You gotta "love" Respironics

Johnny,


Could you please take a look at the following link:

viewtopic.php?t=9928

The software attached is proprietary and was intended to be used by our sales force for demonstration purposes only. It was not intended to be sent out to the general public. Is it possible for you to remove this for us?

Zack Paul
Respironics Global Product Manager - Sleep Therapy
Auto Titration

_________________

viewtopic.php?p=85162#85162

You'll notice the reason for removing the link , my emphasis:
The software "was intended to be used by our sales force for demonstration purposes only"

Here's a group of patients, trying to use the proprietary demonstration to understand their own therapy, or what that company has to offer them, and the Respironics Global Product Manager - Sleep Therapy Auto Titration does not want them to see the demo without a sale force representative.

Compare that to this, by Resmed: The Autoset's 3 lines of defence.

In case you're wondering, Mr. Paul, I use a Puritan Bennett machine.

O.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, Puritan Bennett, Titration, auto

Ozij,

Interesting link. I found this set of statements interesting ...

How Can AutoSet Spirit Help?

* Sensitive & responsive to your needs: If an apnea occurs suddenly, without any preceding flow limitation or snore, AutoSet Spirit increases the pressure after the apnea has ceased to help prevent further apneas.

* Acting early to reduce your problems: Flow limitation and snoring often occur before obstruction of the airway. Typically, by responding early to these events, AutoSet Spirit can help prevent apneas.

* Very gentle on you: If no further events occur, AutoSet Spirit gently decreases the pressure to a minimum set pressure.

***********************************************

This was basically the case I had been wanting to clarify in many of the threads we had going on how AUTOs work.

I have had for some weeks, a complete statement describing how the ResMed Autoset T works for various situations. But as best as I can tell this statement was made in 1999/2000 and was by a ResMed manager describing a 'new' Autoset T model (I managed to buy one of these (as always , at a good price and will have it in 2 weeks). The Spirit S7 and thus the S8 have been stated as being the follow on products to the Autoset-T. This 'new' Autoset T introduced an external pressure line to the mask for the purpose of working with Resmed then new full face masks.

But despite what is said at that Resmed website you linked to, I have been wondering if in fact the algorithms have now changed so that if a sudden blockage occurs as described above, that the newer models will go ahead and increase pressure while the apnea is in effect rather than as described here where ResMed say they wait until after the apnea has been cleared naturally by the 'patient'.

This is an interesting difference of perspeective. To clear a sudden Apnea after it has been cleared naturally or to try to clear it while it is occuring.

The orginal article I have mentions concerns about attempting to clear an Apnea blockage while it is in effect. The issue being that such an attempt may make it worse. This then had me wondering if it was possible or even desirable to try.

The Respioronics patent I read (linked to in one thread by Darth V L ) showed that their 2004 model had two pressure adjustment modes when dealing with 1) snoring and 2) an Apnea.

The implication I drew from their wording was that in the case of 1) snoring their Auto would bump up cms by 1 CMS over a 15 second period then freeze further adjustments for 1 minute then repeat this cycle.

In the case of 2) an Apnea the Respironics AUTO will ... (sects 148-154 of the patent doc)...
If over a 10 sec sampling period, the Apnea detector considers an Apnea is in progress, it requests the pressure controller to raise the cms by 1, (time not specified, only the word 'slowly') then wait 30 secs. After another 10 sec samapling period, if the pattern of breathing again invokes the Apnea controller, it repeats the increase (raises 1 cms 'slowly' & waits 30 secs).

But if the Auto pressure is already at 8cms - then after 3 goes at this cycle, the Auto will begin lowering pressure in response to the same continued pattern. I am presuming that if it is or was under 8 cms when this started, then it will keep repeating the increase should it be possible (allowing for the # of seconds this Apnea is lasting) until either the Apnea clears (for whatever reason) or if the machine was at or above 8 cms or it reaches 8 cms during this episode, it stops increasing cms after going up 3 cms in 1 cms cycles, then starts lowering the cms.


*********************************

What I have been trying to work out, is if the newest Autos are 'hunter killers' rather than 'defenders' by this I mean, rather than as described at the top by Resmed, waiting for an Apnea to pass then increasing cms (a defender), do the newest models go into a hunting mode where they increase pressure to try to 'kill' (remove) the obstruction while it is still detected. In the info from the Respironics patent it is a little difficult to determine if they are attempting to 'eliminate' an Apnea that is still in progress or to are they preparing the machine for a following Apnea or perhaps doing both ?.

