Alogrithm better than Respironics Auto???

My Respironics M Series acts like a Random Number Generator some nights. I have quite a few examples and several are posted in this forum.

I came across this alogrithm and it seems to do a better job from my understanding of the Respironics auto. My M series sometimes takes off of a mask flutter and goes through the roof pressure wise and does not seem to increase pressure on apneas like I thought it would and sure does take forever to decrease pressure once it goes way up.

This alogrithm is from another auto that seems quite appealing and I wonder if anyone has any opinion on how this unit might work? This one will certainly be a straight cash out of pocket expense and I really want to be sure that it works better! So far I have not been able to get hold of the Clinician manual and that might answer some other concerns I have:

------Flow Limitation:
Runs of Inspiratory Flow-Limited and Hypopneic cycles:
0.3 cmH2O increase on identification of run if in conjunction with hypopnea
0.1 cmH2O increase on identification of run in absence of hypopnea
Subsequent pressure increases every 2 breaths until run resolved (up to 3 additional per run). The increase is 0.3 or 0.1 cm h20 depending on the presence of hypopnea
Max of 4 increases or total increase of 1.2 cm H20 on the same run
Delivery cannot exceed Max P
Can be disbled on inspiratory flow limitation
-----Apnea: 10 sec no breath plus 5/8 of avg of last 3 breaths. Classified as obstructive or central with no increase on detected central apneas.
1.0 cm H2o increase once apnea is detected
2nd - 1cmH2O increase after 15 seconds if no breathing is detected
3rd - 1 cmH2O increase after additional 15 seconds if no breathing is detected
3cm H2Ol imit to increase during single apneic event
Cannot increase after Max P
Returns to preset back-up pressure if no breathing detected for 2 minutes
Can set maximum pressure to go to for apnea less than max P
-----Snoring:
0.2 cm H2O increase every 20 seconds if snoring in absence of hypopnea
0.3 cm H2O increase every 20 seconds if snoring in conjunction with hypopnea
3.0 cm H2O maximum increase for snoring in absence of other obstructive events
Cannot exceed Max P
-----Airway Stable:
Fast Mode.
0.5 cm H2O decrease after 5 minutes
Subsequent 0.5 cm H2O decrease each following minute if no events
Slow Mode.
0.2 cm H2O decrease after 5 minutes
Subsequent 0.2 cmH2O decrease each minute if no events
Canot decrease below Min P
-------Other:
26 db noise level

may be better if it works for you,

sounds like the Sandman machine, where is that from?

Time would be better spent, controlling leaks and setting the machine for your best treatment, so it can do the job it's designed for. Obessing about the wheel wheither a 15 in rim it better than a 18 inch rim, time would be better spent making either had the correct amount of air in them to hold up the car. Jim (Goofproof) not hiding just logged off.

Snoredog wrote:may be better if it works for you,

sounds like the Sandman machine, where is that from?

Yes, it is the Sandman Auto. Been reading all I can but never did find anyone with the Clinical manual. The specs look a lot like the Puritan 420E and maybe a little better. Have you hear much about it? Cannot find any reviews - just tons of marketing announcements!!!!

Right now I have to use my M auto for a week with a very limited range of pressures and go back to straight CPAP to get meaniful results. I have no idea why, but my first suggestions as an engineer was that the machine was broke but the DME can tell by their Ouiji board that is ok!!!!!! I can clearly see apneas happening and the machine does nothing, then it goes up in pressure and stays there for an hour or more. It truly is a wonderful random number generator.

Anonymous wrote:Time would be better spent, controlling leaks and setting the machine for your best treatment, so it can do the job it's designed for. Obessing about the wheel wheither a 15 in rim it better than a 18 inch rim, time would be better spent making either had the correct amount of air in them to hold up the car. Jim (Goofproof) not hiding just logged off.

