IntelliPAP Auto 19, M Series Auto A-Flex 11

I am now registered. Thank you for the reccomendation!

DeVilbiss Marketing wrote:I am now registered. Thank you for the reccomendation!

Very good choice of avatar.

-SWS, Using the company logo as an avatar - first time in history of cpaptalk?

[quote="MrSandman This is a nice feature if only you could use the smart card to do the upgrade.[/quote]

With the firmware and IntelliPAP to PC serial port cable (DV51D-615) you can update any IntelliPAP and take advantages of enhancements we make to the devices. We wanted to empower folks to be able to take advantage of periodic updates efficiently.

The firmware upgrade noted in this thread is specific to our SmartCode feature. SmartCode uses a proprietary encryption method that allows therapy and usage data to be generated and compressed into onboard codes. When the codes are entered into the SmartCode report generator (located at http://www.Intellipap.com), the series of characters is deciphered into usable data and charts.

The enhanced version of SmartCode for the AutoAdjust will now allow you to review:
Days at Least 4 hours
% of Days at Least 4 hours
Day Count
Average Hours per Day
While Breathing Hours
Percentile Pressure
Apnea/Hypopnea Index (AHI)
Pressure Plateau
High Leak Flow Time
Non-Responding Event Index (NRI)
Exhale Puff Index (EPI)

This is built-in to each IntelliPAP. There is no need for additional equipment to access this data.

DeVilbiss Marketing wrote:With the firmware and IntelliPAP to PC serial port cable (DV51D-615) you can update any IntelliPAP and take advantages of enhancements we make to the devices. We wanted to empower folks to be able to take advantage of periodic updates efficiently.

What ever gave you guys the silly impression that users might want to update their firmware for the price of a $24.95 cable instead of buying a whole new machine as we did in the past?

DeVilbiss Marketing wrote:When the codes are entered into the SmartCode report generator (located at http://www.Intellipap.com), the series of characters is deciphered into usable data and charts.

The enhanced version of SmartCode for the AutoAdjust will now allow you to review:
Days at Least 4 hours
% of Days at Least 4 hours
Day Count
Average Hours per Day
While Breathing Hours
Percentile Pressure
Apnea/Hypopnea Index (AHI)
Pressure Plateau
High Leak Flow Time
Non-Responding Event Index (NRI)
Exhale Puff Index (EPI)

This is built-in to each IntelliPAP. There is no need for additional equipment to access this data.

Those data reporting & storing conveniences are fine in my opinion. Some people will clearly prefer that method while others will undoubtedly prefer storing and managing data on their own hard drives. But what I see here---and what I hope DeVilbiss designers have in mind---is an absolutely superb way to take a periodic data/efficacy survey, regarding the machine's pressure and event response patterns across the data-reporting patient population. In my own way of analyzing, subsequent firmware tweaks might then be based on any given subtle but compelling data trends that may come to light.

That's potentially a clear patient-population-wide efficacy advantage compared to the previous method of allowing all that potentially priceless data to just fall by the wayside. So Kristen, I sure hope your R&D team plans on making good use of all that data coming your way. If not, tell them to get on the stick---the data memory stick that is.

rooster wrote:Very good choice of avatar.

-SWS, Using the company logo as an avatar - first time in history of cpaptalk?

Uh, yeah. This whole thing is just getting better by the minute in my honest opinion. This is the way it should have been all along: that a PAP manufacturer might actually focus on the people who literally need their machines to survive---rather than almost exclusively focusing on the various DME and other corporate deal-making dynamics that are also absolutely necessary for any PAP manufacturer to survive in this real world.

As much as I like various Craftsman tools, I'm about ready to go scratch that label off my air compressor in the garage and put a "Manufactured by DeVilbiss" sticker on it---just on principle. This is only getting better by the minute. The other manufacturers actually seemed to despise our unsolicited message-board opinions.

By stark contrast it's Saturday and Kristen is here very politely swimming through flack, trying her best to solicit our valuable input.

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Kristen, please excuse my oversight. In all this "customer e-focus" history-making of yours, I almost forgot to congratulate you on the much smaller but preeminently important issue:

CONGRATULATIONS DEVILBISS ON HANDILY WINNING CPAPTALK.COM'S FIRST MACHINE CHALLENGE!!!!

DeVilbiss Marketing wrote:

SharkBait wrote: I'm wondering why anyone would make a modern day blower without this, and there was no comment from the "marketing" guy about exhale relief. It's almost like there are patents in force so the machine has relief but isn't advertising/publishing it... crazy, I know...

