Leak rates .vs. machine limitations

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
-SWS
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Joined: Tue Jan 11, 2005 7:06 pm

Re: Leak rates .vs. machine limitations

Post by -SWS » Wed Nov 19, 2008 3:05 pm

ywp wrote:I am a mechanic, designer and installer of water pumps and air blowers. My cpap theraphy is not "" working"" "" And I probably over fixate on mechanics and logic.

Thank you for the though full replies. And please do not take this personally

But What goes out must come in. Maximum output = Maximum input. Not Maximin output + leak rate + lung effort + hope - denial = real out put.
You guys maybe right about it being a limitation on sensors for control and data. Maybe a velocity problem, laminare flow ? . Sounds like the blower has the "horse power" or performance. Guess that is what I will assume. Good explanation to keep an auto pap locked down to a narrow range or go back to cpap. Does make it harder to trust the data

Just mad at medical community
I sure don't blame you for being frustrated, ywp. This therapy can be frustrating when it doesn't work, and it can even be somewhat frustrating when it does work.

My earlier point was only that the machine spec submitted for discussion only describes impeller delivering capacity when interfaced to a nominal impedance-based reference circuit. And that reference spec does not describe maximum flow through the PAP machine's air intake of that final end-to-end system---when a second biologic contributing circuit is added. I agree that increased turbulent flow at higher velocities will increase overall impedance. For what it's worth, highly dynamic human airway resistance and diaphragmatic effort both factor in once that PAP machine interfaces to a living, breathing human. This equation highlights time-based parameter variations to account for varying airway resistance and pressure having to do with airway factors such as diaphragmatic elastic recoil, etc.:

PpatientR1(t)R2(t)*(% Set)*((R3(t)*(FA)({dot over (V)}))(R4(t)*(VA)(V))R5(t)*EPAP

So that's not your typical physics equation for an automotive water pump or Koi pond impeller. It's a biophysics equation, that factors dynamic diaphragmatic pressure and total airway resistances. Anyway, there are two separate but merged pressure/flow systems at opposite ends of a man/machine dual-interfaced system. And I agree with you that not only laminar flow but especially turbulent flow will factor into airway resistance---and thus final flow at any given pressure.

If you enjoy analyzing pressure/flow systems, take a Google search sometime at the Starling Resistor model, a model that SDB researchers often employ to analyze critical collapse pressure (Pcrit) in the human airway. I can think of two APAP algorithms (yours being one) that rely heavily on the measurement and analysis of that same Pcrit parameter.

Anyway, all PAP machine motors provide enough rotational velocity and torque to work with any mask. And all PAP machine plenum and tubing circuit combinations carry adequate flow-through capacity across that full PAP pressure spectrum as well. Good luck!

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sepool
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Re: Leak rates .vs. machine limitations

Post by sepool » Wed Nov 19, 2008 8:54 pm

I have a hard time explaining what I meant above. Sorry.

Trying again: I think the 35 LPM figure is the maximum output during the ISO-defined pressure stability test. Not the maximum the machine can deliver.

-SWS
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Re: Leak rates .vs. machine limitations

Post by -SWS » Wed Nov 19, 2008 9:33 pm

Thanks for the clarification, sepool!
in this thread ywp wrote:My cpap therapy is not "" working""
I'm thinking it might make sense at this point to try and figure out why ywp's therapy is not working.
in a prior thread ywp wrote:My first sleep study I spent most of the night on my side and had a 0 AHI. Spent a couple hours on my back with a AHI of 30. I think the tech. was napping himself. Tritration same thing. Numbers on pressure were messed up. The doctor declared I needed a 7. I demanded they repeat the second study. Instead they gave me a bi-pap tritration and declared I was a 9-14 (the numbers looked worse than without treatment).
Ywp, so what do you think might be going wrong with your therapy? Is it possible that you're having a CSDB/CompSA type reaction to PAP therapy? For some patients BiLevel seems to be a worse modality than CPAP: http://www.chestjournal.org/cgi/content ... 128/4/2141
in this thread ywp wrote:Good explanation to keep an auto pap locked down to a narrow range or go back to cpap.
If BiLevel and/or APAP pressure variations are aggravating your AHI numbers, then don't rule out the possibility of CSDB/CompSA.