ResMed S9 coming soon?

dsm wrote:5. Wonder what the implications of that smaller dia tube will be - certainly a fraction cheaper to mfg

It'll probably fall apart and develop leak after a month's use....

O.

One other interesting point (for now) I forgot to add was the reference to added 'S9 Oximeter Adapter'

Now - that could get very interesting if they had the smarts to support affordable SpO2 units. But, if
it is the - same old same old - $900 - $1200 unit that is grossly overpriced & proprietary mdule adds
little value, then it will not be anywhere near as interesting as it could be - so here's hoping

What would blow my socks off is if you could feed any USB SpO2 unit into the new S9 but here I think I
am in fantasy land

Lets wait & see what this means as it is really terrific to be able to view SpO2 data that is lined up with
nightly data. Trying to do it by hand, as I have dome many times, is totally time consuming & frustrating.

DSM

Ms.Snuffleupagus wrote: I just noticed that I can't open this link. It says that based on my location, I am unable to access this site and redirects me to the Canada/US Resmed site. I was able to view the UK site when Rested Gal first posted it.
Hummmm...

I saw this as well. I used a UK proxy and downloaded all the PDF files. They are 22MB zipped. I've shot a note off to Rested Gal to see if she'd be kind enough to host them (she offered to host my PDF on how to disable the speaker on the PR1 System One last year).

If anyone else is able to host them on a web server somewhere let me know, or I'll update this post when I hear back from Rested Gal.

Alternatively if anyone REALLY wants some specific doc PM me and I'll email it to you.

jnk wrote:It looks to me from the chart on that page that I linked to that they have slightly modified A10 so that a closed-airway frank apnea above 10 cm will now be considered a criterion for an increase in pressure--but not as a direct challenge to the apnea for the purpose of clearing it, since it will wait until inspiration has resumed to raise the pressure. However, I may be misreading the wording and the chart next to it. The last arrow pointing up on that stair-step chart seems to show an obstructive apnea occurring at 10 cm and the pressure being raised in response to it. I assume that is what the ResMed earnings report meant by "an enhanced AutoSet algorithm."

I agree with your interpretation, jnk.

That PDF document shows: 1) how the old and new algorithms behave differently below 10cm in response to central apneas, and 2) how the old and new algorithms behave differently above 10cm in response to obstructive apneas. Big change!

dsm wrote:...the way FOT works can vary a little but lets assume this is how Resmed's FOT works

1) normal monitoring of breathing rate & minute ventilation
2) A slowing / cessation of air flow is detected during what should be the inspiration phase
3) A very low frequency signal (inaudible & hopefully at a frequency that is not be sensed by the sleeper) is added to the airflow by way of a transducer (like a tiny speaker)
4) The machine then looks for the rebound (reflection) of the signal & analyzes it for an added heartbeat signal

If the airway is open the heartbeat will be readily seen if not then it won't or will be very faint.

Just a comment that any given forced oscillation technique (FOT) and the detection of COS (cardiac oscillation signals) are two separate central-apnea differentiation methods. The two methods may or may not be performed in tandem toward differentiating central apneas. As the respective names imply FOT are based on forced oscillations while COS are based on naturally or biologically occurring oscillations.

A highly sensitive pneumotachograph sensor can pick up either subtle type of oscillation: forced or cardiac. Weinmann uses those two separate techniques in tandem. However, I don't see any evidence yet of other manufacturers using the FOT and COS differentiation techniques together.

Why would I want to convert to this new system?

Ergonomically, it is a disaster for me.
It would have to face the back of the
night stand for proper hose management.
To add water or remove the HH tank, I would
have to remove the hose and turn the system around.
Were the Resmed design engineers driven by marketing guys that
thought the market was being driven by where the hose attaches?
Were the Respironic's engineers dupped by marketing guys that
said everyone is going to systems w/the hose connector on top?
Is this a case of MAD magazine Spy vs Spy???

With the Autoset/Elite I never have to disconnect the hose,
it is a simple motion to flip the HH chamber cover and remove the tank,
and the system is facing me for on/off and adjustments.

New software required. When and to whom will it be available?

Is the new algorithm just an attempt to mimic/catch-up w/Respironics?

My Ozzy heated hose provides excellent rainout/comfort humidity control.

Any ideas on what this "new and improved" system is going to cost??

-SWS wrote: That PDF document shows: 1) how the old and new algorithms behave differently below 10cm in response to central apneas, and 2) how the old and new algorithms behave differently above 10cm in response to obstructive apneas. Big change!

I would like to thank everyone on this forum that has contributed
to my cpap education. Without that education, that graph would
have been meaningless.