Relief on exhalation is a patented technology which makes it difficult to add this feature to devices. We will be investigating opportunities surrounding this feature in the future. We understand that this is a beneficial feature that may ultimately provide additional comfort to the user and therefore potentially more beneficial and adherence to therapy.

I certainly understand as I have quite a few patents myself on my point of sale marketing methodologies...

I assume since both Respironics and ResMed both have exhale relief they either figured out a way around one another's patent or one is licensing from the other.

Thanks for the feedback and good luck in finding a way around it...

I was just thinking myself, that there must be a way around that patent for exhale relief.

Am I correct that Respironics had it first? If so, Resmed found a way around it. I'm confident that DeVilbiss will too! I'll be watching for that!

There has already been a patent fight about exhalation relief. Invacare and Respironics got in a big spat about it that took years to settle. The industry now uses patents not only to protect their own intellectual property but to block others from further developing products that they first patented. Resmed and Respironics have bloodied each other over patents for a long time. They are reluctant to get in more public battles. Respironics could license the rights to other manufacturers as they did with BiPAP technology. I think they still should. Devilbiss or anone else has little chance of developing their own exhalation relief without a legal battle. My take on the Challenge result is that exhalation pressure relief is not as useful in auto titrating cpaps as it is on standard machines at high pressure. I know this is subjective and that some auto users find it is essential.

DME Daddy wrote:My take on the Challenge result is that exhalation pressure relief is not as useful in auto titrating cpaps as it is on standard machines at high pressure. I know this is subjective and that some auto users find it is essential.

EPR is just one of those comfort features that some can do without, others cannot. I've never been able to tolerate a CPAP machine that didn't have this feature. My first DME/DOC prescribed CPAP was an S8 Compact—I just couldn't breath naturally with it, since it didn't have EPR. After two nights of using it, I was on the Internet looking at other models, read about EPR, knew this was what I had to have to use CPAP, fought hard to get the machine exchanged for the S8 Elite with EPR (of course, all of this was more than a year before I found this forum and really started my CPAP education!). So, like all creature comforts, it is a matter of personal preference (and tolerance). EPR is a must have for me. I so hope IntelliPAP is able to add this feature in the future.

Hawthorne wrote:I was just thinking myself, that there must be a way around that patent for exhale relief.

Am I correct that Respironics had it first? If so, Resmed found a way around it. I'm confident that DeVilbiss will too! I'll be watching for that!

I think Respironics first came up with exhale relief by tracking and responding to specific "parameter variations" in the expiratory flow signal (driven by the likes of elastic recoil, etc.). Resmed's expiratory-relief solution had to be just as unique and patentable.

I believe Resmed decided to simply deliver traditional BiLevel relief pressure (a fixed EPAP value). However, when expiratory end-phase obstructive apneas are either precursor-imminent or present, Resmed's algorithm temporarily suspends that BiLevel pressure delivery until "the coast is clear" so to speak regarding apneas.

If DeVilbiss one day decides to pursue exhale relief, they will need to either license an already existing patent or invent a brand new but unique solution.

RipVW wrote:EPR is just one of those comfort features that some can do without, others cannot. I've never been able to tolerate a CPAP machine that didn't have this feature.

I'm one of those strange birds who must turn the Respironics Flex feature off to get more comfortable sleep. Somehow leaving the Respironics Flex feature on manages to create more aerophagia for me. But with Flex turned off, I usually have little or no aerophagia. Go figure! I think my aerophagia experience with the Flex feature is opposite the usual case.

-SWS wrote:I'm one of those strange birds who must turn the Respironics Flex feature off to get more comfortable sleep. Somehow leaving the Respironics Flex feature on manages to create more aerophagia for me. But with Flex turned off, I usually have little or no aerophagia. Go figure! I think my aerophagia experience with the Flex feature is opposite the usual case.

I think your REMstar Auto has just C-Flex, if I remember correctly. It might not make any difference about "flex" causing you aerophagia, but A-Flex feels very, very different to me from the way C-Flex feels. A-Flex feels considerably smoother to me. More like the "breathing out into an empty hose" feeling of a bilevel machine to me.

I echo everyone's kudos to DeVilbiss for officially appearing on this message board to "talk" with actual users! Good for you for doing that, Kristin, and thanks to the powers-that-be at DeVilbiss for allowing this kind of interaction.

rested gal wrote: It might not make any difference about "flex" causing you aerophagia, but A-Flex feels very, very different to me from the way C-Flex feels. A-Flex feels considerably smoother to me. More like the "breathing out into an empty hose" feeling of a bilevel machine to me.

Thanks for that description, Laura. "No-Flex" works so well for me that I may never even muster the inclination to try A-Flex.

