Philips Respironics Launches BiPAP autoSV Advanced Sleep Sys

nghy wrote:I started the BiPAP therapy 1/4/2010 so today marks the end of two months. I had a very successful follow-up meeting with my doctor earlier today. I have had 100% compliance which pleased the doctor no end. To date I have eliminated the EDS (excessive daytime sleepines) and any Narcolepsy. My diabetes has been much easier to control. My personal energy and sense of wellbeing has been restored.

Getting back to the doctor visit, I brought along the compliance reports, graphs of recent sleep activity including the SPO2 records, my suggestions for changes in my pressure prescription and a list of grevances with the DME the sleep center assigned to supply the machine and services. The information provided by everyone here and especially rested gal, dsm, sws and mdbose were instrumental in my being able to formulate an intelligent discussion.

To make a long story short the doctor will 1) provide the compliance report so Medicare will purchase the machine; 2) will write a new prescription for me along the guidelines I suggested to provide my BiPAP autoSV Advanced greater latitude to dynamically adjust EPAP and Pressure Support; 3) speak to the DME about his negligent performance and especially about not filling the prescription for Encore Pro software; and 4) will assist me in finding a more suitable DME. The doctor was very intent listening to me and took notes about the white bacteria filer I use and the solutions for manageing the Large Air Leak issue (papcap, and REMZzzs).

It was a good day.

nghy

That is very good progress. The really good part thus far is that you are seeing improvements to yourself & now the thing is to keep that happening.

Am very pleased we have been able to help you & thanks too to you for the stuff you dug up. I had no luck with a provider manual until you found it.

DSM

nghy wrote:... I started the BiPAP therapy 1/4/2010 so today marks the end of two months. ... I have had 100% compliance ... To date I have eliminated the EDS (excessive daytime sleepines) and any Narcolepsy. My diabetes has been much easier to control. My personal energy and sense of wellbeing has been restored. ...

Good for you! It takes hard work, but you show that it makes a huge difference. I also find that with good sleep my blood glucose levels are under much better control.

nghy wrote:... Getting back to the doctor visit, I brought along the compliance reports, graphs of recent sleep activity including the SPO2 records, my suggestions for changes in my pressure prescription and a list of grevances with the DME the sleep center assigned to supply the machine and services. The information provided by everyone here and especially rested gal, dsm, sws and mdbose were instrumental in my being able to formulate an intelligent discussion. ...

It's amazing how much it can help if we do some homework to prepare for our meetings. Glad it went so well.

nghy wrote:... To make a long story short the doctor will 1) provide the compliance report so Medicare will purchase the machine; 2) will write a new prescription for me along the guidelines I suggested to provide my BiPAP autoSV Advanced greater latitude to dynamically adjust EPAP and Pressure Support; 3) speak to the DME about his negligent performance and especially about not filling the prescription for Encore Pro software; and 4) will assist me in finding a more suitable DME. The doctor was very intent listening to me and took notes about the white bacteria filer I use and the solutions for manageing the Large Air Leak issue (papcap, and REMZzzs). ...

Sounds as if it was a very good day.

Glad it went so well. You've worked hard to get there. And you demonstrate the value of actively managing your own health. The rewards make all the difference in the world.

You are the second or third person I've seen mention the REMZzzs. I probably need to try them. I've had LOTS of problems with large leaks. When these ASV units crank up the pressure, most masks just don't seem to be able to handle it.

I will also try the Hybrid. But I think I will give the REMZzzs a shot as well.

Thanks for your questions. I've also had the chance to learn form your questions, observations and the posting of others (as you noted: rested gal, dsm, sws, mdbose, muffy and others ...). Just being able to learn helps make the journey not seem as fruitless as it might seem otherwise.

Keep up the good work!

[\quote]
JohnBFisher said

You are the second or third person I've seen mention the REMZzzs. I probably need to try them. I've had LOTS of problems with large leaks. When these ASV units crank up the pressure, most masks just don't seem to be able to handle it. I will also try the Hybrid. But I think I will give the REMZzzs a shot as well.

[/quote]

REMZzzs offers an inexpensive trial package good for about one week. The REMZzzs is a crude solution but it is effective for me. The REMZzzs is a soft thin jersey cotton fabric cut with a die to approximatly cover the seals on the mask with a cutout for your nose and mouth. One holds the mask with the seals facing up, lays the cloth over the seals and bends over to place one's face into the mask. The tension of the headgear keeps the REMZzzs cloth in place once the mask is fastened in place. I find that a good five o'clock beard anchors the cloth. The cloth is comfortable in contact with the skin and wicks away oils or moisture that compromise the seal. It is also good for people who use skin creams at night. I also think there is a small amount of air that leaks through the cloth maintaining comfort through the sleep period. I wish they had some sort of very low tack adhesive to keep the cloth in place on the seals. Getting one's face into the mask without distubing the cloth is hit and miss at best. You could sacrifice a clean old T-shirt and approximate one for yourself. They also supply a small rectangle of cloth that is supposed to go over the forehead cushions of the mask. The makers reccommend a new cloth each night, but I can reuse the same cloth two or three nights in a row.

nghy wrote:... I find that a good five o'clock beard anchors the cloth. ...