My reading of the pressure change info is that perhaps they are (in a sort of fashion) trying to actually clear a blockage as it happens while preparing to try to prevent a following Apnea.


Cheers

DSM

[quote="Anonymous"]Ozij,

Interesting link. I found this set of statements interesting ...

How Can AutoSet Spirit Help?

* Sensitive & responsive to your needs: If an apnea occurs suddenly, without any preceding flow limitation or snore, AutoSet Spirit increases the pressure after the apnea has ceased to help prevent further apneas.

* Acting early to reduce your problems: Flow limitation and snoring often occur before obstruction of the airway. Typically, by responding early to these events, AutoSet Spirit can help prevent apneas.

* Very gentle on you: If no further events occur, AutoSet Spirit gently decreases the pressure to a minimum set pressure.

***********************************************

This was basically the case I had been wanting to clarify in many of the threads we had going on how AUTOs work.

I have had for some weeks, a complete statement describing how the ResMed Autoset T works for various situations. But as best as I can tell this statement was made in 1999/2000 and was by a ResMed manager describing a 'new' Autoset T model (I managed to buy one of these (as always , at a good price and will have it in 2 weeks). The Spirit S7 and thus the S8 have been stated as being the follow on products to the Autoset-T. This 'new' Autoset T introduced an external pressure line to the mask for the purpose of working with Resmed then new full face masks.

But despite what is said at that Resmed website you linked to, I have been wondering if in fact the algorithms have now changed so that if a sudden blockage occurs as described above, that the newer models will go ahead and increase pressure while the apnea is in effect rather than as described here where ResMed say they wait until after the apnea has been cleared naturally by the 'patient'.

This is an interesting difference of perspeective. To clear a sudden Apnea after it has been cleared naturally or to try to clear it while it is occuring.

The orginal article I have mentions concerns about attempting to clear an Apnea blockage while it is in effect. The issue being that such an attempt may make it worse. This then had me wondering if it was possible or even desirable to try.

The Respioronics patent I read (linked to in one thread by Darth V L ) showed that their 2004 model had two pressure adjustment modes when dealing with 1) snoring and 2) an Apnea.

The implication I drew from their wording was that in the case of 1) snoring their Auto would bump up cms by 1 CMS over a 15 second period then freeze further adjustments for 1 minute then repeat this cycle.

In the case of 2) an Apnea the Respironics AUTO will ... (sects 148-154 of the patent doc)...
If over a 10 sec sampling period, the Apnea detector considers an Apnea is in progress, it requests the pressure controller to raise the cms by 1, (time not specified, only the word 'slowly') then wait 30 secs. After another 10 sec samapling period, if the pattern of breathing again invokes the Apnea controller, it repeats the increase (raises 1 cms 'slowly' & waits 30 secs).

But if the Auto pressure is already at 8cms - then after 3 goes at this cycle, the Auto will begin lowering pressure in response to the same continued pattern. I am presuming that if it is or was under 8 cms when this started, then it will keep repeating the increase should it be possible (allowing for the # of seconds this Apnea is lasting) until either the Apnea clears (for whatever reason) or if the machine was at or above 8 cms or it reaches 8 cms during this episode, it stops increasing cms after going up 3 cms in 1 cms cycles, then starts lowering the cms.


*********************************

What I have been trying to work out, is if the newest Autos are 'hunter killers' rather than 'defenders' by this I mean, rather than as described at the top by Resmed, waiting for an Apnea to pass then increasing cms (a defender), do the newest models go into a hunting mode where they increase pressure to try to 'kill' (remove) the obstruction while it is still detected. In the info from the Respironics patent it is a little difficult to determine if they are attempting to 'eliminate' an Apnea that is still in progress or to are they preparing the machine for a following Apnea or perhaps doing both ?.

My reading of the pressure change info is that perhaps they are (in a sort of fashion) trying to actually clear a blockage as it happens while preparing to try to prevent a following Apnea.


Cheers

DSM

[quote="Anonymous"][quote="Anonymous"]Ozij,

Interesting link. I found this set of statements interesting ...

How Can AutoSet Spirit Help?

