IntelliPAP Auto 19, M Series Auto A-Flex 11

RipW.....how did you "feel" after using the Intellipap? Your results sounded similar to mine.

Thanks SWS, I don't have a history or centrals reported, however maybe that doesn't mean anything in this context.

It is surprising how dramatic a difference I feel today on a similar different machine. It's going to be difficult to try another night.

Georgio

Edit to show response from DevilBiss:

Hi George,

Here are some questions and comments.

What settings are you set on with Hypopnea % , Hypopnea duration and Apnea % and Apnea Duration?
When looking at the graph, the AHI was 10/hour while in the Delay Mode (set for 30 minutes). The Delay mode is like a ramping setting in standard CPAP so it does not adjust pressure at that time. It is used to keep pressure low to allow the patient to fall asleep. So this is not the AutoAdjust mode which has AHI of 4/hour which is very acceptable.
Your max leak rates are higher indicating either a mask leak or mouth breathing during the night. Reported significant leaks are not reported until the leak rate is greater than 95 l/min which you are not even close to but you do have higher leaks than I would expect.
When you “sensitize” the algorithm by changing the settings, you are changing both how the AutoAdjust responds and also how it counts respiratory events. So I would expect to see higher AHI’s with an adjustment but I would also expect a quicker response to these respiratory events.


Hope this helps

DAVE

Georgio wrote:Thanks SWS, I don't have a history or centrals reported, however maybe that doesn't mean anything in this context.

Central hypopneas are seldom differentiated from obstructive hypopneas during a PSG, Georgio.

So we would expect patients experiencing exclusively obstructive hypopneas during the PSG to come home with no reports of central hypopneas. However, we would also expect plenty of patients with central hypopneas to come home with no reports of central hypopneas versus undifferentiated hypopneas.

The sleep industry doesn't even agree how to diagnostically differentiate central hypopneas for that matter. But if you're feeling poorly just because of a few outstanding hypopneas, those disporportionate symptoms kind of go with a slight CompSAS/CSDB reaction to the pressure increases themselves----as does your increased HI count, when those hypopneas receive more dynamic or responsive treatment pressure.

That etiologic scenario would probably fare better with less hypopnea sensitivity on the AutoAdjust instead of more hypopnea sensitivity.

Hi SWS,

Yes ... I had only 1 central *apnea* on my PSG but when I had my Respironics on Auto, it would always end up with 90% pressure about equal to the max pressure setting. Then I tried a fixed pressure and increased it one point at a time as long as my apneas were going down and then found that suddenly at a pressure of 14, the number of apneas skyrocketed and I felt worse. When I dropped back to 13, it was reasonable though I couldn't seem to get below an AHI of 2-3. With the Sandman I've got it set to not chase apneas and the top pressure no longer matters ... and my AHI is down to 0.5 - 1 with my pressure set at a range of 10-20, average pressure 10.1.

Mindy

OK....I have tried the hypopnea % at the default of 50%, then changed it to 40% (like Resperonics), if I decide to try it again I believe we're saying to adjust the hypopnea % to 60%. I don't see any reason to adjust the apnea settings from the 20% for 10 seconds where I have it. I assume that the percentages between the two machines are not measured the same and cannot be equally compared.

Georgio

-SWS wrote:Central hypopneas are seldom differentiated from obstructive hypopneas during a PSG, Georgio.

Is this true? During my sleep study, I had almost all central apneas, but my hypopneas were labeled obstructive. I asked the sleep doctor if it was possible the hypopneas were also centrals, but she assured me they weren't. It just didn't make sense to me that the apneas would be centrals, but the hypopneas not.

I am sleeping better with an autopap than before treatment, and increased pressure from my titrated pressure seems to decrease both apneas and hypopneas, so something is helping. I have just been curious about this issue.

riverdreamer wrote:

-SWS wrote:Central hypopneas are seldom differentiated from obstructive hypopneas during a PSG, Georgio.

Is this true? During my sleep study, I had almost all central apneas, but my hypopneas were labeled obstructive. I asked the sleep doctor if it was possible the hypopneas were also centrals, but she assured me they weren't.

Well, when it comes to central versus obstructive hypopneas, there's absolutely no lack of diverse opinions. But there is clearly a lack of differentiating methodology that would approach reasonable measurement sensitivity and specificity IMHO.

That's not to say there aren't hypopnea differentiation methods employed in practice:
http://www.sleepreviewmag.com/issues/ar ... -04_07.asp

And that, in turn, is not to say that researchers think they have a handle on various hypopnea etiologies or even hypopnea-differentiation methodology. Resmed's AutoSet inventor, for instance, thinks all hypopneas are inherently central. Yet others believe that all hypopneas are inherently obstructive. Then, among all practicing and researching experts who believe that both hypopnea types exist (seemingly the majority), there's plenty of disagreement about just what might constitute adequate means of differentiation. Some contend that if the hypopneic flow waveform is purely sinusoidal, then the hypopnea is inherently central----and that if the waveform shows an obstructive-hinting shape at the very top, then the hypopnea is inherently obstructive.

