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Getting Hosed
#1
Cool 
Getting Hosed
For some reason she denied that different hose sizes exist when I questioned my sleep therapist but prior to that I did indeed get out my trusty ruler. I have one that is 15mm in diameter and one that is 22mm. I acknowledge that my CPAP can be set for either one of these. But how about from the user's point of view? Does it feel or work much differently? My old 22mm hose is considerably more flexible and is a bit longer than the other one so I don't know if I should retire it just yet. But I want to know if there are any differences I should be aware of. I was first made aware of a different size with the Respironics heated tube but I took a quick dislike for that machine and traded it in - with a "regular" tube also obviously thinner than my old one. Any thoughts of observations?
Huh
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#2
RE: Getting Hosed
The S9 series can use 3 different hoses. The standard, the slimline and the climateline. The difference, in my opinion, is weight pulling on the hose. The slimline is much lighter.

It is merely a comfort feature and the treatment is no different. The S9 can be told which hose you are using, although I am not sure why.

My grief with the climate line is the mask end of the hose is slightly larger than other hoses. I am constantly getting disconnected during the night. I'm going to wrap a piece of duct tape on it. Same swivel adapter as before. Had the same problem last winter (but had different hose, of course).
PaulaO

Take a deep breath and count to zen.




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#3
RE: Getting Hosed
Stick with the big hose unless you have problems with the weigh of the hose making it difficult to keep your mask in place.

The machine should be able to make either type work correctly, but it's probably slightly easier with the big hose.

Get the free OSCAR CPAP 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.
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#4
RE: Getting Hosed
Hi Ugly,
I use the "Climateline" (Heated,) hose which is the thinner hose and I like it very much and don't have any trouble with it.
trish6hundred
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#5
RE: Getting Hosed
if you do swap the hose i believe you need to
Change the settings in the setup manual so the machine can compensate for the thinner hose
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#6
RE: Getting Hosed
(11-09-2012, 10:17 PM)PaulaO2 Wrote: The S9 can be told which hose you are using, although I am not sure why.

The machine probably makes a slight change in pressure based on the fact that a thinner hose offers more resistance to the flow of air. The same is true of different masks, for example a nasal pillows mask offers a greater resistance than a full face mask.

If you tell the machine there's greater resistance the machine lowers the pressure to compensate. This is what happens, for example, when you dial up the "System One Resistance" on a PRS1 machine. The machine simply reduces the pressure by a small amount. Probably less than 1 cm.
Sleepster

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#7
RE: Getting Hosed
(11-10-2012, 09:56 AM)Sleepster Wrote: The machine probably makes a slight change in pressure based on the fact that a thinner hose offers more resistance to the flow of air. The same is true of different masks, for example a nasal pillows mask offers a greater resistance than a full face mask.

The change in pressure would be small only if the air flow is not large, such as when there are not large unintentional leaks AND the pressure is not very high. I think a high mask pressure like 15 might make the normal air flow through the mask vents high enough to cause the pressure drop across the hose to be more than 1 cm, which would be compensated for by the machine raising it's pressure by the proper amount as long as the machine is set for the correct hose resistance (or set for the correct diameter and length so the machine can correctly calculate the hose resistance).

Quote:If you tell the machine there's greater resistance the machine lowers the pressure to compensate. This is what happens, for example, when you dial up the "System One Resistance" on a PRS1 machine. The machine simply reduces the pressure by a small amount. Probably less than 1 cm.

That is not true for hose resistance. The higher the hose resistance, the higher the machine needs to raise its pressure, to compensate so the pressure reaching the mask (and you) will be maintained unchanged.

But if there is pressure and no air flow, like when the mask is replaced with a nanometer allowing little or no air flow through the hose, the hose will drop little or no pressure at all. This is because, mathematically, the pressure lost across the hose is the hose resistance times the amount of airflow through the hose.

So if I want to measure the difference in pressure reaching the mask (and me) using a 15 mm hose versus using a 22 mm hose, I would need to use a "T adapter" and connect to the hose both the nanometer and the mask (and be wearing the mask).

Take care.
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#8
RE: Getting Hosed
I believe the machines attempt to estimate the pressure at the mask and regulate that pressure, not just the pressure at the outlet of the blower.

When the machine is trying to to "fast" things such as EPR/Flex/bilevel/BiPAP/VPAP/ASV or simply keep the pressure constant as your inhale and exhale, there's a time delay between changes in the pressure at the mask and pressure at the blower end.

In order to calculate how to quickly adjust and regulate the pressure at the mask end, the machine needs to estimate the volume of air in the hose and mask, the resistance to airflow, etc. The hose diameter affects both the resistance to airflow and the volume of air being compressed. The hose length affects this and increases the length of the hose, adding further complication to the calculation.

In addition to regulating the pressure, the machine is trying to determine things like central vs. obstructive based on changes in the airflow in reaction to pressure pulses.

The problem may not be that bad, but I have heard people saying their bilevel machine wouldn't switch from inhale to exhale when they used a double length hose. Some older machines actually used a separate small hose to the mask to sense mask pressure.
Get the free OSCAR CPAP 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.
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#9
RE: Getting Hosed
(11-09-2012, 10:17 PM)PaulaO2 Wrote: The S9 series can use 3 different hoses. The standard, the slimline and the climateline. The difference, in my opinion, is weight pulling on the hose. The slimline is much lighter.

It is merely a comfort feature and the treatment is no different. The S9 can be told which hose you are using, although I am not sure why.

My grief with the climate line is the mask end of the hose is slightly larger than other hoses. I am constantly getting disconnected during the night. I'm going to wrap a piece of duct tape on it. Same swivel adapter as before. Had the same problem last winter (but had different hose, of course).

I put the gray piece on the hose then warp a rubber tightly band around the hose
works great.
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#10
RE: Getting Hosed
(11-09-2012, 10:17 PM)PaulaO2 Wrote: The S9 series can use 3 different hoses. The standard, the slimline and the climateline. The difference, in my opinion, is weight pulling on the hose. The slimline is much lighter.

What about the S8? As I have said, in order to discover a working pressure, my supplier is lending me an S8 AutoSet II. I can set the hose LENGTH but it doesn't seem to differentiate between thicknesses (standard and slim). After I had water accumulate in my standard hose I switched to the slim tube last night. I think I slept better. 10.05 hours. The pressure I was assigned was 11.0 though. I couldn't find a size setting other than length. I couldn't activate AutoStart even from clinician mode but fortunately that's minor. The setting to see if the mask fit properly was neat. Not necessary. After 14 years I can feel a leak when there is one. But still - it was interesting. Was I rested last night? No. I almost never am. But I guess it was better than many nights. But I do want to know if the slim hose is OK or if I should go back to the standard while I'm using the S8.
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