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Another titation and System One Resistance
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archangle Offline
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Machine: ResMed S9 AutoSet
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Post: #11
RE: Another titation and System One Resistance
I think resistance doesn't make much difference except for things like exhale relief and bilevel. I suspect the difference is minor even then. It probably won't adversely effect a titration where a human being is adjusting pressure and watching the results.

Respironics uses it to try and make you think you need to use their brand of mask.

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If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-03-2012 11:48 AM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Post: #12
RE: Another titation and System One Resistance
(08-02-2012 09:12 PM)zonk Wrote:  Thanks MJ. I asked because on my S9 there is an option to select the type of mask (pillows, nasal, full face) and I select nasal. The S9 need to know the type of mask. I know it is not the same with System One Resistance but was wondering if different setting would give you different result, higher or lower pressure during titration. btw what setting do you use

When I set mine to X4 (the highest level) it supposedly lowered the pressure. This is the recommended setting for the small pillows on the ComfortLite 2 mask. You can go to the website and look at the different settings for the different size pillows.

I think setting your S9 to "pillows" does the same thing.

I also think that the keeping the settings specific to their own masks is just a marketing scheme for Respironics.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-03-2012 12:07 PM
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mjbearit Offline

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Machine: REMstar Auto AFlex DS550
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Post: #13
RE: Another titation and System One Resistance
Archangel and Sleepster beat me to it. It's all about marketing!

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
08-03-2012 01:51 PM
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Sleepster Offline
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Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #14
RE: Another titation and System One Resistance
(08-03-2012 11:48 AM)archangle Wrote:  I think resistance doesn't make much difference except for things like exhale relief and bilevel. I suspect the difference is minor even then.

My DME eyeballed it at a drop of about 0.5 cm of pressure for the maximum PRS1 Resistance setting of X4. If my understanding is correct it's present in CPAP's, too.

This is my understanding based on the way he explained it to me. Small nasal pillows restrict the flow of air more than larger nasal pillows do. Or nasal masks, etc. Because of this restriction the pressure at the mask end of the hose is higher than the pressure at the CPAP end. Hence, when we dial up the PRS1 Resistance to a higher setting the machine simply sets the pressure a tad lower.

At first this didn't make sense to me, and I had a hard time believing it. It seemed to contradict Bernoulli's Principle, but there was no doubt it made my hypopnea index increase by about 3 consistently over a period of several days.

I've since convinced myself that the effect is perfectly consistent with Bernoulli's Principle and depends on the fact that, due to the high compressibility of air, there's a pressure gradient along the length of the hose. The larger the restriction at the mask end of the hose, the larger the gradient.

Sleepster
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www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-03-2012 02:36 PM
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archangle Offline
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Machine: ResMed S9 AutoSet
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Mask Make & Model: ResMed Swift FX
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CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #15
RE: Another titation and System One Resistance
(08-03-2012 02:36 PM)Sleepster Wrote:  At first this didn't make sense to me, and I had a hard time believing it. It seemed to contradict Bernoulli's Principle,

Bernoulli's principle doesn't apply. Bernoulli only affects pressure within the venturi, not the pressure on either side of the restriction.

This is just pressure drop through a restriction, which is not related to Bernoulli.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
08-03-2012 04:06 PM
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MrSafety Offline

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Machine: PRSys1 BiPAP Auto-750P
Mask Type: Nasal mask
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CPAP Pressure: 7 Epap / 18 Ipap cmH2O
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Other Comments: 1ST DIAGNOSED ~20 YRS AGO... 3 yrs with PRSys1 BiPAP Auto w/Bi-Flex (mod. 750p)

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Location: S.F. Bay Area... Novato, CA

Post: #16
...PRS1 Bi-PAP's Resistance Cntrl. settings for "OFF-BRAND" masks !
Sorry that this "Newbie" is chiming in more than 12 months late on the subject of this THREAD, but I only recently was faced this issue and/or (technical point)... mixing different brands of masks with "Auto" Bi-PAP(s).

I changed my general HealthCare provider on Jan 1, 2013 and due to poor sleep performance using my new PRS1 BiPAP Auto Bi-Flex 750P, I needed help from someone knowledgeable!

My new certified Sleep Medicine MD took a look at the recent data on my SD chip and simply indicated that my machine's algorithms were NOT able to function effectively because there was a "whole lot of leaking going on" (my paraphrase) and mine was showing well over the 25 LPM he indicated was an accepted maximum. He instructed me to get with my DME tech to help me resolve this and then come back when I had ~30 days of fresh data without the leaks for him to analyze!

Well working with my DME, we discovered that my PRS1's Resistance control setting was set at "X2" and she felt this was NOT CORRECT for she normally used "X1" for any & all brands of "Full-Face" masks regardless of brand. Mine mask is a Full-Face F&P 431!

The first night with my PRS1 set at "X1" my Session was 5.5 Hrs [above average for me] and my AHI calculation dropped dramatically from its moderate-to-high [ 6-to15 ] calculation down to less than 5.0.