Jim, with the UMFF, leaks are under control and with a time with a straight leak line, you can see events happening and no response, but let the mask fart and the pressure will go to maximum. That is why I wondered if the alogarithms were better on the Sandman auto. I would really like to have an auto that works for me.

It would be no nice to have a machine that acts in a predictable manner and a mask that always yields a straight leak line and you could toss and turn and everything worked right. So lets start with the machine.....

You can't get any meaningful information from comparing a (supposedly) broken machine to a (supposedly) functioning algorithm on another machine.

I'm all for the PB/Covidien algorithm it works fine for me - but don't buy by algorithm alone.

Your DME may not want the hassle of returning a machine machine to Respironics, but see if they will rent you another M series - so you can compare results. If the loaner behavers like your own machine, that may be the Respironics algorithm interacting with your breathing. If it doesn't, then you've go a good case for proving your own machine is broken - and that may make thinks easier for your DME when they confront Respironics.

Any chance of your sharing the source for this for this algorithm that you "came across"? Any reason for making this into a mysterious guessing game?

You will find many discussion of the PB's "response to flow limitation runs" on this forum - quite a large number of people have to disable it because it registers far too many or their breaths as flow limited - identifying unlimited chains of "runs" and responding by raising the pressure endlessly. These very same people will have far less flow limitations identified on another machine. You have no way of knowing ahead of time which group you will fall into.


I am very satisfied with my ("response to flow limitation runs disabled") PB 420E. That does not mean you will be.

O.

Everyone is different, the results from the machines will be different. With enough money you could buy and try all of them, but probably no one will fill the bill for everyones wants. If they are set correctly most will give good treatment.

I learned long ago that the machine has to be set to limit what it can react to, for me it's not mask farts, it a noise like snoring, due to congestion and some airway parts flapping in the breeze maybe. We learnd to set APAP in a 3 cm range around our ideal pressure, but have lately been setting it to 15 cm on APAP, no range at all. If I allowed my machine to go past what works best for me it would hang on 20 cm and leak would be the result. I don't care about the machines brain, I just out-think it, and get along with my sleep. Jim

I am NOT convinced that Sandman machine is any better than the DeVilbiss Intellipap, especially for the $700 price tag they are wanting.

The DeVilbiss is dirt cheap by comparison, so is the 420e and we know what its reports are like and how it performs.

The User reviews on the Intellipap appear very good, but I find it interesting that NO one mentions anything about data being displayed on the LCD or mentions a single word on it not displaying any.

But the Sandman looks to have a SD card slot on the left side and it comes with a memory card they just don't say what type. IF the Sandman wrote patient files to that memory card that would be cool, but we just don't know yet.

Ozzie: I didn't mean to make it a game. I just had a hard time finding the data and posted it here. It is the Sandman Auto. I also got hold of the patient manual, but not the clinical manual. It looked like an improvement on the PB420-E. Respironics reports quite high "variable breathing" so you may have hit the nail on the head. It may be that my breathing gets shallow at night and may not register as well with the m-series alogarithm.

No, I now believe my m-series works as it was designed. I just wish they had left a little more control to the user on how it responds to events.

Snoredog: Yes, they show a 2m and 15m RS232 cables, 2m USB cable and a Clinicians kit that contains Software and a card reader but it looks like a USB to Serial converter. Their memory card does not look like a SD card, more like a proprietary usb or RS232 molded memory with a price to match.

200 sessions of 8 hours stored in memory.
50 sessions of 8 hours stored on memory card (now that leads credence to "bring your memory card in once a month and we will see how you are doing".

Your advise is good and I won't jump off and buy one until they have been reviewed and on the market for several months to see that they really are better.

In two weeks my M series auto has done the same thing. I was getting ready to narrow the band in which this thing operates, and set it to straight bipap. Otherwise it's almost comical. I wake to a mask that's exploding off of my face.

I'm glad you posted this, just for the confirmation that someone else is having it. I thought the machine was defective. Or I was having some serious breathing troubles that set it off.