It has been released in the UK about a week ago but they are waiting for stock to arrive which will be in the next few weeks im told .

Here goes the price -

S9 auto machine -£478.00 if you join there real sleep club (free) it will come down to £454.00

Humidifier which contains climate control /comfort slimline tube -no rain out they say will be £155.00 with real sleep club that would go down to £147.25.

Like the idea of the heated tube in with the humidifier that will surely solve rainout once and for all.

The new slimline tube still has the normal rubber ending to fit onto whatever mask you have

This info was obtained from Resmed's main UK office in Oxford.

The S9 will be released on March 1st in North America.

-SWS wrote:

jnk wrote:It looks to me from the chart on that page that I linked to that they have slightly modified A10 so that a closed-airway frank apnea above 10 cm will now be considered a criterion for an increase in pressure--but not as a direct challenge to the apnea for the purpose of clearing it, since it will wait until inspiration has resumed to raise the pressure. However, I may be misreading the wording and the chart next to it. The last arrow pointing up on that stair-step chart seems to show an obstructive apnea occurring at 10 cm and the pressure being raised in response to it. I assume that is what the ResMed earnings report meant by "an enhanced AutoSet algorithm."

I agree with your interpretation, jnk.

That PDF document shows: 1) how the old and new algorithms behave differently below 10cm in response to central apneas, and 2) how the old and new algorithms behave differently above 10cm in response to obstructive apneas. Big change!

dsm wrote:...the way FOT works can vary a little but lets assume this is how Resmed's FOT works

1) normal monitoring of breathing rate & minute ventilation
2) A slowing / cessation of air flow is detected during what should be the inspiration phase
3) A very low frequency signal (inaudible & hopefully at a frequency that is not be sensed by the sleeper) is added to the airflow by way of a transducer (like a tiny speaker)
4) The machine then looks for the rebound (reflection) of the signal & analyzes it for an added heartbeat signal

If the airway is open the heartbeat will be readily seen if not then it won't or will be very faint.

Just a comment that any given forced oscillation technique (FOT) and the detection of COS (cardiac oscillation signals) are two separate central-apnea differentiation methods. The two methods may or may not be performed in tandem toward differentiating central apneas. As the respective names imply FOT are based on forced oscillations while COS are based on naturally or biologically occurring oscillations.

A highly sensitive pneumotachograph sensor can pick up either subtle type of oscillation: forced or cardiac. Weinmann uses those two separate techniques in tandem. However, I don't see any evidence yet of other manufacturers using the FOT and COS differentiation techniques together.

SWS

Yes I agree & was without any doubt you would be able to pinpoint the technique clearly as I recall you discussing FOT impedance based sampling some time back. I did realize that they weren't sampling heartbeat when I read the current patent app for this new FOT technique (as added).

What particularly caught my eye was the mention that the 2006 application relied on proximal sensing but the new one doesn't & also that they claim sampling the signal at the flow generator is more accurate. That is interesting - I would have thought that mask sampling would be more accurate but flow-gen sampling is how they do it. Any thought on that ?

Cheers

DSM

Based on the patent stuff DSM posted earlier, it looks like they are trying to measure the reactive (in an an AC electronics sense) component of the response to a pressure change challenge.

I also noticed that both of the machines they listed are fully data capable. Maybe the days of non data capable machines are finally over.

I additionally noticed that there is a provision for breath waveform recording, something I just learned some Respironics machines have.

In any case, major advances!

Just helping jdm out with the hosting, sorry if these links go bad with exceeded bandwidth.
I will host as long as i can, hopefully Resmed USA will host them soon

S9 Auto Set
http://tinyurl.com/ydwl9fu

S9 Elite
http://tinyurl.com/ykhsnn9

S9 Information Guide
http://tinyurl.com/yhrq837

S9 Welcome Guide
http://tinyurl.com/ycu9cqv

S9 Patient Management
http://tinyurl.com/yepmepk

S9 User Guide
http://tinyurl.com/ydk9upn

S9 Tech review
http://tinyurl.com/ybtap76

ClimateLine Air Tubing Insutructions
http://tinyurl.com/y9mmxr8

H5i Welcome Guide
http://tinyurl.com/ycklgmt

H5i User Guide
http://tinyurl.com/y9jsn72

H5i and ClimateLine Heated Air Tubing Information
http://tinyurl.com/yejeg6j

H5i Accessories Guide
http://tinyurl.com/yb9syhm

Uncle_Bob

A helpful set of links

Thanks

DSM

timbalionguy wrote:Based on the patent stuff DSM posted earlier, it looks like they are trying to measure the reactive (in an an AC electronics sense) component of the response to a pressure change challenge.