Well that won't be a problem for me. I started shaving in 6th grade!

nghy wrote:... I wish they had some sort of very low tack adhesive to keep the cloth in place on the seals. ...

Post It! Notes for CPAP users!

nghy wrote:... You could sacrifice a clean old T-shirt and approximate one for yourself.
I might head in that direction. But let's see if it helps.

nghy wrote:... The makers reccommend a new cloth each night, but I can reuse the same cloth two or three nights in a row. ...

Uh, to be polically incorrect, the "Scotch" in me would shoot for week or so per liner.

Thanks for your thoughts. I definitely will try to see if it helps.

OutaSync wrote:I went to high school (last two years) with Eddie Van Halen, but I never saw his Frankenstrat.

Did you try sneaking up on him when he was in the Locker Room?

Muffy

[quote="JohnBFisherUh, to be polically incorrect, the "Scotch" in me would shoot for week or so per liner.

[/quote]


John,

I don't know if the Remzzzz will hold up that long. I tried one for three nights in a row. THe nose hole got all stretched out and the edges, inner and outer, curled up so it was hard to place back on the mask without a fold. THen I tried to wash it and laid it flat to dry. It started to fray on the edges and had to be ironed to smooth out. The nose hole is still too big.

So I found an old T-Shirt last weekend and cut out 18 gaskets from just half of the shirt. It's been working much better. The material doesn't roll in on the edges, much easier to deal with. It had already been washed a lot, so no additional shrinkage. So far, so good. It protects my face from the silicone and I can plaster my face with any lotion I want. My leak rate went up a little, but not so much that the machine can't handle it. I figure that these things should cost about 25 cents and last at least a week.

Bev

nghy wrote:To date I have eliminated the EDS (excessive daytime sleepines) and any Narcolepsy.

Are you saying that your bipap use has eliminated your symptoms of narcolepsy entirely? I wouldn't think that's possible, unless it wasn't narcolepsy in the first place. Or are you calling uncontrollable sleep episodes "narcolepsy"?

Your doctor sounds like a keeper.

[quote="-SWS"Are there ANY long-term adverse effects (in either the obstructive SDB or normal populations) to continuous proportional maintenance of inspiratory volumes? [/quote]

What does "continuous proportional maintenance of inspiratory volumes" mean? Then I'll answer your question.

SleepingUgly wrote:

nghy wrote:To date I have eliminated the EDS (excessive daytime sleepines) and any Narcolepsy.

Are you saying that your bipap use has eliminated your symptoms of narcolepsy entirely? I wouldn't think that's possible, unless it wasn't narcolepsy in the first place. Or are you calling uncontrollable sleep episodes "narcolepsy"?

Your doctor sounds like a keeper.

Hi
I was never diagnosed with narcolepsy. I had episodes where I would suddenly and without warning fall into sleep. These are gone completely. I sleep 7-8 hours each night. The rest of the time I am alert and active...................... I just checked on the internet for definitions of Narcolepsy. I had chronic sleepiness, troubled sleep and would fall into deep sleep suddenly during the day. I gave up driving (which I love) after falling asleep at the wheel. I am not prepared to argue whether I had true Narcolepsy or not.

nghy


P.S. I'm back to driving with confidence.

SleepingUgly wrote:

-SWS wrote:Are there ANY long-term adverse effects (in either the obstructive SDB or normal populations) to continuous proportional maintenance of inspiratory volumes?

What does "continuous proportional maintenance of inspiratory volumes" mean? Then I'll answer your question.

I'll guess


Inspiratory volumes = the breath-in part of normal tidal flow (tidal flow = flow goes in flow goes out - insp = the breathing in part)

Maintenance = supporting a particular level of inspiratory flow

proportional = maintaining the support to be a minimum proportion of the tracked inspiratory flow.

Put together = SV (servo ventilation)

DSM

A new milestone. Last night the odometer clicked over 500 hours on the SV Advanced. Today my doctor sent the new prescription and the compliance reports to the DME. WooHoo!!!

Sometimes life gets really, really exciting.....

nghy

Our electric power has been restored after being down for two+ days. I missed using the bipap and I am not feeling the best. I would like to make plans to have a back up power source. Respironics sell a DC Power Adapter that uses 12V batteries. Have any of you used this setup? What size and type of battery do you recommend? This was by far the longest outage in 30 years living here. Most times the problems lasts less than one day. Has any one used the portable gel pack? Thanks for any suggestions.

nghy

You might want to look at the following post:

viewtopic.php?p=449334

It describes a battery backup design I put together for my ResMed VPAP Adapt SV.

