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Most Unusual Night
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wolson Offline

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Machine: PRS1 C-Flex
Mask Type: Other
Mask Make & Model: Dreamwear
Humidifier: Remstar
CPAP Pressure: 10 cm H20 C-flex x3
CPAP Software: SleepyHead EncoreBasic

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Sex: Male
Location: Red Canyon, Lander, Wyoming

Post: #11
RE: Most Unusual Night
(02-07-2016 05:51 PM)PaytonA Wrote:  I have a question on the flow rate chart on wolson's 3rd chart. each of the two CAs in the middle of the time period has what looks like a small breath in the middle. Is that PRs pressure pulse to determine if the airway is clear or obstructed?

Best Regards,

PaytonA


The answer is no: the machine does not have this capability.

The visit to the pulmonologist was very interesting! For years, based on chest xrays, i was told I have moderate COPD. Well that diagnosis was shattered after a full PFT. I don't have COPD. While I have some hyperflation of the lungs, there is no emphysema and no evidence of bronchial obstruction! Huh? My apneas are considered extrathoracic!

So what is causing COPD like symptoms? My doctors nor I know the answer to that question. So I am under going a groups of tests mainly focusing on my vascular system.

It seems I have both an aneurism and a partial blockage in the descending aorta. Both were picked up on a CT scan. I had an angiogram a few years ago that failed to pick up on this (I was having the same symptoms then.) So is that creating the physical symptoms of COPD?

Now the question is what to do about it and will that cure the COPD symptoms? What effect will this have on my apneas?

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
(This post was last modified: 02-11-2016 06:46 PM by wolson.)
02-11-2016 06:43 PM
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PaytonA Offline
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Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Orange County,California

Post: #12
RE: Most Unusual Night
(02-11-2016 06:43 PM)wolson Wrote:  
(02-07-2016 05:51 PM)PaytonA Wrote:  I have a question on the flow rate chart on wolson's 3rd chart. each of the two CAs in the middle of the time period has what looks like a small breath in the middle. Is that PRs pressure pulse to determine if the airway is clear or obstructed?

Best Regards,

PaytonA


The answer is no: the machine does not have this capability.

Walt,

Your machine looks like an auto machine running in auto mode and it looks like it is a Philips Respironics. The answer to your docs answer is that your machine does discriminate between CAs and OAs I think and it does so by measuring the return on a pressure pulse that it sends out.

Best Regards,

PaytonA
(This post was last modified: 02-11-2016 09:13 PM by PaytonA.)
02-11-2016 09:11 PM
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wolson Offline

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Posts: 92
Joined: Dec 2015

Machine: PRS1 C-Flex
Mask Type: Other
Mask Make & Model: Dreamwear
Humidifier: Remstar
CPAP Pressure: 10 cm H20 C-flex x3
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Red Canyon, Lander, Wyoming

Post: #13
RE: Most Unusual Night
(02-11-2016 09:11 PM)PaytonA Wrote:  
(02-11-2016 06:43 PM)wolson Wrote:  
(02-07-2016 05:51 PM)PaytonA Wrote:  I have a question on the flow rate chart on wolson's 3rd chart. each of the two CAs in the middle of the time period has what looks like a small breath in the middle. Is that PRs pressure pulse to determine if the airway is clear or obstructed?

Best Regards,

PaytonA


The answer is no: the machine does not have this capability.

Walt,

Your machine looks like an auto machine running in auto mode and it looks like it is a Philips Respironics. The answer to your docs answer is that your machine does discriminate between CAs and OAs I think and it does so by measuring the return on a pressure pulse that it sends out.

Best Regards,

PaytonA

Payton,

I am can only report what he said. I don't if that is the way the machine's algorithm distinguishes between a CA an a OSA. There is clearly a lot of "magic" going on in its algorithms. Unfortunately, the algorithms, as far as I know, are not published and probably regarded as trade secrets. However, since FDA had to approve the machine for medical use, the algorithms are probably protected by patents and those are discoverable. ( Something for a " round tuit.")

Whether or not the PRS1 has the servo response required is questionable as I do not see this in regions where I have long period hypopneas. I also do not see this in all of the CA's. Perhaps later, I will clip some wave forms to show this.

Walt

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
(This post was last modified: 02-12-2016 09:15 AM by wolson.)
02-12-2016 09:12 AM
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Sleeprider Offline
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #14
RE: Most Unusual Night
Although the PRS1 Auto does not treat CA with servo ventilation pressure support, it does indeed send a rapid 2 cm pressure pulse to detect an open or closed airway. A compliant airway, indicated by the small inhale/exhale response to that pressure pulse indicates a clear airway apnea, or CA, which was flagged. A pressure pulse with no response is an OA. The pressure pulse just bounces off an obstructed airway kind of like sonar. Anyway, this is how PRS1 differentiates between the events.

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02-12-2016 11:06 AM
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richb Online

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Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
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CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #15
RE: Most Unusual Night
The machine also does not use the pressure pulses to test for Hypopneas or periodic breathing. Respiration is still taking place albeit at a lower level during the hypopneas.

