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[CPAP] AUTO or not - Is the auto-CPAP machine inherently better than a CPAP?
#51
zimlich Wrote:Off the topic, but I shouldn't have said I felt personally attacked. I did feel my opinion was not respected in certain replies, but as Katie said, I need a thicker skin.
Thanks to all who have and continue to respond.
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#52
Sleepster Wrote:
HeadGear,(time=1325097670) Wrote:The machine does not have to collect and store data in order to respond to respiratory events, etc.
Then what does it use to respond to events? How does it know events have occurred, and whether and how to respond? It's gotta have something going for it that a dumb CPAP doesn't in terms of data collection.

Now, perhaps it doesn't store and process that data in such a way that's it's accessible to humans. Is that what we're talkng about here?
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#53
HeadGear Wrote:
Sleepster,(time=1325110042) Wrote:
HeadGear,(time=1325097670) Wrote:The machine does not have to collect and store data in order to respond to respiratory events, etc.
Then what does it use to respond to events? How does it know events have occurred, and whether and how to respond? It's gotta have something going for it that a dumb CPAP doesn't in terms of data collection.

Now, perhaps it doesn't store and process that data in such a way that's it's accessible to humans. Is that what we're talkng about here?
Presentation of data is only for human consumption! By data, we mean something, a measure or event, is recorded, stored away and retrievable. The machine does not have to do that in order to function. Sensors pick up on respiratory changes which then triggers responses from the machine, according to preset treatment algorithms. It is like steering a car, the steering mechanism simply responds to the input changes, (turn of the wheel,) without any intermediate data recording. But, note, even the "dumber" machines record some data, such as blower hours, number of sessions, etc.
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#54
zimlich Wrote:Each brand of machine has it's own algorithm that it uses in order to and how to respond to events. For instance machines don't respond toclear airway events (except perhaps ASV machines) because they're not respirators. The newer machines however are able to detect CA events and record them.
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#55
HeadGear Wrote:
Sleepster,(time=1325183707) Wrote:
zimlich,(time=1325165320) Wrote:For instance machines don't respond toclear airway events (except perhaps ASV machines) because they're not respirators.
That's interesting. I have a BiPAP machine. It increased dramatically the number of clear airway events I experienced. The doctor lowered the pressure and successfully reduced them. This is something that an auto machine would not do?
Why not? An auto machine does not operate at a fixed pressure. In the presence of CA, it can either do nothing to raise pressure or it can reduce pressure. The APAP has likely been set to operate at a range of pressure, several cm. H2O below titrated level to several cm. above. In presence of CA, the likely result is that average pressure runs below the titrated level.

In your case, it may have been clear that CA was pressure related. That is not always the case, so that treatment of a CA problem may not be as simple as reducing pressure. For example, sometimes, I have an increase in CA with my S9, even at lower pressure. It was tough to figure out the cause, given all the variables. I suspect there is more than one cause, but a gastroesophogeal issue (GERD) is highly suspected as the primary event inducing CA - in my case. Some individuals may have CA induced by other stimuli, such as changes in pressure, either by APAP or by BiPAP, or by EPR or x-FLEX. Sometimes, it is hard to win! There could be serious health issues involved as well as the influence of serious medication.
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#56
archangle Wrote:
Sleepster,(time=1325110042) Wrote:
HeadGear,(time=1325097670) Wrote:The machine does not have to collect and store data in order to respond to respiratory events, etc.
Then what does it use to respond to events? How does it know events have occurred, and whether and how to respond? It's gotta have something going for it that a dumb CPAP doesn't in terms of data collection.

Now, perhaps it doesn't store and process that data in such a way that's it's accessible to humans. Is that what we're talkng about here?
I believe the non-data APAPs work the same as data APAPs, they just don't save the data.

I believe APAP machines usually require an airflow sensor. Fully data capable manual CPAP machines do too.

There are some non-data CPAP machines that don't have an airflow sensor. Pretty much all CPAP machines have pressure sensors.

I believe for several manufacturers, APAP, bilevel, bilevel auto, and ASV machines are the same hardware as data capable manual CPAP. The difference is in the software.
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#57
archangle Wrote:
Sleepster,(time=1325183707) Wrote:
zimlich,(time=1325165320) Wrote:For instance machines don't respond toclear airway events (except perhaps ASV machines) because they're not respirators.
That's interesting. I have a BiPAP machine. It increased dramatically the number of clear airway events I experienced. The doctor lowered the pressure and successfully reduced them. This is something that an auto machine would not do?
Some people think a bilevel machine will sometimes reduce central apneas.

Lowering the pressure on any CPAP may reduce centrals.

Was the inhale pressure on your bilevel machine higher than what you hand on the previous machine.

Centrals are weird. Sometimes they seem to change on their own or change for strange reasons.
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#58
Sleepster Wrote:
HeadGear,(time=1325189450) Wrote:
Sleepster,(time=1325183707) Wrote:
zimlich,(time=1325165320) Wrote:For instance machines don't respond to clear airway events (except perhaps ASV machines) because they're not respirators.
That's interesting. I have a BiPAP machine. It increased dramatically the number of clear airway events I experienced. The doctor lowered the pressure and successfully reduced them. This is something that an auto machine would not do?
Why not?
It would be a response to a clear airway event.
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#59
Just for clarification of terms...

"Clear Airway Event" is often used by Philips-Respironics instead of "Central Apnea Event".

CSA = Central Sleep Apnea

CA event = can mean Central Apnea event or Clear Airway event.

The difference is that Respironics cannot say for certain that an event that occurs while the airway is open is positively a Central Apnea event (so they use the term "Clear Airway" event instead). They appear to be more cautious in labeling something a central event.

ResMed labels seems comfortable labeling them as "central apnea events", and they claim their S9 machines are better equipped to tell when a central event occurs.

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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#60
Sleepster Wrote:
archangle,(time=1325191539) Wrote:Was the inhale pressure on your bilevel machine higher than what you hand on the previous machine.

Centrals are weird. Sometimes they seem to change on their own or change for strange reasons.
The CPAP pressure was 13. The BiPAP pressures were originally 13 IPAP and 8 EPAP. They are now 11 and 8.

I had no clear airway events on CPAP, but they immediately appeared in large numbers (about 15 per hour IIRC) when I switched to BiPAP. Now, with the lower IPAP I have only about 3 per hour. They are, and were, always short in duration, lasting only 10-15 seconds; and by far the major contribution to my AHI.
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