The other amazing thing about my own strangeness with Respironics' exhalation relief: aside from the aerophagia, I can't even feel the difference between pressure-relief on and pressure-relief off. I'm thinking I may suffer heavily-blunted afferent receptors--- a key part of my own SDB etiology perhaps. Recall that I have "silent" acid reflux disease that I have never been able to feel either. Again, go figure!

Anyway here are two interesting graphs showing how A-Flex differs from C-Flex on that top-most descending slope. Basically, that rounding at the top distinguishes those two versions of Flex:

C-Flex:



A-Flex:


In summary both Flex versions share that bottom-curve softening which: "provides flow-based pressure relief at the beginning of exhalation. "
Additionally, A-Flex provides that slight top-curve softening which: "softens the pressure transition from inhalation to exhalation to provide additional comfort in an auto-CPAP mode." (pictures and descriptions were taken from Respironics web site)


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rested gal wrote:I echo everyone's kudos to DeVilbiss for officially appearing on this message board to "talk" with actual users! Good for you for doing that, Kristin, and thanks to the powers-that-be at DeVilbiss for allowing this kind of interaction.

Not to lose yet another well-deserved pat on the back. ...Okay, a hand-clap, then. I didn't have a pat-on-the-back animated icon.

Yeah, both graphs and both descriptions show the exhalation pressure relief being "C-Flex", and A-Flex affecting only a different part of the curve.

I don't know why it is, though...maybe just my imagination... ... but I don't feel that "BOOM, here it is again!" feeling of pressure rushing back in toward the end of my exhalation with A-Flex, like I do with "just C-Flex." I had learned to ignore that with C-Flex, but if I'm using C-Flex and thinking about it, I can definitely feel it.

Anyway, all of it, exhalation and inhalation...all the transitions up or down...just feel smoother and more natural to me with A-Flex turned on than with C-Flex turned on. Maybe it's just me!

rested gal wrote:I don't know why it is, though...maybe just my imagination... ... but I don't feel that "BOOM, here it is again!" feeling of pressure rushing back in toward the end of my exhalation with A-Flex, like I do with "just C-Flex." I had learned to ignore that with C-Flex, but if I'm using C-Flex and thinking about it, I can definitely feel it.

It's apparent to me that you somehow ended up with my missing afferent-receptor sensitivity.

But seriously, Respironics wouldn't have added that top-most pressure curve smoothing unless some people "felt it" in a beneficial way. So I have absolutely no doubt that you can feel the difference, Laura. Now may I please have my missing afferent-receptor sensitivity back?

rested gal wrote:Yeah, both graphs and both descriptions show the exhalation pressure relief being "C-Flex", and A-Flex affecting only a different part of the curve.

I don't know why it is, though...maybe just my imagination... ... but I don't feel that "BOOM, here it is again!" feeling of pressure rushing back in toward the end of my exhalation with A-Flex, like I do with "just C-Flex." I had learned to ignore that with C-Flex, but if I'm using C-Flex and thinking about it, I can definitely feel it.

Anyway, all of it, exhalation and inhalation...all the transitions up or down...just feel smoother and more natural to me with A-Flex turned on than with C-Flex turned on. Maybe it's just me!

I think the C-Flex "rush" is due to the fact that it just feels like the machine has turned off. At least with A-Flex you can still feel the machine is on so the move back to pressure isn't as extreme. While my results with C-Flex are as good as with A-Flex, I just can't get past the fact that it feels like it's backing off too much. The "C" in CPAP makes me want to feel like the machine is maintaining a little pressure during exhale. I know, weird...

SharkBait wrote:

rested gal wrote:Yeah, both graphs and both descriptions show the exhalation pressure relief being "C-Flex", and A-Flex affecting only a different part of the curve.

I don't know why it is, though...maybe just my imagination... ... but I don't feel that "BOOM, here it is again!" feeling of pressure rushing back in toward the end of my exhalation with A-Flex, like I do with "just C-Flex." I had learned to ignore that with C-Flex, but if I'm using C-Flex and thinking about it, I can definitely feel it.

Anyway, all of it, exhalation and inhalation...all the transitions up or down...just feel smoother and more natural to me with A-Flex turned on than with C-Flex turned on. Maybe it's just me!

I think the C-Flex "rush" is due to the fact that it just feels like the machine has turned off. At least with A-Flex you can still feel the machine is on so the move back to pressure isn't as extreme. While my results with C-Flex are as good as with A-Flex, I just can't get past the fact that it feels like it's backing off too much. The "C" in CPAP makes me want to feel like the machine is maintaining a little pressure during exhale. I know, weird...

I presume you know that you can adjust the A-FLEX and C-FLEX settings to 1, 2 or 3 to reduce or increase the effect of the feature.