So the long-winded point I'm building up to is that IF MY Sleep Medicine MD is correct, it appears when the PRS1 sees LEAKage over 25 LPM, this must cause the algorithm's to no longer effectively calculate and thus deliver the pressures needed to fend off OA, H, CA events. And when I examine my past data I see that the Pressure changes ordered by the algorithm tends to go to zero as soon as the level of Leakage increases above 25 LPM! I'ms hard for me to read the #(s) on my SleepHead's data graphs/charts so I'll have my DME take a look with her Respironics software!

To summarize:
1/ I'm sure the PRS1 measures and thus knows the total LPM of air it is sending down the tube to us as we snooz!...
2/ The Resistance Control setting gives the PRS1 a way to fairly accurately estimate the "engineered leakage" that normally/continuously passes through and out the vents on whatever full-face mask we are wearing [no knowledge of the nasal or pillow masks] !
3/ The PRS1's microprocessor simply subtracts one # from the other and it instantly knows what the unwanted leakage is... and thus maybe they do in fact teach the MD(s) and DME(s) that this leakage should not exceed 25 LPM.

So IF I'm correct in my understanding that their algorithm becomes unreliable when the unwanted leakage goes above 25 LPM... then my burning question is: Q - Why didn't they incorporate some kind of optional warning alarm feature that would wake you up!??
Best regards,
Sam Ross
P.S. - I was once did fire protection engineering where we had to calculate fluid flows and friction losses in pipes using a complex equation known as "Hazen-Williams" as well as how much fluid would be emmited from the individual nozzles of fire sprinklers... so I can well imagine that certain algorithms might just have such limits!
12-12-2013 12:58 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #17
RE: ...PRS1 Bi-PAP's Resistance Cntrl. settings for "OFF-BRAND" masks !
(12-12-2013 12:58 PM)MrSafety Wrote:  Well working with my DME, we discovered that my PRS1's Resistance control setting was set at "X2" and she felt this was NOT CORRECT for she normally used "X1"

That's probably a difference of about 0.25 cm of pressure. Not enough to make a significant difference.

The reason for the fault with the high leak rate is that the machine can no longer use its pressure and flow rate meter readings to determine things such as your AHI, or what pressure adjustments are needed.

Getting the leak rate under control is first and foremost, if the leak rate is too high nothing else you do matters.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-15-2013 09:01 PM
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me50 Offline

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Machine: resmed S9 VPAP Auto
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Post: #18
RE: Another titation and System One Resistance
You mention with the change the DME made that you slept longer and your AHI was below 5 but you didn't mention how your leaks were or if you did, I missed it.
12-15-2013 09:46 PM
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MrSafety Offline

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Posts: 17
Joined: Oct 2013

Machine: PRSys1 BiPAP Auto-750P
Mask Type: Nasal mask
Mask Make & Model: Respironics "Wisp"
Humidifier: PRSys1... set @ "4"
CPAP Pressure: 7 Epap / 18 Ipap cmH2O
CPAP Software: SleepyHead

Other Comments: 1ST DIAGNOSED ~20 YRS AGO... 3 yrs with PRSys1 BiPAP Auto w/Bi-Flex (mod. 750p)

Sex: Male
Location: S.F. Bay Area... Novato, CA

Post: #19
RE: Another titation and System One Resistance
(12-15-2013 09:46 PM)me50 Wrote:  You mention with the change the DME made that you slept longer and your AHI was below 5 but you didn't mention how your leaks were or if you did, I missed it.
Thanks "Sleepster" & "me50",
My very next night my AHI was = 10.0 !
As to putting #s to my Leaks: The night my AHI was 3.01:
My leaks data when AHI=3.01 was:
Ave=13.86...Min=0.0... Med=4.0... 95%=47.0... Max=50.0
My Total Leaks data was:
Avg=64.75...Min=35.0... Med=60.0...95%=100.0... Max=103.0

Q- Am I correct that when they say the leaks should not exceed 25 lpm that they are referring to the "Ave=13.86" shown above (in RED)!

The next night my AHI was 10.0 and the corresponding LEAKS were:
My Leaks data when AHI=10 was:
Avg=11.72... Min=0.0... Med=4.0... 95%=50.0... Max=54.0
My Total Leaks data was:
Avg=54.49... Min=34.0... Med=49.0... 95%=94.0... Max=98.0

Does this help "me50"? The LEAKs #(s) on the strip charts are not readable (to me)!

Tomorrow I'll try and see how my DME's Pilips Respironics software reads the leaks!

Note... It's funny that the "Avg" figures above do not show up in SleepyHead's "Daily"..."Statistics" tables of data... but it does appear when I BLOCK/COPY/PASTE ... go figure!??

Regards,
Sam Ross
12-17-2013 12:54 AM
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me50 Offline

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Machine: resmed S9 VPAP Auto
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CPAP Software: SleepyHead

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Post: #20
RE: Another titation and System One Resistance
Sam,

I don't use your machine so I am not familiar with how it works, etc. There are many here that do. To me, it looks like your leaks are way too high. Hopefully, someone else will have better answers for you.
12-17-2013 04:02 AM
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