RichB
02-12-2016 12:15 PM
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GPSMapNut Offline

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Posts: 175
Joined: Nov 2015

Machine: DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed AirFit P10 and PR DreamWear
Humidifier: DreamStation + heated hose
CPAP Pressure: 9-16
CPAP Software: SleepyHead EncorePro Other Software

Other Comments: Used Respironics REMstar Pro with C-Flex for 11 years and ResMed S9 Elite loaner for 3 months

Sex: Male
Location: Mississauga, ON, Canada

Post: #16
RE: Most Unusual Night
With PR machines, there is no need to guess if it was a pressure pulse or not. Look at report in Encore Pro and you will see the PP ( pressure pulses) clearly marked as such.

Everything I post on this board is nothing more than an opinion expressed by an apneak. Normally, it's based on facts and experience but sometimes, I may get things wrong or not have all the facts.
I reserve the right to change my mind. Why? Because tomorrow I may know better.
(This post was last modified: 02-12-2016 12:38 PM by GPSMapNut.)
02-12-2016 12:38 PM
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wolson Offline

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Posts: 92
Joined: Dec 2015

Machine: PRS1 C-Flex
Mask Type: Other
Mask Make & Model: Dreamwear
Humidifier: Remstar
CPAP Pressure: 10 cm H20 C-flex x3
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Red Canyon, Lander, Wyoming

Post: #17
RE: Most Unusual Night
(02-12-2016 11:06 AM)Sleeprider Wrote:  Although the PRS1 Auto does not treat CA with servo ventilation pressure support, it does indeed send a rapid 2 cm pressure pulse to detect an open or closed airway. A compliant airway, indicated by the small inhale/exhale response to that pressure pulse indicates a clear airway apnea, or CA, which was flagged. A pressure pulse with no response is an OA. The pressure pulse just bounces off an obstructed airway kind of like sonar. Anyway, this is how PRS1 differentiates between the events.

I have considerable evidence to show that this is probably not true. Please examine the following clips of various CA's:

[Image: QzJwhAt.jpg]

While quite a few CA's do have that small pulse and rebound, quite a few do not as indicated by the figure. Also look at the trace send from the bottom. You will see the pulse and rebound signature marked by a hypopnea. I have a lot of these pulse and rebounds that are not flagged for apneas.

Thus, I due not believe that the PRS1 is creating them as confirmed by my pulmonologist

As always, I am open to second opinions.

Walt

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
(This post was last modified: 02-12-2016 12:51 PM by wolson.)
02-12-2016 12:50 PM
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richb Online

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Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Built in
CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #18
RE: Most Unusual Night
(02-12-2016 12:50 PM)wolson Wrote:  
(02-12-2016 11:06 AM)Sleeprider Wrote:  Although the PRS1 Auto does not treat CA with servo ventilation pressure support, it does indeed send a rapid 2 cm pressure pulse to detect an open or closed airway. A compliant airway, indicated by the small inhale/exhale response to that pressure pulse indicates a clear airway apnea, or CA, which was flagged. A pressure pulse with no response is an OA. The pressure pulse just bounces off an obstructed airway kind of like sonar. Anyway, this is how PRS1 differentiates between the events.

I have considerable evidence to show that this is probably not true. Please examine the following clips of various CA's:

[Image: QzJwhAt.jpg]

While quite a few CA's do have that small pulse and rebound, quite a few do not as indicated by the figure. Also look at the trace send from the bottom. You will see the pulse and rebound signature marked by a hypopnea. I have a lot of these pulse and rebounds that are not flagged for apneas.

Thus, I due not believe that the PRS1 is creating them as confirmed by my pulmonologist

As always, I am open to second opinions.

Walt

Does this machine have a backup rate set?
RichB
(This post was last modified: 02-12-2016 01:02 PM by richb.)
02-12-2016 01:00 PM
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wolson Offline

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Posts: 92
Joined: Dec 2015

Machine: PRS1 C-Flex
Mask Type: Other
Mask Make & Model: Dreamwear
Humidifier: Remstar
CPAP Pressure: 10 cm H20 C-flex x3
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Red Canyon, Lander, Wyoming

Post: #19
RE: Most Unusual Night
(02-12-2016 01:00 PM)richb Wrote:  Does this machine have a backup rate set?
RichB

Good question: what is the backup rate and what does it do? I don't know how to answer this question.

Walt

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
02-12-2016 01:10 PM
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PoolQ Offline

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Location: Sillicon Valley

Post: #20
RE: Most Unusual Night
I am pretty sure that they do indeed use pulses because not only do they say they do, but I have looked at their patents and they disclose that they do, they both (Resmed and PR) use different methods for patent reasons I assume.

It has to do with impedance of the airway. You have a tube with a relatively large plastic bottle on the end and right before the bottle you have a valve that can be open or shut. You can send a pressure pulse down the tube and measure the pressure changes. If the valve is closed the pressure will increase more quickly and higher then if the valve is open, because air is compressible. This is how they both test for OA verses CA.

As for COPD. Both my Doctor and my pulmonologist said that I clearly do not have COPD before the testing. After the testing they said I have unspecified COPD, they have no idea what it really is but "may" be COPD. They prescribed me the first level of COPD meds and bingo I could now sleep. Is it COPD? I have no idea and neither do they really. Am I just way more sensitive than most? Could be. Whatever the case, the meds are working and I am comfortable enough to sleep really well.

Edited for reality Smile
(This post was last modified: 02-12-2016 05:51 PM by PoolQ.)
02-12-2016 01:16 PM
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