What would an ideal APAP/CPAP machine be? What features etc?

[SevereApnea]

Hi sndraco

Here is  a thread I started last year but it seems to have scared everyone off!

Keep the ideas coming because if I remember correctly someone on the Board felt that ResMed etc do watch the boards: maybe they can see this as an opportunity for further research and development.

Given the number of people with Sleep Disordered Breathing this is a growing market.

If they get their act together they could even market this at those who don't have SDB but do want to look at improving their sleep patterns.

Having said that, I have seen AI implemented in a work situation and see this is still somewhat removed from becoming mainstream.

Regards, Chris.

[Millstone50]

Isn't the Airsense 11 very similar to the Airsense 10 except for touch screen? ie rest of the system, algorithm, pressure changes, what it measures, how it measures, reports etc all the same as the 10?

S

It's one number higher than 10, it must be superior!

[Geer1]

Arousals and RDI would be nice but that would require EEG data which is not easy or likely to be incorporated anytime soon since for the majority of cases it is not required. 

Basic timing controls would be nice, trigger and cycle sensitivity would be good enough and could leave Ti min/max stuff for bilevels.

Ability to increase EPR/PS up to 4 cm would be nice. Not needed for most patients so I understand why they limit it to 3 though.

Those above items wouldn't be an issue if it was easier to get a bilevel. Rather than increasing the capability of these basic machines perhaps they could improve reporting to doctors indicating another machine should be considered (like say if central apnea is high and the machine sent doctor report saying ASV should be considered).

The biggest weakness with these machines is that they lack the ability to interpret results and adjust settings to avoid future issues. Some sort of algorithm/AI that could review the data and draw conclusions on ideal EPAP, EPR and pressure ranges would be nice and pretty much put us out of the job if effective. It would be difficult to do though and I understand why this is left to manual interpretation and control. Maybe one day they will have at least some level of this capability.

[cathyf]

I think a huge win that would not require extra technology is for the machines to flag periods when the algorithm is unable to understand what is going on.

Some of us have seen ResMed data where it's clear that the machine first gets in a state that it knows something is wrong with your breathing, but the sensor readings don't match any of the patterns that the machine uses to classify what is wrong. Leading up to that state the machine sees flow rate severely flattened and so it reacts by goosing pressure to maximum or near maximum as it records tidal volumes at impossibly low and falling. But then your pressure goes even flatter and it records tidal volume as zero for awhile and then just completely gives up, and if StupidStop is enabled, turns itself off. Then -- if you don't die while the machine is off -- eventually it senses that you are still there when it detects you taking a big enough breath, and it turns back on. But it doesn't act like "turn back on after properly turned off" and so it very guiltily comes back on at the pegged-at-max pressure that it was running when it gave up and turned off.

"The CPAP did not report that something bad happened" is NOT the same thing as "The CPAP did report that nothing bad happened."

And then Dr Duck quacks out "the machine is controlling your apnea" when that's NOT what the machine did and it's NOT what the machine even reported that it did. What really happened is that the machine isn't programed with a procedure to follow when it sees the particular apnea pattern that you experienced, and because it didn't know what to do it did nothing and reported nothing and didn't even control itself properly, let alone controlling your apnea.

(At least in the A11 ResMed made it possible to turn SmartStart on without forcing you to turn StupidStop on as well.)

[sndraco]

This feature is quite difficult it would be good if for the first say 10 days there was a titrate mode, where it played with minimum pressure, EPR, etc and then at the end of that it had some recommended minimum pressures with info on why.

Also better processing of waveforms to see real events vs. not, ie what a sleep dr or sleep tech can detect why can't machine do the same.

Other ideas above also great. And having extra features for all even if they don't need it (assuming it doesn't increae costs too much)

S

[srlevine1]

RE: What would an ideal APAP/CPAP machine be? What features etc?

Isn't the Airsense 11 very similar to the Airsense 10 except for touch screen? ie rest of the system, algorithm, pressure changes, what it measures, how it measures, reports etc all the same as the 10?

S

[size=undefined]

It's one number higher than 10, it must be superior![/size]

The value in any xPAP device lies in its algorithm, adequate output of the blower motor, durability over time, ability to capture and report meaningful therapeutic data, and its footprint.  

In my opinion, the S11 is in some ways inferior...

(1) No longer supports a pulse oximeter with an adapter. 
(2) Unnecessary gamification of the interface using a small touchscreen.



Time will tell!

[Crimson Nape]

My 2 cents on this; The AS11 seems to be a stop gap model that, unlike an A10 owner, will prevent its owner from being able to hack the firmware to become a more advanced model. My beliefs are based on the fact that Resmed is using all available A10 parts to make the more expensive and advanced models. If they had any intention of using the current AS11 for these models, they wouldn't be doing that.

With all that I said, I have no factual proof. It's just a feeling based on what I have seen.

[srlevine1]

I read in the forum that they are using the same blower as the Air Mini whose durability and performance are unknown to me. However, I often suspect that smaller and cheaper go hand-in-hand. I sure wish ResMed would give more consideration to the users rather than considering only their sellers.

Nicko on CPAP Reviews disassembled an Air Mini and AS11 and they both use the same blower, thus the description above of Air Mini with lipstick. He also found the blower on a Chinese web site for about $20. Check his YouTube videos to see what the insides look like.

http://www.apneaboard.com/forums/Thread-...now?page=3