* Sensitive & responsive to your needs: If an apnea occurs suddenly, without any preceding flow limitation or snore, AutoSet Spirit increases the pressure after the apnea has ceased to help prevent further apneas.

* Acting early to reduce your problems: Flow limitation and snoring often occur before obstruction of the airway. Typically, by responding early to these events, AutoSet Spirit can help prevent apneas.

* Very gentle on you: If no further events occur, AutoSet Spirit gently decreases the pressure to a minimum set pressure.

***********************************************

This was basically the case I had been wanting to clarify in many of the threads we had going on how AUTOs work.

I have had for some weeks, a complete statement describing how the ResMed Autoset T works for various situations. But as best as I can tell this statement was made in 1999/2000 and was by a ResMed manager describing a 'new' Autoset T model (I managed to buy one of these (as always , at a good price and will have it in 2 weeks). The Spirit S7 and thus the S8 have been stated as being the follow on products to the Autoset-T. This 'new' Autoset T introduced an external pressure line to the mask for the purpose of working with Resmed then new full face masks.

But despite what is said at that Resmed website you linked to, I have been wondering if in fact the algorithms have now changed so that if a sudden blockage occurs as described above, that the newer models will go ahead and increase pressure while the apnea is in effect rather than as described here where ResMed say they wait until after the apnea has been cleared naturally by the 'patient'.

This is an interesting difference of perspeective. To clear a sudden Apnea after it has been cleared naturally or to try to clear it while it is occuring.

The orginal article I have mentions concerns about attempting to clear an Apnea blockage while it is in effect. The issue being that such an attempt may make it worse. This then had me wondering if it was possible or even desirable to try.

The Respioronics patent I read (linked to in one thread by Darth V L ) showed that their 2004 model had two pressure adjustment modes when dealing with 1) snoring and 2) an Apnea.

The implication I drew from their wording was that in the case of 1) snoring their Auto would bump up cms by 1 CMS over a 15 second period then freeze further adjustments for 1 minute then repeat this cycle.

In the case of 2) an Apnea the Respironics AUTO will ... (sects 148-154 of the patent doc)...
If over a 10 sec sampling period, the Apnea detector considers an Apnea is in progress, it requests the pressure controller to raise the cms by 1, (time not specified, only the word 'slowly') then wait 30 secs. After another 10 sec samapling period, if the pattern of breathing again invokes the Apnea controller, it repeats the increase (raises 1 cms 'slowly' & waits 30 secs).

But if the Auto pressure is already at 8cms - then after 3 goes at this cycle, the Auto will begin lowering pressure in response to the same continued pattern. I am presuming that if it is or was under 8 cms when this started, then it will keep repeating the increase should it be possible (allowing for the # of seconds this Apnea is lasting) until either the Apnea clears (for whatever reason) or if the machine was at or above 8 cms or it reaches 8 cms during this episode, it stops increasing cms after going up 3 cms in 1 cms cycles, then starts lowering the cms.


*********************************

What I have been trying to work out, is if the newest Autos are 'hunter killers' rather than 'defenders' by this I mean, rather than as described at the top by Resmed, waiting for an Apnea to pass then increasing cms (a defender), do the newest models go into a hunting mode where they increase pressure to try to 'kill' (remove) the obstruction while it is still detected. In the info from the Respironics patent it is a little difficult to determine if they are attempting to 'eliminate' an Apnea that is still in progress or to are they preparing the machine for a following Apnea or perhaps doing both ?.

My reading of the pressure change info is that perhaps they are (in a sort of fashion) trying to actually clear a blockage as it happens while preparing to try to prevent a following Apnea.


Cheers

DSM

Seems to me that we're getting mixed messages here.

First of all, we have someone who claims to be a contractor for one of the manufacturers asking the following question.

Research_Guy wrote:Just curious what you think...what type of info do patients need, want or expect from OSA device manufacturers? Thank you.

Then, when we DO get information that many of the users enjoyed, we get the following:

Zack Paul wrote:The software attached is proprietary and was intended to be used by our sales force for demonstration purposes only. It was not intended to be sent out to the general public.

Now, I'm not connecting the dots that these two people work for the same entity, but if Mr. Paul has been monitoring this forum, it doesn't take a "rocket scientist" to figure out what information the users of this equipment want to see or know.