So there are many doctors and researchers that would probably agree with your own doctor, while there are yet plenty others who would likely disagree.

riverdreamer wrote:... increased pressure from my titrated pressure seems to decrease both apneas and hypopneas, so something is helping. I have just been curious about this issue.

The important thing is that pressure treatment actually helps with your hypopneas. The fact that they respond well to pressure suggests inherently obstructive hypopneas. But there are supposedly a few theoretical etiologies that suggest certain (but not all) central hypopneas respond well to pressure also. And, of course, adaptive servo ventilation is all about giving a central hypopnea or central apnea a very nimble pressure increase.

Mindy wrote:I had only 1 central *apnea* on my PSG but when I had my Respironics on Auto, it would always end up with 90% pressure about equal to the max pressure setting. Then I tried a fixed pressure and increased it one point at a time as long as my apneas were going down and then found that suddenly at a pressure of 14, the number of apneas skyrocketed and I felt worse. When I dropped back to 13, it was reasonable though I couldn't seem to get below an AHI of 2-3. With the Sandman I've got it set to not chase apneas and the top pressure no longer matters ... and my AHI is down to 0.5 - 1 with my pressure set at a range of 10-20, average pressure 10.1.

Most interesting, Mindy! Are there any already-existing threads with your Encore and/or Sandman charts? On second thought I'm sure there are, so I'll go searching...

-SWS wrote:[

Mindy wrote:I had only 1 central *apnea* on my PSG but when I had my Respironics on Auto, it would always end up with 90% pressure about equal to the max pressure setting. Then I tried a fixed pressure and increased it one point at a time as long as my apneas were going down and then found that suddenly at a pressure of 14, the number of apneas skyrocketed and I felt worse. When I dropped back to 13, it was reasonable though I couldn't seem to get below an AHI of 2-3. With the Sandman I've got it set to not chase apneas and the top pressure no longer matters ... and my AHI is down to 0.5 - 1 with my pressure set at a range of 10-20, average pressure 10.1.

Most interesting, Mindy! Are there any already-existing threads with your Encore and/or Sandman charts? On second thought I'm sure there are, so I'll go searching...

SWS - I've posted some but probably not that whole sequence. If I can find some time & energy this weekend I'll ferret out those reports and post them here. That scenario seemed to be easily reproducible. It's not totally as cut and dried as I described it above but "close enough". It's the reason I switched to using the Sandman as my primary machine.

Mindy

mindy wrote:SWS - I've posted some but probably not that whole sequence. If I can find some time & energy this weekend I'll ferret out those reports and post them here. That scenario seemed to be easily reproducible. It's not totally as cut and dried as I described it above but "close enough". It's the reason I switched to using the Sandman as my primary machine.

Mindy, your ongoing analysis and retrospective summary is plenty good for me! Please don't put a dent in your weekend plans.

If you happen to be ferreting through your data in the future, and happen to stumble across interesting charts to post, then please do! But don't dare impact a perfectly good weekend for cpaptalk "geekery"!

Oh gosh and golly, SWS - you're not the slavedriver I thought you were

It's been a long week so I think I'll take your advice!

Mindy

Please do enjoy the weekend!

Besides, there will be plenty of weekends (i.e. near-future weekends, distant weekends, and countless weekends in between) for that much-needed data mining!








j/k

btw - love that avatar, SWS .... methinks you won't last long as a chimney

mindy

mindy wrote: .... methinks you won't last long as a chimney

Well, thank goodness I don't smoke in real life, Mindy. However, I do have opposable thumbs, walk upright during socially refined moments, and I even wear eyeglasses.

And speaking of refined moments... I even stayed at a Holiday Inn Express once!

Would like to find a list of approved oximeters that can be connected to my SmartLink module. I can't for teh life of me find such a list in my literature or on Devilbiss web site.

Anyone?

It appears to support Nonin's data protocol. Here are two quotes I found on the Internet:

There is also an optional oximetry port, allowing the module to record up to 72 hours of oximetry data from a Nonin Oximeter.

source: https://www.cpap.com/productpage/devilb ... ystem.html

In addition, the SmartLink Therapy Module includes a port for an optional Nonin® oximeter. Collected oximetry data can be exported to Nonin nVision® software.

source: http://www.talkaboutsleep.com/sleep-dis ... System.htm

I'm not sure if the Nonin nVision® software is required in addition to the DeVilbiss SmartLink Desktop software. Best to email or call DeVelbiss to find out which Nonin or Nonin-compatible model(s) are supported, and whether the Nonin software is required. Please post here if anyone finds the answers.

IF ANYONE THINKS FOR ONE MINUTE THAT 30 POEPLE MAKE UP A STUDY YOU GOT ROCKS IN YOUR HEAD!

If 19 people like it that means 68% people liked it? I don't know about anyone else but if I went to a sleep center, had a study done and was told that the best machine was the IntelliPAP based on 30 people I would seriously doubt the ability of those trained professionals.

This is not the kind of information that should be posted here as it is meaningless.

Look, if you had to go to a sleep study run by professionals using commercial equipment how can an individual (who is asleep by the way) comment on how a machine is working?