Questions for Respironics regarding their APAPs.

Hi DME_Guy,

Bet this isn't turning out the way you wanted! Just make a copy of this thread, give it to the Rep and tell him send it to the head of "Technical Design and Research". Then give him a second copy to send to the head of marketing and ask why there is so much confusion among the end users. Shouldn't all of this be covered in the brochures?

Here are a some questions you can ask him before he takes you out for a nice liquid lunch:

- When are they going to improve the smart card so it can handle more data. For example, instead of seven nights how about 6 - 12 months? Also why no alarm when the card is full?

- Why do many MD's not accept APAP's because they do not believe the algorithm is proven or does not work and continue to flog CPAP's?

- What exactly is the difference in the algorithms between CPAP and APAP and is there any real significant difference of these algorithms between manufacturers vis a vis effective patient treatment?

- What steps are they taking to promote APAP's with insurance companies, stressing the fact it could be cheaper for them in the long run.

- When will they cease manufacturing CPAP's as the APAP's offer better patient treatment. This will reduce mfg costs plus increasing revenue per unit sold.

- Also be sure to confirm the rumor they are expanding operations by developing a new product line. Hover and Electrolux are already hunkered down to combat their new design carpet and floor cleaning unit which utilizes only the amount of sucking power needed for the amount of dirt etc that is encountered. By adjusting the sucking power automatically only the correct amount of force is used to remove the varying dirt levels. This has been proven be environmentally friendly, reduce power consumption, lessen the noise factor and of course limit the wear and tear of valuable floor covering - particularly synthetics and high grade wool. Dirt Devil has been working on this for years but just could not get the unit to function as needed. Seems if you turned the machine off, say to move furniture or go to another room, you had to wait ten minutes for it to resume.

Very much appreciate your efforts in this regard and look forward to any info you can get.

All the best.

Bob F

Sorry,

Somehow I am not being logged in. Thought I was. The above post was me.

Bob F

Uncle Bob wrote:- When are they going to improve the smart card so it can handle more data. For example, instead of seven nights how about 6 - 12 months? Also why no alarm when the card is full?

Better question, when are they going to put a USB 2.0 port on the back (or front). A lowly 128 MB USB SanDisk Cruzer or Lexar is about $10 nowadays. Think of the OTHER advantages... plug it directly into the 'puter. Plug a wireless adapter into the USB port, no need for the external memory, talk directly to the wireless LAN, or via the internet to headquarters, the sleep lab, the mother ship, whatever. And since it's Christmas, maybe some onboard memory.

-Ric

-SWS wrote:

NightHawkeye wrote:I am amazed that this small glitch has attracted so many folks to defend the algorithm so profoundly.

I see quite a few people trying to analyze the problem, Bill. I also see varying degrees of personal preference regarding when to draw a conclusion versus analytically discussing possible alternatives. I think it's nice to very respectfully compare contrasting ideas toward making discoveries.

I'm also anxious to hear Respironics' official explanation.

Nicely put, -SWS.

Today, just as a casual experiment of sorts, I got out my REMstar Auto, put on the Breeze with my reading glasses under it, and sat here turning the machine on and off while I did a couple of hours worth of bookwork at the computer. No question that I was wide awake the whole time.


On (on/off button) for 30 minutes.
Off (on/off button) for 2 minutes.

On (via breathing into mask) for 30 minutes.
Took mask off, left machine running with mask off for 2 minutes.
Put mask back on, continued letting machine run for 10 more minutes, making total run of 40 minutes.
Off (on/off button)

Left the machine turned off for 45 minutes

On (on/off button) for about 30 minutes.
Off (on/off button) and downloaded the Smart Card.

The data reflected all those things perfectly, including a tiny little mark denoting "Large Leak" while the machine was left running for two minutes with mask removed.

Granted, NightHawkeye is using a BiPAP Auto, not the REMstar Auto I have. But since Bob's profile shows his machine to be a REMstar Auto, and he says his data does the little blip that NHe's does, I thought it would be interesting to see if I could make my REMstar auto do that, too.

Also granted, this was just one very short, wide-awake test. However, in over a year's worth of regular downloads from my REMstar Auto, I've never seen on my data the ten minute/two minute thing that appears on NightHawkeye's BiPAP Auto data with some regularity and on Bob's REMstar Auto, if his is correct.

The Encore Pro version I use is 1.4.91, if that makes any difference. The REMstar Auto I have is well over a year old, perhaps two years old...got it back when C-Flex was added to the REMstar Autos.

Pressure 10 - 16, C-Flex on "3".

It would be very interesting indeed to know why the ten minute/two minute blip occurs for some, but not for others.

Here's the graph from my on/off awake experiment Sunday afternoon:

RG,

Bill corrected me & said it was his Remstar AUTO not his BiPap AUTO.

Also,

Bob's data chart looks questionable.

Compare your night pressure base line appearance to 'Bobs'

DSM

dsm wrote:Take a very very close look at where the min/max lines start & end compared to the nights levels. (shows up even clearer if you use a graphics pgm to look at the image)

I used photoshop to enlarge the image captured directly from the source. Here is an enlargement down to the pixel resolution of the left "endzone" where the three lines originate. Notice there is some "bounce" in the intensity of the colors where they transition from the black. Not impossible to forge, but unlikely. I'm pretty sure the gap that is apparent from the phpbb rendering of the picture is an artifact, nothing more. I noticed that too when I first looked at it closely, I don't think this looks like a fake. I declare Bob to be vindicated. (Unless he confesses!)