You can certainly look at the DC to DC converter for your Respironics BiPAP AutoSV unit. It will allow you to use a smaller battery.

Hope it helps.

JohnBFisher wrote:You might want to look at the following post:

viewtopic.php?p=449334

It describes a battery backup design I put together for my ResMed VPAP Adapt SV.

You can certainly look at the DC to DC converter for your Respironics BiPAP AutoSV unit. It will allow you to use a smaller battery.

Hope it helps.

Thanks John Your article was very helpful. The information raised lots of questions. As I understand the Respironics DC adapter for the biPAP autoSV Advanced increases the battery voltage from 12V to 24V. This seems fine for using an automobile's battery or the gel cell pack. But could I just use two 12V batteries in series or even a 24V battery such as used for golf carts and in warehouse fork trucks. Does your system provide for the heated humidifier. The heater I think requires a pure sine wave AC. Most inverters produce a "modified AC" with all sorts of harmonics.

nghy

nghy wrote:... The information raised lots of questions. ...

Well, you've come to the right place. I have all sorts of questions for answers. ... Or was that answers for questions? I never can remember which it's supposed to be!

nghy wrote:... As I understand the Respironics DC adapter for the biPAP autoSV Advanced increases the battery voltage from 12V to 24V. This seems fine for using an automobile's battery or the gel cell pack. But could I just use two 12V batteries in series or even a 24V battery such as used for golf carts and in warehouse fork trucks. ...

You could use two 12v DC batteries in series to give you 24v DC. However:

1. Respironics only warrants use of their DC converter
2. The DC converter does a lot more than just bumping the voltage to 24v DC

I fear I can no longer find the information on the DP Power Adapter. Here's the link to the CPAP.com listing:

https://www.cpap.com/productpage/DC-Pow ... Bipap.html

However, it essentially helps guarantee the voltage to the unit is 24v DC. If you put two batteries in series, you won't get 24v DC as they are used. It also protects your unit from over voltage and under voltage situations.

The Respironics Heated Humidifier manual is at:

http://global.respironics.com/UserGuide ... difier.pdf

It notes:

DC to AC inverters cannot be used with this humidifier; damage could occur to the humidifier.

So, if you use your humidifier, you will need another approach.

nghy wrote:... Does your system provide for the heated humidifier. The heater I think requires a pure sine wave AC. Most inverters produce a "modified AC" with all sorts of harmonics. ...

As you see, you are correct.

If you need a heated humidifer, you will want to use a Pure Sine Wave Inverter.

To do that you will need to figure the amp hours you need to drive you unit and humidifer. The manual for the AutoSV unit says it uses 1.25 amps. The manual for the humidifier says it uses 1.0 amps. Let's assume you are going to use an AGM battery (they are no spill and have lots of advantages ... that's what I purchased).

In that case, we need to assume you will use no more than 1/2 of the battery ... draining it completely can kill it pretty quickly.

So, to drive the unit you will need 2.25 amps x N hours. Since you just had a two day outage, let's assume that is 16 hours ( 2 x 8 ). The amp-hours you need is then 2.25 x 16 = 36 amp-hours. Double that (so you don't use more than 1/2 of the battery) and you get 72 amp hours. Plus the pure sine wave inverter uses some overhead. And you might like some reserve. So you need at least 72 amp hours on that battery and possibly more.

Remember, no humidifier takes about 1/2 of the power ... so, I chose to forgo a humidifier if we loose power.

Anyway, you can find find the wattage needed (to determine the size of the inverter) by multiplying the input voltage times the amperage. So, it's 110 x 2.25 = about 250 watts (247.50). Again, you might want a little head room, so figure 300 watts.

Here's one that would work:

http://www.theinverterstore.com/the-inv ... 2s-top-rgb

It is about $130.

But if you did without the humidifier, you would have 110 x 1.25 = about 150 watts (137.50). So, if we add some headroom we might look for 180 watts. And we find:

http://www.theinverterstore.com/the-inv ... pwri18012s

It is about $100.

Of course, you can get a modified sine wave inverter for the BiPAP unit without any humidifier. They are a LOT less expensive. For example this 150 watt inverter:

http://www.theinverterstore.com/the-inv ... -front-rgb

is only about $25.

By the way, I just picked the first link to an inverter store that I knew would carry those units. I recommend doing some online shopping to get the best price and service.

I decided to do without the humidifier if necessary. Or at least without the humidifier on. If I have it turned off, it just acts as a passover humidifier. That is better than nothing. And it might make it bearable for the time I do not have power.

But other than those changes, the approach remains the same. That is how I would build such a Battery Backup System if I had your unit. I would still pay attention to the battery type. I would use a Battery Tender charger (designed for an AGM battery). I would still use the case. And so on.

Hope that helps.