New Intellipap First Impressions

[Slartybartfast]

I got my new Intellipap which I'll keep at my wife's place where I visit about one weekend/month.

Unpacked it and put it together. I got a Swift FX mask just to see how come it's so much more popular than the Opus 360 I got with my S9. Set it to 9 - 20 cm in automatic mode, same as my S9.

Didn't sleep very well because the pillows I chose (large) were probably too big. They tended to slide around and leaked. I had set the humidifier to 1, then later 2, and finally 3 during the night, not knowing at what point I'd start generating rainout. Woke up feeling only OK, with 4.0 AHI which is lots higher than I usually get with my S9. Because of the differences in the machines' methods of reporting, I compare AHIs generated from one machine to that from another with caution.

Second night I swapped out the large Swift FX pillows for the medium. I reset the pressure to 8 - 20 and cranked up the humidifier heat to 4. Everything worked fine and I slept like the dead. Got up and entered the smart code into the site at http://www.intellipap.com and learned that my AHI was 1.0 with one expiratory puff/hour. The S9 doesn't report expiratory puffs, by the way.

Overall impression is that the Intellipap is every bit as good at providing comfortable therapy as is the S9 Autoset. Only downside to the IPAP are the unavailability of the Climateline (Do you hear me DeVilbiss?) and the freely available software. Knowing what I know now, were I buying another machine, I'd have a really hard time deciding between the IPAP and the S9 Autoset, especially given the price difference.

Re: the masks, I don't like the Swift FX as much as the Opus 360. The Swift produces a tightly focused high-velocity jet of air through the exhaust port that makes a lot of noise if it happens to blow on a sheet, pillow case, even a blanket. The noise woke me a number of times. The Opus has a much more diffused air exhaust and doesn't cause that problem to nearly the extent that the Swift FX does. The Opus 360 also has a ball and socket connector for the air hose, providing much better freedom of movement of the hose during the night, and the headgear is more comfortable, too. Were I considering a new mask, I'd buy the Opus 360 again without hesitation. It's about $30 cheaper than the Swift FX, too.

[DocWeezy]

I'm with you about the IP....I love mine and it FEELS the same as my S9. The only down side is that I seem to have a NOISY one, so I really don't use it very often. If it weren't so noisy, I'd probably use it all the time; as it is, I just use it for travel or emergencies (easy to set up for power outages). A heated hose for it would be nice.

Weezy

[Emilia]

Glad you like it! Remember, even with the price of the software on top of the machine cost, it is still LESS than the S9. Check out the Aussie heated hose.... it will work with the IP. I have no need for it in FL, but those in other climes may want it.

[Janknitz]

OK, so what the heck is an "expiratory puff"???? And do we care?

[Bikersguide]

Hi Slartybartfast,

is the IP louder than your S9? Can you hear the Darth Vader sound with the IP?

[DocWeezy]

Hi Slartybartfast,

is the IP louder than your S9? Can you hear the Darth Vader sound with the IP?

Mine is. There is really no motor sound, but the inhale/exhale sounds are quite loud and Darth-ish. But I think I have a noisy one compared to most. If it were as quiet as my S9, I'd be using it every night.

Weezy

[Emilia]

Here is a good DeVilbiss doc with definitions of all types of events: http://www.devilbisshealthcare.com/file ... T-2089.pdf

The IP's noise level is the next to the quietest on the market... only the S9 is quieter. Mine is just about silent, but in/exhale sounds are noticeable.

[DeVilbiss Marketing]

We hear you.

[Slartybartfast]

Well, bummer. Looks like there's a problem. Three nights in AUTO mode where my 95% pressure level is equal to my minimum setting. It seems it's not adjusting, though it's in AUTO mode. Whether in CPAP mode or AUTO mode, same lack of response to me shutting off airflow through my nose and breathing through my mouth, simulating an obstructive apnea. I didn't mess with the factory-default settings of obstructive event flow and duration. Yet pressure just stays at the minimum level.

However, since everything else is working correctly, I suspect operator error, so I'll continue fiddling with it. But it's not ramping up like my S9 Autoset does when I breathe through my mouth airflow through my nose shut off.

Stay tuned.

[Emilia]

What does the data look like? I often remain at a low pressure throughout the night.... it is, evidently, sufficient to keep my airway open and get excellent results. Are you wanting pressure variations up and down all night? It is only going to increase if an event warrants it, and if your minimum pressure keeps your airway open, it may be all that is needed. I have many, many nights where there are no leaks and my pressure is at the minimum all night with maybe a blip up by .5 for a bit. Other nights, I do have more variations in pressure, but I am pretty steady most nights. Isn't that what we are striving for? Great sleep, open airway, low AHI?

[Slartybartfast]

THat's what I thought at first, then, when I saw another night, and then another, where the pressure never rose off my minimum setting, I began to get suspicious that something wasn't right. So I simulated an apnea. Held my breath for over a minute. No joy. Pressure never rose off the minimum setting.

[Slartybartfast]

Last night I set it to 9 cm in Auto mode. Wife and I stayed at a resort/spa on Hood Canal in Washington State. They were having one night specials at a price we couldn't resist, it being Valentine's Day and all. So checked in, had a dinner to die for, then went to sleep late.

Set pressure to 9 cm. This morning the 90th percentile pressure read 9.5, while the 95th read 10.0. That's more in line with what I expected. Without the data package, it's kind of hard to know what's going on. But I think everything is OK. For some reason I must have had two or three nights during which I didn't require much pressure. I think I'll take the Intellipap home with me and play around with it for a few weeks to make sure I fully understand it. And I'm interested to A/B it with my S9 Autoset, both using the same mask.

I'm still happy with the Intellipap. It's a great machine with lots of features for a reasonable price.

[edit: Or perhaps it's that the Intellipap algorithm is a little sluggish compared to that of the S9 Autoset, and all the adjustments I'm expecting to happen just aren't taking place in the timeframe I'm expecting them to. My data from last night indicates that might be what's happening.]

[Slartybartfast]

OK, so what the heck is an "expiratory puff"???? And do we care?

Per DeVilbiss:
Expiratory Puffs

Expiratory puffing occurs when a patient who normally breathes in and out through the nose begins
to exhale in short, high-volume puffs through the lips. Patients usually return to normal nasal
breathing patterns after an expiratory puffing event. Reporting puffing is valuable to therapy analysis
because, while puffs cause a distorted flow signal, they are also precursors to mouth breathing.
Expiratory puffing is a breathing event often observed in sleep labs during titration

The Resmed software doesn't report this. I knew I was doing it, just didn't know how much of the time. The Intellipap records expiratory puffs and gives you their frequency both on the LCD disply and through the SmartCode report. It's worth knowing.