In fact, Mr. Paul has got it BACKWARDS! He's lost track of who his clientele REALLY is.....the end users......US.
It is probably "proprietary software", but the demonstration DID reach the audience for whom it SHOULD HAVE been intended......US.

Mr. Paul......WE are not the "general public"!!! The "general public" doesn't have OSA.....WE DO. WE are the ones who ultimately purchase your products.....DO YOU UNDERSTAND???

Have a nice day

Den

well said, hopefully he reads this and understands.

Interesting. Well, from my range of 8 to 17 I notice the press pressure is 17! Max. And while my AHI has been going down from just over 8 down to 7.5, I skipped a night the night before last, and last night my AHI was 17.something!!!! I have no idea what happened. I did go to sleep just after midnight and I was up at 6:30am. But I can't see how that would play into a one-night major increase like that.

Also, I'm left wondering...if I raise my max up to 18, will it then go to 18? And again to 19 and 20 if those adjustments are made? If so, that just seems odd to me when my regular CPAP was set at 13 before I switched it out for this unit. Now, keep in mind my S8 autoset Vantage will operate as a standard CPAP so all is not lost if a change needs to be made. And at that point I get to use EPR!

If you read the manuals on both Resperonic Pro 2 Bipap and new Auto Bipap doesn't record snores above 17 cm. I was wondering why pressures over 17 cm had a zero SI on Encore. So does this mean the machines don't adjust for snores over 17 cm? What's with the 17 cm cutoff?

It is fair to say that cpaptalkers (the folks who actually use cpap equipment) are often ignored by the manufacturers of cpap equipment. This has been the case since the first machines were purchased by DME companies.

Cpaptalk has given us a voice. When a poster that is representing a manufacturer posts something, it is an opportunity for us all to build a relationship that ultimately can much improve our lives. Shrill, angry responses may be deserved, but reasoned, friendly responses that engage and inform these visitors will yield the best results for us in the long term.

And what is your response, MaskedMechanic?
O.

MaskedMechanic wrote:Cpaptalk has given us a voice. When a poster that is representing a manufacturer posts something, it is an opportunity for us all to build a relationship that ultimately can much improve our lives. Shrill, angry responses may be deserved, but reasoned, friendly responses that engage and inform these visitors will yield the best results for us in the long term.

MM,

The person in question, Mr. Paul, didn't "post" that message here on the forum.....he (apparently) sent the message directly to Johnny (presumably in an e-mail or PM).
I can't say as I can recall them (the manufacturers) going out of their way to try to build a "relationship" with US.....the people who ultimately purchase their products....and who have to rely on those products for the improvement and/or maintenance of our health.
Not being shrill or angry.....just trying to get their attention (if they're reading). We are, after all, their customers.
And, you know what they say..... "The customer is ALWAYS right."

Best wishes,

Den

Good points, Den!

O.

Rastaman,
I would deduce from what is being said in this thread is, you are snoring.
I think a voice recorder could be used to verify this. You may want to try a RemStar Auto, because its response to snoring is a bit different than ResMed.

This seems AMAZING to me:

1. Last winter, the Respironics website allows free public access to a new piece of software that enables one to download sleep data from certain Respironics equipment. Sometime later, they take it down, but you can still buy it.

2. Now, presumably, a Respironics sales rep gives a copy of their software explaining auto functions to a DME. Right?.......Then, the DME makes it available to the cpaptalkers. Right?....... Now, Respironics wants the link removed because it's getting out to the wrong audience. If this were a competitive issue, Respironics would not even release this product to their sales guys.

It sure seems like Respironics had little or no controls in place if they really wanted limited distribution of these products.

Respironics might want to rethink their document controls program.

[quote="HP"]This seems AMAZING to me:

1. Last winter, the Respironics website allows free public access to a new piece of software that enables one to download sleep data from certain Respironics equipment. Sometime later, they take it down, but you can still buy it.

2. Now, presumably, a Respironics sales rep gives a copy of their software explaining auto functions to a DME. Right?.......Then, the DME makes it available to the cpaptalkers. Right?....... Now, Respironics wants the link removed because it's getting out to the wrong audience. If this were a competitive issue, Respironics would not even release this product to their sales guys.

It sure seems like Respironics had little or no controls in place if they really wanted limited distribution of these products.

Respironics might want to rethink their document controls program.