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EERS Experiment Data (sherwoga)
#51
RE: EERS Experiment Data (sherwoga)
(12-05-2019, 11:28 AM)slowriter Wrote: My assumption is that EERS would have no impact on FL, but the pressure settings would.

EERS increases tidal volume, which means the user is breathing more deeply with each breath. That in turn affords a greater opportunity for flow limitation as airway resistance increases with the increased flow rate.  The solution, that is not being used in this case, is pressure support or EPR.  By using pressure support, the larger inspiratory flow rate is supported or made easier, and flow limitation can be reduced.  The whole idea with EERS is to reduce CA to enable the use of pressure support, so I'm a bit surprised the therapy has not moved in that direction.
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#52
RE: EERS Experiment Data (sherwoga)
(12-07-2019, 09:17 AM)Sleeprider Wrote: ... The whole idea with EERS is to reduce CA to enable the use of pressure support, so I'm a bit surprised the therapy has not moved in that direction.

That's the next step.

He, at the suggestion of bonjour, is doing an experiment to assess impact of EERS.

He's doing three runs at different EERS volume, min pressure, and EPR settings.

Idea is this would hopefully be turned into a wiki page.
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#53
RE: EERS Experiment Data (sherwoga)
(12-07-2019, 09:17 AM)Sleeprider Wrote:
(12-05-2019, 11:28 AM)slowriter Wrote: My assumption is that EERS would have no impact on FL, but the pressure settings would.

EERS increases tidal volume, which means the user is breathing more deeply with each breath. That in turn affords a greater opportunity for flow limitation as airway resistance increases with the increased flow rate.

Good point; I obviously hadn't thought of that.

Hopefully the data sherwoga is generating will demonstrate that.
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#54
RE: EERS Experiment Data (sherwoga)
(12-07-2019, 09:17 AM)Sleeprider Wrote:
(12-05-2019, 11:28 AM)slowriter Wrote: My assumption is that EERS would have no impact on FL, but the pressure settings would.

EERS increases tidal volume, which means the user is breathing more deeply with each breath. That in turn affords a greater opportunity for flow limitation as airway resistance increases with the increased flow rate.  The solution, that is not being used in this case, is pressure support or EPR.  By using pressure support, the larger inspiratory flow rate is supported or made easier, and flow limitation can be reduced.  The whole idea with EERS is to reduce CA to enable the use of pressure support, so I'm a bit surprised the therapy has not moved in that direction.

Thanks SR,
This is literally an experiment to test the effectiveness of EERS in staving off Central Apnea with EPR both present and absent.   
sherwoga has designed this experiment where the order of the settings tested is randomized (he has experience in experiment design)  

with EERS extensions of 0 (none), 18 and EPR of 0,1,2,3 

When complete we will certainly be writing a Wiki article and be moving him into a more optimal setup.

Your comments are more than welcome.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#55
RE: EERS Experiment Data - Seq #8 Design #2
(12-07-2019, 06:20 AM)sherwoga Wrote: 12/06/2019 EPR(Min Pressure),EERS pair = 3(8),0

   

Note:  I may repeat this run at the end of the 12 runs in the design.  There are large CA event clusters at both the beginning and the end of the night that correspond to time periods when I was fully awake.  On the other hand, this is a replicate of Run #1 when Bonjour recommended discounting similar clusters of events.  Further, this set of designed experiment conditions comes the closest to those I had been using for more than a year prior to my discovery of the Apnea Board and of Oscar software.  Throughout the previous year it was not uncommon to see AHI values between 10 and 20, but without Oscar, I was seeing only the AHI value as an indication of sleep quality.  So I'm not real sure what should be done here, follow Bonjour's recommendation, repeat this set as a 13th run (rejecting this one), or let the data stand as it is.  Decision can wait, but thoughts/input appreciated.

I'll suggest running 3 nights with this setting following to see if the Centrals persist with this setting.  I see more centrals even discounting the awake ones.  And this is what we expect, with EPR=3 and no EERS Centrals should be higher.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#56
EERS Experiment Data - Seq #9 Design #7
12/07/2019 EPR(Min Pressure),EERS pair = 0(5),18

This is the first replicate of conditions used on Dec 4.  Tidal Volumes on the 7th are large but not quite as large as on the 4th.  Respiration rates and flow limitations are similar, but take a look at the 1 minute overlay of Flow Limitations and Mask Pressure.  Beautiful, repetitive flow patterns, if that was what I wanted, but I'm pretty sure this should give cause for concern. 

           


   
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#57
EERS Experiment Data - Seq #10 Design #1
12/08/2019 EPR(Min Pressure),EERS pair = 3(8),18

This run completes the set of three run at this combination of settings.  Data for the three were collected on Dec 1, 3, and 9.

           

[This post corrected on 12/13/2019 by Sherwoga.  I had posted two screenshots from Oscar that were the same.  I forgot to scroll down between taking the screen shots.]
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#58
EERS Experiment Data - Seq #11 Design #10
12/09/2019 EPR(Min Pressure),EERS pair = 3(8),0

This run completes the set of three run at this combination of settings.  Data for the three were collected on Nov 29, Dec 6, and Dec 9.

           
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#59
EERS Experiment Data - Seq #12 Design #3
12/10/2019 EPR(Min Pressure),EERS pair = 0(5),18

This run completes the set of three run at this combination of settings.  Data for the three were collected on Dec 4, 7, and 10.

           
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#60
RE: EERS Experiment Data (sherwoga) Design Modification
My last post completed the original Designed Experiment (three runs at each of four combinations of EPR and EERS for a total of twelve nights of data).  

I've begun analyzing the data.  I can already report that the impact of changing the settings for EPR and EERS will be small and may not be statistically significant.  I also see one run that appears to be what a statistician would call an "outlier".  It is the 8th data set collected on Dec 6 and reported in Post #50.  I noted in that post the very high CAs and Fred Bonjour recommended in Post #55 that I repeat that run three times.  I am going to repeat it at least once to replace the outlier data.  Repeating more times will create an imbalance in the design of the experiment so I will reserve judgement on how best to proceed.  One option is to stop after one repeat to replace the outlier (leaving me with just the twelve nights of data).  I might also chose to increase the total number of useful data sets for the design from twelve to sixteen by, in addition to replacing the outlier, repeating all four combinations of the settings for EPR and EERS one more time. Doing so would improve the statistics.  Instead of having only three nights at each combination, I will have four nights at each combination. Statistics should get marginally better for minimal effort.   

So, I may be another 5 nights before I'm ready to complete the analysis.  

I am encouraged by what I see and believe I could improve my own sleep performance with my current equipment and the right size EERS without investing in a CPAP that could provide still greater pressure support (than does my ResMed AirSense 10 Autoset), something several have indicated would the correct thing for me.   At the very least I hope to have some good data for the Wiki article.  

Stay tuned.
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