Love RespCare Hybrid but ASV doesn't???

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!
My S9 was born last year (2014).
Now, it is possible that VPAP's behave differently, PR and I have had a conversation about leaks and baselines and there is some indication that the VPAP line does things a little differently then the c/apap machines in compensating for leaks. But, you can try this test and see what happens.

Jay Aitchsee wrote:Nate, I don't think I buy it. The machine doesn't know what mask is on the end of the hose. It only knows that you've told it what type of mask (I.e., Full Face, nasal etc,) and is therefore expecting a certain vent rate typical for that type of ResMed mask. But, we've already established the hybrid vent rate is close to typical for a ResMed FFM. Now, it's possible there is some elaborate electronics and algorithms in place to determine the brand of mask on the end of the hose, but I really doubt it.
I contend that if you get a flow rate on the end of the hose that is close to the expected vent rate as selected by the mask setting you will get a happy face. You can test this, and I will too, by placing just your hand over the end of the hose in "mask fit" and adjusting your fingers to control the exhaust to see if you can get a Happy Face.
Off to try it!

We use Rogers Family Coffee in our Keurig, so we've got a drawerful of those "freedom clips" they keep sending us with each box of x-cups to make the Keurig think it's Green Mountain coffee.
Maybe I should try sticking one of those clips in the end of my ResMed machine!

Don't worry - jus'kiddin'!

Nate

NateS wrote: I am not in a position to judge this theory and welcome input from my colleagues here on cpaptalk as to whether this is pure malarkey or has some substance.

it sounds like fertilizer to me.

Jay Aitchsee wrote:The machine doesn't know what mask is on the end of the hose. It only knows that you've told it what type of mask (I.e., Full Face, nasal etc,) and is therefore expecting a certain vent rate typical for that type of ResMed mask. But, we've already established the hybrid vent rate is close to typical for a ResMed FFM.

Right.

NateS wrote: I am not in a position to judge this theory and welcome input from my colleagues here on cpaptalk as to whether this is pure malarkey or has some substance.

Sales rep balognac musings.

He is an idiot for not immediately shipping you another frame to try - as speculated above, the vent holes could be the wrong size. This possible variable needs to be eliminated before chasing all kinds of wild geese.

NateS wrote:We use Rogers Family Coffee in our Keurig

Shame on you.

http://money.cnn.com/2015/03/04/news/k- ... r-regrets/

Hang Fire wrote:

NateS wrote:We use Rogers Family Coffee in our Keurig

Shame on you.

http://money.cnn.com/2015/03/04/news/k- ... r-regrets/

Unlike Keurig k-cups, Rogers Family Coffee x-cups are Bio-degradable and Earth-friendly!

http://www.rogersfamilyco.com/index.php ... y-onecups/

So at least I'm not losing any sleep over my choice of x-cups!

Just over my choice(s) of sleep apnea masks, which is driving me crazy!

Regards, Nate

NateS wrote: We use Rogers Family Coffee in our Keurig, so we've got a drawerful of those "freedom clips" they keep sending us with each box of x-cups to make the Keurig think it's Green Mountain coffee.

there's a really easy way to disable the whole bs, you take the side off, and pull one wire from a connector... and suddenly, it's a regular machine....

friend of mine says it works BETTER now, because it's much less of a pain to use most anything... I can get you the video off youtube if you're interested.

NateS wrote:Rogers Family Coffee x-cups are Bio-degradable and Earth-friendly!

It makes you pee more on Mother Earth. What's friendly about that?

palerider wrote:

NateS wrote: We use Rogers Family Coffee in our Keurig, so we've got a drawerful of those "freedom clips" they keep sending us with each box of x-cups to make the Keurig think it's Green Mountain coffee.

there's a really easy way to disable the whole bs, you take the side off, and pull one wire from a connector... and suddenly, it's a regular machine....

friend of mine says it works BETTER now, because it's much less of a pain to use most anything... I can get you the video off youtube if you're interested.

Thanks but we don't need either the free clips or any surgery on our Keurig, which was made before the second version came out. We just keep throwing the clips in the drawer because I'm afraid the clips might not be bio-degradeable! And who knows, some day a friend might want one?

Still hoping/wishing for a solution to what I had hoped would be my "ideal" mask!

Best wishes, 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!
My S9 was born last year (2014).
Now, it is possible that VPAP's behave differently, PR and I have had a conversation about leaks and baselines and there is some indication that the VPAP line does things a little differently then the c/apap machines in compensating for leaks. But, you can try this test and see what happens.

