacy via those two important measures---residual AHI and subjective quality-of-sleep assessments.

Here's a 2006 study that found AutoAdjust to be just as empirically efficacious as CPAP, but subjectively preferred by participants:
http://www.chestjournal.org/content/129/3/638.full

All in all, I think the above product challenge managed to convey highly useful information. The documented anecdotal comparisons gave people an idea that this FDA-approved product is not at all a dud. And it also let us know that a good percentage of people in this limited-scope survey actually preferred the AutoAdjust over their previous M-Series model.

[SleeplessInNyack]

About the data reports...

It's been mentioned by several people that the Intellipap's data report is not as detailed as the Resmed's report. Can someone specify what data elements are lacking and how critical are those to reviewing the effectiveness of the therapy?

I don't have the Intellipap data module yet, I've been using the free SmartCode, which gives a basic report online, until I get the full data module.

If the Resmed does offer critical analysis that the Intellipap does not, I think it would be helpful to be specific, so Devilbiss can get to work.

[yardbird]

Let's see...

I see apneas, hypopneas, snores, EPI (exhalation puff index.... when the machine feels as though you've breathed in through your nose and out through your mouth), and Non-responsives.

I see my 2pressure lines (both max pressure and avg pressure), and leak line.

In the summary is AHI, AI, HI, tidal volume, time in max leak, and more (doing this from memory... I'm at work)....

I've used both the Encore Pro and now the SmartLink software. I haven't noticed anything missing from SmartLink that I had in Encore Pro. And the SmartLink is much easier to use.

I have not used Encore Viewer. If you search through my posts.... I think First Night with Hybrid ..... somewhere there's a link to one of my reports in pdf format. I'm pretty happy with this machine (the Intellipap)

[SleeplessInNyack]

Thanks for the details yardbird...

I ordered the module today to see what's going on; I'm in my week 5 and I've yet to have a good nights sleep; I've tried my titrated pressure (12), tried auto ranges around, above, below. No matter what I don't get a low AHI (<=5). I've got four masks. I think my next step is the full data report, see if there's leaking going on that I don't realize. I'm hoping I picked the right machine for me... as someone else said, too many variables.

Let's see...

I see apneas, hypopneas, snores, EPI (exhalation puff index.... when the machine feels as though you've breathed in through your nose and out through your mouth), and Non-responsives.

I see my 2pressure lines (both max pressure and avg pressure), and leak line.

In the summary is AHI, AI, HI, tidal volume, time in max leak, and more (doing this from memory... I'm at work)....

I've used both the Encore Pro and now the SmartLink software. I haven't noticed anything missing from SmartLink that I had in Encore Pro. And the SmartLink is much easier to use.

I have not used Encore Viewer. If you search through my posts.... I think First Night with Hybrid ..... somewhere there's a link to one of my reports in pdf format. I'm pretty happy with this machine (the Intellipap)

[yardbird]

Thanks for the details yardbird...

I ordered the module today to see what's going on; I'm in my week 5 and I've yet to have a good nights sleep; I've tried my titrated pressure (12), tried auto ranges around, above, below. No matter what I don't get a low AHI (<=5). I've got four masks. I think my next step is the full data report, see if there's leaking going on that I don't realize. I'm hoping I picked the right machine for me... as someone else said, too many variables.

Just from my own experience, I am seeing the lowest leaks using my SwiftLT or the ComfortLite2. But the data report will show you if you have issues with leaks. With the nasal pillow masks (and, I'm assuming, the regular nasal masks) the EPI number will tell you if you're puffing out of your mouth. That's really the only leak issue I ever have with the SwiftLT. The report will also show if your AHI is what it is due to apneas or hypopneas. I have many nights with zero apneas, but several hypopneas recorded. It bothered me to have so many hypops and not know what it was doing to my oxygen levels. So I bought an inexpensive recording pulse oximeter (the CS50E you may have seen many talking about... $139 on line) and found that apparently the hypopneas were having virtually no effect at all on my oxygen levels. So from a reporting aspect, yes, I'll still try things to see if I can get the hypopnea count down. But from a health aspect, I'm not "chasing the numbers" because they don't appear to be a health risk... at least at this time. AHI below 5 is great. But if my AHI is 6 or 7 or 8 and it's entirely made up of reported hypopnea events that are having no effect on my oxygen levels, then I'm not going to panic about it. I'll just keep working at finding places I can make improvements.

[SleeplessInNyack]

Just from my own experience, I am seeing the lowest leaks using my SwiftLT or the ComfortLite2. But the data report will show you if you have issues with leaks. With the nasal pillow masks (and, I'm assuming, the regular nasal masks) the EPI number will tell you if you're puffing out of your mouth. That's really the only leak issue I ever have with the SwiftLT. The report will also show if your AHI is what it is due to apneas or hypopneas. I have many nights with zero apneas, but several hypopneas recorded. It bothered me to have so many hypops and not know what it was doing to my oxygen levels. So I bought an inexpensive recording pulse oximeter (the CS50E you may have seen many talking about... $139 on line) and found that apparently the hypopneas were having virtually no effect at all on my oxygen levels. So from a reporting aspect, yes, I'll still try things to see if I can get the hypopnea count down. But from a health aspect, I'm not "chasing the numbers" because they don't appear to be a health risk... at least at this time. AHI below 5 is great. But if my AHI is 6 or 7 or 8 and it's entirely made up of reported hypopnea events that are having no effect on my oxygen levels, then I'm not going to panic about it. I'll just keep working at finding places I can make improvements.

That's the data I need, AI and HI; The SmartCode only shows AHI for a given session. I've been switching from the Swift LT, to the Swift II, to a Breeze mask, but I do need the detailed report to see how they fare. I don't want to chase numbers either, I just want to use them to get to the point where I sleep through the night and wake up relatively refreshed.

[-SWS]

This information seems somewhat related to this thread as well:

Very interesting talks, you have to register, but they're free.
And despite being from Devilbiss, they contain enough general information about autos to be worthwhile for anyone who wants to learm more.

Sound quality on my laptop was horrendous.

http://www.devilbissclinicaleducation.com

“Autotitrating CPAP: Theory and Practical Aspects”

“Autotitirating CPAP: Interpreting Studies”

The Devilbiss autoadjust algorithm:
Does not use flow limitations (if I heard properly)
And: Treats a 95% reduction in air flow as a central apnea. An obsturctive, according to Devilbiss is 90% reduction (both 10 seconds). Consequently, pressure will not be raised in response to 95% (or more) reductions.