Love RespCare Hybrid but ASV doesn't???

Just heard back a few minutes ago from the InnoMed rep with whom I am dealing.

They are sending me a brand-new replacement Hybrid mask and arrangements for the one I purchased to be sent into them for testing and study and then further follow-up between us.

Regards, Nate

Jay Aitchsee wrote:I'm back, I tried it, I got a Happy Face simply by holding my palm against the end of the hose. Let too much air escape, it turns to red angry, close it off, back to Happy! So much for electronics and algorithms! …

Jay and palerider,

Not to get too academic in a field in which I have no formal training, but …

Here's part of what the InnoMed rep said to me yesterday in a followup text message after his first conversation with their engineers about ResMed's "Mask Fit" process:

Nate: "Is there a way that you can do the mask test with another mask and then use the hybrid with out doing the test? See if the report differs. I am curious as to the algorithm in the mask test and how it is manipulating results"

and here is an excerpt from one of ResMed's patent applications that I found during a patent search this morning:

"Determination of mask fitting pressure and correct mask fit
US 7100608 B2
Abstract
A method for determining a mask-fit test pressure to be applied to a wearer's mask by ventilatory assistance apparatus includes adaptively determining the mask-fit pressure from prior use."

Therein follows what I interpret to be Claims for 19 different tests being applied by the ResMed machine during the "Mask Fit" process, including but not limited to the one described in the title above.

The first of the nineteen methods claimed to be applied during the "Mask Fit" test is described in part as follows:

1. A method for determining a mask-fit test pressure to be applied to a wearer's mask by ventilatory assistance apparatus, wherein the mask-fit pressure is adaptively dependent on a prior pressure treatment session of the wearer,….

https://docs.google.com/viewer?url=pate ... 100608.pdf

Respectfully,

Nate

NateS wrote:Just heard back a few minutes ago from the InnoMed rep with whom I am dealing.

They are sending me a brand-new replacement Hybrid mask and arrangements for the one I purchased to be sent into them for testing and study and then further follow-up between us.

Regards, Nate

I happen to be privy to what the engineer thought when he got the call from the sales rep - >

Jeez, Do I have to tell these sales chumps to send them a replacement mask to make sure the problem is not simply a defective mask?

OK, I see. In other than the cpap mode, the pressure used for Mask Fit test is the "95th percentile of the previous session". And, if the previous session 95th percentile was extremely high, it could skew the results. I don't know if your 95% P at around 23 would be considered extremely high, but kudos to the Rep for wanting to rule that out. I do like the engineer's thought, "Jeez, Do I have to tell these sales chumps to send them a replacement mask to make sure the problem is not simply a defective mask?"

The determination of correct mask fitting occurs on commencement of a treatment session with the patient in a wake state. The microcontroller 38 has an operational “Mask-Fit” mode that can be entered manually by a patient using pushbutton controls, or automatically. In either case, an initial constant pressure level is applied by the blower 14 to the mask 12. If the functional mode is the Manual mode, then the mask-fit test pressure is the current ‘set’ pressure. If the functional mode is the Automatic Titration mode, the mask-fit test pressure is the 95th percentile pressure of the previous session—if there was one—otherwise it is the base treatment pressure, e.g. 10–12 cm H2O. This constant pressure is applied for a period of time, typically 1–3 minutes.

NateS wrote:

Jay Aitchsee wrote:I'm back, I tried it, I got a Happy Face simply by holding my palm against the end of the hose. Let too much air escape, it turns to red angry, close it off, back to Happy! So much for electronics and algorithms! …

Jay and palerider,

Not to get too academic in a field in which I have no formal training, but …

Here's part of what the InnoMed rep said to me yesterday in a followup text message after his first conversation with their engineers about ResMed's "Mask Fit" process:

what I think may have gotten pushed to the wayside with the mask fit stuff is the reported excess leak calculations from sleepyhead for the nights you used it, where the leaks were reported as 48-168lpm.

the mask fit is just a quick and easy test, but I don't see anyway that SH could be showing that the machine is comig up with 48-168 excess leak without something being wrong.

hopefully one, or both of the new masks will give some clues.

The patent suggests that there are two criteria involved in the mask fit report. The first is if the pressure can be maintained, and the other is the leak rate. They suggest a typical leak threshold of 0.2 L/second which is 12 L/minute.

There is no indication of any electronics in the mask or measuring anything other than the air flow at the generator.

Anxiously waiting for the doorbell to ring in a day or two or three.

Nate

While awaiting the cavalry to arrive at my front door with the next steps towards a hoped-for solution for the Hybrid mask, I had another good night with the AirFit F10, which I credit to a resized Comfort CPAP sticky foam liner sample sent to me by Ferris:
http://www.cpap-pads.com/order.html

It's called a "2a"



Makes me glad I chose not to return the AirFit F10 even though it didn't work at all the first 30 days of trying. And it doesn't hurt to have more than one arrow in one's quiver.

Regards, Nate

So Nate, how about an update? I assume by now you've received and tested a replacement mask from InnoMed?
FWIW, I found my old Hybrid a while back and tested it using the Mask Fit feature of my S9...I could not get a Happy Face without covering one of the vent ports. To be fair, I didn't spend much time with it as the mask is uncomfortable to me.