Not to be argumentative, Jay but are you suggesting that ALL of the described functions of a ResMed ASV machine (taken from the ASV description on ResMed's website) can be replicated by simply holding the palm of your hand against the end of the hose? And without the air passing into and out of a specially designed sleep apnea mask?:

The clinically-published ASV algorithm constantly learns, responds, predicts and synchronizes with the patient’s respiratory pattern to help rapidly stabilize respiration.

The pressure support varies to respond to the patient's need. Mandatory breaths are delivered at the patient’s recent spontaneous breath rate.

In ASVAuto mode, this bilevel machine not only responds within the breath, adjusting Pressure Support to stabilize respiration, it also automatically adjusts the expiratory pressure in order to provide the minimum pressure required to maintain upper airway patency.

It analyzes the state of the patient’s upper airway on a breath-by-breath basis and delivers expiratory pressure within the allowed range.

Easy-Breathe pressure waveform mimics the wave shape of normal breathing and replicates it for your breathing comfort.

Continuous leak management enables reliable delivery of therapy pressure while maintaining patient-device synchrony. 

Suppose we were to take ulterior motive and competitive issues out of the equation, and simply ask:

Is it not possible that some of the functions of ResMed's most advanced systems are assigned to the machine and other of those functions are assigned to the mask? Or are dependent upon the precise design assigned to the mask?

In addition, ResMed seems to say as much, in a reverse example, on their own website:

Q. Can a ResMed mask be used with another manufacturer's CPAP device?

A. Probably — but if you're using a non-ResMed APAP or bilevel device, you may want to check with the manufacturer to ensure it doesn’t compromise your sleep apnea therapy. The technical specifications of the mask are provided for your clinician or equipment supplier to check that they are compatible with a CPAP or bilevel device. If used outside specification or with incompatible devices, the seal and comfort may not be optimal.

http://www.resmed.com/us/en/consumer/su ... r-you.html

Best wishes, Nate

Since it is in my nature to be inclined to give the InnoMed rep the benefit of the doubt until I hear back further from him, hopefully tomorrow, there is another hypothesis.

In an attempt at humor, I posed the Keurig II analogy, where the Keurig Green Mountain Coffee company deliberately set out to try to exclude competing coffee companies from selling cups which worked in the Keurig II machine. The cups fit perfectly but, until the workaround, the Keurig would refuse to brew coffee from them.

But there is an alternate analogy, wherein Apple and Microsoft periodically issue operating system updates which temporarily disable full functioning of some 3rd party products, sometimes because the 3rd party companies have simply lagged behind the curve in reading the fine print passed out with alpha and beta copies of the update, and/or performing compatibility testing.

In the latter case, it is possible that InnoMed, a 3rd party mask company which does not make xpap machines, simply needs to scramble to adapt their masks to accomodate the newest line of ResMed and/or other machines (and the former "top of the line model" which may have also incorporated that additional sophistication), no matter how clear or how obscure ResMed may have been in alerting others to the update characteristics and requirements.

I keep coming back in my mind to his remark that they "are getting a slew of reports of their masks not working" with ResMed new machines. If his only motive was to cast InnoMed's status into a favorable sales light, that wouldn't be a well-chosen way to tell me. Not exactly a way to instill confidence in their product line in customers' minds. Which makes me want to give him and InnoMed the benefit of the doubt until proven otherwise. After all, he was not brushing me off and saying it wasn't their problem and goodbye. He was telling me he wants to consult further with those engineers and try to solve the problem for me so I can use their mask. At least, that's how things were left when we ended our latest conversations.

The engineers would understand these details better, I assume, than the rep I am talking to, whose duties combine both sales and support.

So I will see what tomorrow brings. I just want a working mask that does what it is supposed to do - provide me with the intended therapy without disturbing our sleep and turning my mouth into a Sahara desert unfixable by chinstraps, gels, tape, elastic headbands, etc. or distorting my morning face sufficiently to scare even me when I look into the mirror.

Best wishes, Nate

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!
My S9 was born last year (2014).
Now, it is possible that VPAP's behave differently, PR and I have had a conversation about leaks and baselines and there is some indication that the VPAP line does things a little differently then the c/apap machines in compensating for leaks. But, you can try this test and see what happens.

Not to be argumentative, Jay but are you suggesting that ALL of the described functions of a ResMed ASV machine (taken from the ASV description on ResMed's website) can be replicated by simply holding the palm of your hand against the end of the hose? And without the air passing into and out of a specially designed sleep apnea mask?:

well, I think he's just saying the leak test can be replicated by restricting the airflow, which, when you think about it, is all that happens if you put a mask on your face. pressure builds up, the machine measures the flow rate, and if it's too high, gives you mr frowny face. if the flow rate is within expected parameters for that pressure, you get mr happy face. ... that's all that there is to it, at that point.

all the rest of it is smarts that the asv does, manipulating the speed of the blower to change the pressure and flow based on what it sense happening with the pressure and flow.