-Ric

.

Ric,

The baseline should not be present for when the pressure is at min.

Check Bills & RG's images. The data should really only appear in that color as it (cms) goes above min. Else, the Bill & RG charts would mix the colors.

Still looks sus to me - also llok at the far right of all the charts where they end.

Cheers

DSM

yes, i see the gaposis on the far right. hmmmm.... suspicious... bob is hereby unvindicated. more importantly, how does the pressure go above the yellow line at all ??? that was one of the earlier points. makes no sense at all to me, at this point in my pathway to enlightenment.

now to Bill's comment, here is an example of RemStar AUTO, set to 6.5-16, on 5 of the last seven days it shows the curious "settling gap" on startup up:



and 2 of the last 7 days, no gap:



I was starting to interpret the little dot at the beginning of each gap to mean something like "power-on, settling gap to follow" (or something like that). The above examples were all started without the on/off button, airflow initiated only. Maybe that's another piece of the puzzle?

-Ric

unclebob accidentally guesting himself wrote:Hi DME_Guy,

Bet this isn't turning out the way you wanted!

Ain't it the truth! LOL!!

Hover and Electrolux are already hunkered down to combat their new design carpet and floor cleaning unit which utilizes only the amount of sucking power needed for the amount of dirt etc that is encountered. By adjusting the sucking power automatically only the correct amount of force is used to remove the varying dirt levels.

------

Dirt Devil has been working on this for years but just could not get the unit to function as needed. Seems if you turned the machine off, say to move furniture or go to another room, you had to wait ten minutes for it to resume.

OMG, unclebob...you are great!!

Bob... wrote: it pretty much matches Bill's to a T.

Just reread his post and look at my graph, something is just not right.

That's Bob with my emphasis.
I vote for prank - I think he confessed....

Edited out a wrong comment about sl3 inital vs. starting pressure.

Bill, I see what you mean in the graphs, now. Which brings up another point: Can anyone complain of a bug in the algorithm while not using a mask okayed by the maker?

An issue for the Respironics' users group (I hope a non-respironics non-resmed user is allowed to make suggestions): Getting manufacturers to test other manufacturers masks on their machine, and report their behavior.

Bill, do you know which mask you were using when the glitch appears?

O.

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ozij wrote:Can anyone complain of a bug in the algorithm while not using a mask okayed by the maker?

Good point, ozij. Actually, I don't think I ever used a Respironics mask during the year or so that I used the Respironics REMstar Auto with no trouble. Used PB's Breeze, mostly, back at that time -- also a ResMed Activa quite a bit, and occasionally the ResMed Ultra Mirage FF, and then the Aura when it came out. Never had those odd blips appear on my data.

But of course, some individuals' particular type of SDB and/or breathing at times could be more problematic to a machine trying to "read" them through a different manufacturer's mask.

Still, though, even mixing mask/machine brands I wouldn't expect to see a break in the data graph lines, as if a machine had been turned off, for those ten minute gaps that are happening in NHe's data. Very odd.

Re masks and diff manufacturers.

One older statement I have from an AUTO mfg when asked about if they will support another manufacturer's mask was,. that because masks come and go and change so quickly it was impractical for them both in effort and investment, to examine their AUTO with other manufacturer's masks so they wouldn't do it.

I can understand this point well. Perhaps a xPap User's group can do some tests & offer guidelines or advice (very cautiously worded of course).

It will be interesting to ask each mfg this question.

DSM

RG, I totally agree about the oddness of NHe's results. I was thinking along fromal lines - the mfs shirking responsibility for that reason.

dsm - the equivalent of "consumers union" for cpapers would be a godsend. Is there any way of getting consumer union intersted in running those tests?

O.

ozij wrote:Is there any way of getting consumer union intersted in running those tests?

You could certainly write them and ask, Ozij. I would think it unlikely though, and of limited value even if they did. In the years I've subscribed to Consumers Reports I don't think I've ever seen them come close to questioning FDA or physicians' standard practices. In that arena they very much seem to toe the line. For xPAP'ers, I suspect that would mean Consumers Reports recommendations would be along the lines of the following:
- No software
- No APAP's
- No adjustment without physician consultation
- Beware internet vendors
- Avoid the temptation of following seemingly well-meaning advice offered on internet chat groups
- Most people would be well advised to follow the treatment regimen prescribed to them by their physician, who, after all, has had years of training in this area, rather than attempting to enhance or make their therapy more comfortable using unproven remedies offered by internet charlatans or word-of-mouth advice available from internet chat groups; free advice is often worth about what you pay for it.

Just my opinion of course. I could be wrong.

Regards,
Bill

DME_Guy wrote:If you guys don't mind, keep your post to questions only and only in regards as to how the alogrithm detects and responds to apneas, snores, flow limitations, and hyponpneas. And of course anything else I missed. What I need is a simple list of questions.

Example:

If the machine is set between 4 and 20, and the patient needs a pressure of 15 to prevent an apnea, how quickly will the machine repsond?

My main goal is get a good list of questions together that I can also ask the Resmed people and post up their answers here. I'd really like to know how each machine repsonds to events and what they respond to.

I am meeting with a sales rep but he's been in the business many years. If he can't answer a question we can get tech support on the phone.

DME_Guy,

Just wanted to suggest you might need to start a new thread with that same request. This thread, through natural progression, has evolved into something else and it would be shame for your original offering to be missed by anyone. That way this thread can remain concentrated on NightHawkeye's vacuities.