Jay Aitchsee wrote:So Nate, how about an update? I assume by now you've received and tested a replacement mask from InnoMed?
FWIW, I found my old Hybrid a while back and tested it using the Mask Fit feature of my S9...I could not get a Happy Face without covering one of the vent ports. To be fair, I didn't spend much time with it as the mask is uncomfortable to me.

Thanks for asking, Jay. I got pretty discouraged. The new Hybrid sent by the company, and an almost-new Hybrid graciously sent to me by a friend, both performed just like the first one I purchased. Exactly the same. Never could stop the incredibly high leaks. Never could get a Happy Face to stay on screen with the three minute Mask Fit test. My tentative conclusion is that it is unsuitable for an ASV machine but maybe someone else here with an ASV has had better luck.

In addition, the AirFit F10 went back to leaking a lot after a couple nights with the Comfort CPAP sticky foam liner sample sent to me by Ferris. It was easy to see why. The liner is stiff and flat and only temporarily can be squeezed into the contours and dips of the F10 cushion, but after a few nights it rebels and tries to resume its flat shape or gets distorted, leaving gaping open areas. The softer, floppy Remzzz had no trouble conforming to the shape of the F10 cushion, but following the instructions from their co. to pull and stretch it out to create a seal always resulted in floppy areas at the top tickling my eyelids and/or I wouldn't pull it out enough to get a seal or too much and had to start over.

So I went back to my old faithful Wisp but, having seemingly exhausted all other measures to control mouth breathing and dryness, I finally managed to overcome my former "hostage" aversion to taping with a 2 inch micropore tape from Amazon, which comes off pretty easily from my mustache and light chin beard in the morning with a little warm water, and I'm getting good charts and we are both happily sleeping through the nights, so far!

Best wishes, Nate

PS - An unexpected beneficial side effect of this very thin tape is that placing it right below my nose and thus under the bottom of the Wisp seems to have stopped the Wisp from its former habit of wanting to slide slightly upward against my nostrils during the night.

NateS wrote:So I went back to my old faithful Wisp but, having seemingly exhausted all other measures to control mouth breathing and dryness, I finally managed to overcome my former "hostage" aversion to taping with a 2 inch micropore tape from Amazon, which comes off pretty easily from my mustache and light chin beard in the morning with a little warm water, and I'm getting good charts and we are both happily sleeping through the nights, so far!

Too bad about the Hybrid, but I'm glad the Wisp seems to be working for you. I hope it continues.

Hey Nate,

Have you seen the latest sort of hybrid mask? It's called the Amara View (totally different from the regular Amara).
viewtopic/t105013/newbie-with-Amara-View-mask.html
So far not yet available to the general public. Apparently out to select DMEs as a promo mask.
If I can get my hands on one I plan to try it and I am using the S9 Adapt and I can check to see if the machine thinks it is leak city or not. I am working on trying to find one sooner than later.

Jay Aitchsee wrote:So Nate, how about an update? I assume by now you've received and tested a replacement mask from InnoMed?
FWIW, I found my old Hybrid a while back and tested it using the Mask Fit feature of my S9...I could not get a Happy Face without covering one of the vent ports. To be fair, I didn't spend much time with it as the mask is uncomfortable to me.

I have used the Innomed Hybrid for years and the last 16 months with ResMed AutoSet S9 with pressure range 10 - 20. I have always had widely varying pressure needs and the Innomed and ResMed machine perform flawlessly for me.

But I have never used the Mask Fit feature.

Sheffey wrote:

Jay Aitchsee wrote:So Nate, how about an update? I assume by now you've received and tested a replacement mask from InnoMed?
FWIW, I found my old Hybrid a while back and tested it using the Mask Fit feature of my S9...I could not get a Happy Face without covering one of the vent ports. To be fair, I didn't spend much time with it as the mask is uncomfortable to me.

I have used the Innomed Hybrid for years and the last 16 months with ResMed AutoSet S9 with pressure range 10 - 20. I have always had widely varying pressure needs and the Innomed and ResMed machine perform flawlessly for me.

But I have never used the Mask Fit feature.

I had high hopes for it, Sheffey! I really wanted it to work. Glad it is working for you. Maybe some day we can find out why it is not working for me.

Regards, Nate

Pugsy wrote:Hey Nate,

Have you seen the latest sort of hybrid mask? It's called the Amara View (totally different from the regular Amara).
viewtopic/t105013/newbie-with-Amara-View-mask.html
So far not yet available to the general public. Apparently out to select DMEs as a promo mask.
If I can get my hands on one I plan to try it and I am using the S9 Adapt and I can check to see if the machine thinks it is leak city or not. I am working on trying to find one sooner than later.

Thanks for the tip, Pugsy! I will be interested in hear more!

It looks much like the RespCare Hybrid except for the "nose cushion" instead of the wiggly things, but I don't think that's where my leaks were coming from with the Hybrid because, at palerider's suggestion, one of my localization experiments was to remove the wigglies and seal off the nasal holes with duct tape just to try to narrow down the origin of the leaks, and it still gave a continuous Angry Face during the Mask Fit.

Regards, Nate