I also noticed that both of the machines they listed are fully data capable. Maybe the days of non data capable machines are finally over.

I additionally noticed that there is a provision for breath waveform recording, something I just learned some Respironics machines have.

In any case, major advances!

Timbalionguy

You might be able to offer some comments on this which is a summary of the Resmed patent.

DSM

1. A method for determining the occurrence of an apnea comprisingmeasuring respiratory air flow from a patient's airway to provide an air flow signal,applying an oscillatory pressure waveform of known frequency to the patient's airway,calculating a complex quantity representing a patient admittance, andcomparing the values of the complex quantity with regions indicative of patency or closed airways.

2. The method for determining the occurrence of an apnea of claim 1, further comprising comparing a patient admittance with admittance during normal breathing.

3. A method for distinguishing between closed and open respiratory apneas in a patient using a CPAP apparatus having a mask and a flow generator comprisingapplying a pressure wave having a waveform of some amplitude at the flow generator,determining the magnitude of the pressure waveform at the mask,adjusting the pressure amplitude at the flow generator to produce a desired amplitude at the mask,determining the patient admittance and comparing it to values representative of closed or open apneas.

4. The method for distinguishing between closed and open respiratory apneas of claim 3, wherein the step of adjusting the pressure amplitude is accomplished by increasing the pressure at the flow generator by the ratio of the desired to the actual pressure magnitude at the mask.

5. A method of distinguishing between open and closed airway apneas of a patient comprising the steps of:(i) connecting a respiratory device to a patient via an air delivery tube and a patient interface;(ii) delivering an alternating pressure waveform to the patient from the respiratory device to the patient via the air delivery tube;(iii) measuring a flow rate and pressure of air at the respiratory device;(iv) determining a capacitive component of an air delivery tube impedance;(v) determining a patient admittance from said measured flow and pressure of air and said capacitive component;(vi) distinguishing between an open and closed airway apnea on the basis of said patient admittance.

6. The method of claim 5 further comprising the step of correcting the said flow rate for leak.
7. The method of claim 5 further comprising the step of correcting the said flow rate for vent flow.

8. A method of distinguishing between open and closed airway apneas of a patient comprising the steps of:(i) connecting a respiratory device to a patient via an air delivery tube and a patient interface;(ii) delivering an alternating pressure waveform to the patient from the respiratory device to the patient via the air delivery tube;(iii) measuring a flow rate and pressure of air at the respiratory device;(iv) determining an inductive component of an air delivery tube impedance;(v) determining a patient admittance from said measured flow and pressure of air and said capacitive component;(vi) distinguishing between an open and closed airway apnea on the basis of said patient admittance.

9. The method of claim 8 further comprising the step of correcting the said flow rate for leak.
10. The method of claim 8 further comprising the step of correcting the said flow rate for vent flow.
11. The method of claim 5 or claim 8 further comprising the step of determining the phase angle of the admittance.
12. The method of claim 5 or claim 8 further comprising the step of determining the magnitude of the admittance.
13. The method of claim 5 or claim 8 further comprising the step of determining the real component of the admittance.
14. The method of claim 5 or claim 8 further comprising the step of determining the imaginary component of the admittance.
15. The method of claim 5 or claim 8 whereby said alternating pressure waveform has an frequency of approximately 4 Hz.
16. The method of claim 5 or claim 8 whereby said alternating pressure waveform has an frequency in the range of approximately 2-8 Hz.
17. The method of claim 5 or claim 8 whereby said alternating pressure waveform has an frequency in the range of approximately 1-16 Hz.
18. The method of claim 5 or claim 8 whereby approximately the first 250 ms of flow or pressure data following an application of the pressure waveform are not measured.

[quote="carbonman"]

Is the new algorithm just an attempt to mimic/catch-up w/Respironics?

[quote="-SWS"]


I'm wondering, too. Anyone?

fadedgirl wrote:

carbonman wrote:
Is the new algorithm just an attempt to mimic/catch-up w/Respironics?

-SWS wrote:

I'm wondering, too. Anyone?

I don't think so.

Resmed had a FOT based machine in approx 2002/3 that they never released. IIRC it was called the Resmed Autset II.

If I had a guess it would be that Respironics knew Resmed were close to releasing the S9 range with FOT & dived in 1st with their 'puff of air'
sampling approach which is a minimalistic approach.

I am not certain but I think Resmed would have to have got FDA approvals through before releasing machines with FOT into the US market.

This is just me speculating

DSM

See this discussion - SWS knows

viewtopic.php?f=1&t=40904&p=358433&hili ... 03#p358433