NateS wrote: Is it not possible that some of the functions of ResMed's most advanced systems are assigned to the machine and other of those functions are assigned to the mask? Or are dependent upon the precise design assigned to the mask?

I have no proof of it, but in my opinion, that's very unlikely. masks keep air around your face/nose, and vent a set amount of air.... there's really nothing more that a piece of plastic and silicone can do.

that stuff about 'resmed masks blah blah others, etc" is lawyer cya crap.... in the even that there's some crazy wild thing someone wants to use.

seal up the mouthhole and the nose holes with tape or by pressing the mouth opening against your arm, or other appropriately curved thing it can seal against, and block off the nose bits, and see if that gives you a frowny face.

Palerider, your comment seems to have appeared exactly at the same moment as mine just came in above yours, so I'm not sure whether you've had a chance to read/consider mine yet.

My understanding is that InnoMed does not sell xPAP machines; just sleep apnea masks and possibly other accessories. If they don't sell machines, what possible benefit could they derive from announcing that now their masks might not work right with ResMed machines, one of the leading makers?

How could it possibly benefit their company to take a position to lose all future mask sales to ResMed machine owners, just to blow off one measly customer who is having trouble with an InnoMed mask? (And I have not been blown off - not yet, at least.)

Regards, Nate

NateS wrote:Palerider, your comment seems to have appeared exactly at the same moment as mine just came in above yours, so I'm not sure whether you've had a chance to read/consider mine yet.

My understanding is that InnoMed does not sell xPAP machines; just sleep apnea masks and possibly other accessories. If they don't sell machines, what possible benefit could they derive from announcing that now their masks might not work right with ResMed machines, one of the leading makers?

How could it possibly benefit their company to take a position to lose all future mask sales to ResMed machine owners, just to blow off one measly customer who is having trouble with an InnoMed mask? (And I have not been blown off - not yet, at least.)

I did read yours, and I still can't come up with any possible way that the machine could know.

you're dealing with flowing air, I don't think the machine could be smart enough to be able to tell what kind of mask it has on it... heck, if it could, you wouldn't need to set pillows/nasal/full face, it would just know

and would probably come back and say "invalid mask" not show a huge leak.

I just don't see how it's possible.... it sounds like the fingerpointing game... "it's THEIR fault!" as opposed to figuring out what the issue is and fixing it.

palerider wrote:well, I think he's just saying the leak test can be replicated by restricting the airflow, which, when you think about it, is all that happens if you put a mask on your face. pressure builds up, the machine measures the flow rate, and if it's too high, gives you mr frowny face. if the flow rate is within expected parameters for that pressure, you get mr happy face. ... that's all that there is to it, at that point.

Yes Nate, I was just saying the Mask Fit feature could be replicated by placing the palm of the hand over the end of the hose. At this point the machine is just looking for a flow approaching or less than that indicated by the mask selection entry, no matter what's actually on the end of the hose. Did you try it?
This was to counter the blah blah of the Rep who said, as you reported, something about the machine detecting the type/brand of mask during Mask Fit. I agree that this probably could be done, but highly unlikely to the point of ridiculous, that it is.

I think your mask is most probably defective. Either the vent holes are too large, the Anti Asphyxiation valve is not working, a coupling is leaking, or the Pillows are not seated properly in the base. Since there is air venting in this area from the vent holes, leaks from the AA valve port, pillows, or the coupling could be hard to determine by feel. You might be able to eliminate these by placing tape over each suspect area one at time. I would start with the AA port.

Maybe the "slew of reports" the Rep mentioned is because Innomed has done something to increase the static vent rate beyond that which will pass ResMed's Mask Fit test and it just happens to coincide with the release of the AirSense line? However, if the vent rate is still that which was referenced earlier, it should pass.

This is interesting, if you haven't seen it. The guy seems to like the mask pretty much. http://www.cpaphelpdesk.com/cpap-hybrid-mask.html

Here's an old (2006) thread which talks about the hybrid's "generous' vent rate: viewtopic/t14097/Hybrid-and-S8-machine- ... mouth.html

innomed wrote:Some Hybrid users with S8 machines are blocking one port to account for the issues this CPAP has with the Hybrid’s generous flow rate. We are looking into modifying our mask in the near future to be more compliant with the S8 in the future, so please check back with us on that

.

The two links above turned up when I was searching via Google for hybrid- ResMed incompatibility. I didn't find anything recent. If there had been a "slew of reports", one would think there might be something posted somewhere.