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Respironics: hose diameter vs. setting
#1
It's my first post here, so please be gentle...

I'm a recently-diagnosed user and I was originally supplied with a Respironics System One CPAP with it's associated humidifier and a ResMed Quattro Air full-face mask. After approximately 10 days of all-night use (I'm highly motivated for this therapy to work) I was still seeing AHI's of 15+ so my DME "sleep concierge" (as she calls herself) came by yesterday and provided a System One BiPAP/Bi-flex pump in place of the original unit. First night AHI was 12.5. (FWIW, I'm a stage 4 throat cancer survivor and my trachea is small due to radiation treatment scar tissue.)

Being a design consultant/engineer (entertainment/control systems) the first thing I did was hold down the two buttons (duh) to take a peek at the "protected" settings – which drives my DME berserk even tho I NEVER change anything without her approval (thus far). I noticed that the "hose" setting on the BiPap is set to "15H" even tho I have a 22mm hose. When asked, DME said "mismatch doesn't matter" but my Inner Engineer says "Phillips wouldn't have put the variable in there if it didn't matter". I'm sure my college fluid dynamics prof would have said that "the flow/pressure characteristics of different size hoses would indeed be different"... but whether or not it's important in this application I truly don't know.

Any info anyone can provide would be most appreciated.
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#2
(11-06-2015, 02:36 PM)touch33 Wrote: but my Inner Engineer says "Phillips wouldn't have put the variable in there if it didn't matter"

I agree. As I hold the sleep industry in near absolute disdain I will let others with possibly more rational feelings tell you how they see it.

I would suggest you install Sleepyhead as a hands on I imagine person you are gonna want to see for yourself how your therapy progresses. Just don't tell her AND remember NO one is as interested in your getting better than are you.
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#3
There are two reasons why the hose setting is important. One is flow impedance. I'm sure you get the electrical analogy there. The other is wave propagation (analogy to a transmission line.) The machines score apnea type based on reflected wave.

The "sleep concierge" is out of phase!
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
(11-06-2015, 03:12 PM)justMongo Wrote: There are two reasons why the hose setting is important. One is flow impedance. I'm sure you get the electrical analogy there. The other is wave propagation (analogy to a transmission line.) The machines score apnea type based on reflected wave.

The "sleep concierge" is out of phase!

Pretty much my thoughts exactly – although I've been wondering from Day One how the AHI is calculated and whether or not anything I'm doing (and/or the abnormally small size of my trachea) has anything to do with how many AHI are actually occurring vs. what the System One is reporting.

Riddle me this: I went into the protected setup to correct the hose size, and there is a small "padlock" icon next to the setting and I'm unable to alter it. What gives?
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#5
(11-06-2015, 03:47 PM)touch33 Wrote: Riddle me this: I went into the protected setup to correct the hose size, and there is a small "padlock" icon next to the setting and I'm unable to alter it. What gives?
You can unlock the padlock/lock symbol from the clinical menu

Setup guide and how to get the clinical manual fro your CPAP machine
http://www.apneaboard.com/pr-system-one-...structions

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#6
You have a great machine than can be a CPAP, auto CPAP, BiLevel, and auto BiLevel.
Now all you need is to get past any possible compliance issues and then you can self manage your machine/therapy. The collective wisdom here FAR exceeds anything you will get from a DME or sleep doc for that matter. I wish you well!
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
Reply


#7
(11-06-2015, 04:35 PM)Mark Douglas Wrote: You have a great machine than can be a CPAP, auto CPAP, BiLevel, and auto BiLevel.
Now all you need is to get past any possible compliance issues and then you can self manage your machine/therapy. The collective wisdom here FAR exceeds anything you will get from a DME or sleep doc for that matter. I wish you well!

Thanks, Mark – having done some homework prior to meeting with my DME (a pleasant-enough person, though clearly overworked and unable to spend a lot of time with a client who asks pointed questions and expects accurate answers...) I decided to drop some additional $$$ beyond what Aetna would pay to upgrade to the Respironics SysOne. The recent change to "Bi +" was apparently justified by the lack of AHI reduction using the CPAP-only version for the first ten days.

My biggest take-away from my cancer treatment is that the more informed I am the better my outcome – which is why this forum is a Godsend. I'm truly hoping that this treatment avenue will be a productive one, since four years of sleep deprivation is definitely taking its toll.

If there are any tips that anyone cares to send my way I'm all ears!

Bruce
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#8
(11-06-2015, 04:35 PM)Mark Douglas Wrote: You have a great machine than can be a CPAP, auto CPAP, BiLevel, and auto BiLevel.
Now all you need is to get past any possible compliance issues and then you can self manage your machine/therapy. The collective wisdom here FAR exceeds anything you will get from a DME or sleep doc for that matter. I wish you well!

Ditto what Mark said. It's interesting that we all have the same machine too. I also was at the 10-15 AHI mark for a long time -- almost a year. Suddenly, after a year, it seemed to drop to a range of about 3.5-4.5 AHI.

SleepyHead's summary page will indicate the best results for various settings. Be careful though in the beginning that you don't wildly tinker continuously with the settings like I did -- trying to find blissful results. The problem is that there are so many factors at play in addition to settings...
- mask, mask fit, mass leakage on a particular night
- daily food & drinks
- bed time
- etc.

One of the kings on this board (you'll get to know them) gave me that advise... to do very subtle changes and leave it for 5-7 days (something like that).

Lastly OP, I like your sense of humor, given all that you're going through. We all need that! I look forward to your future posts...
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#9
Hose size settings do matter, so adjust them. The padlock might be if you have a heated hose, which will lock the setting to 15 automatically because the heated hose is 15 and they don't want you to mistakenly change it. It should unlock automatically if you are using a non heated hose.
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#10
DocWills is correct. As a matter of fact, the machine will automatically change the hose setting by itself as soon as you switch from a regular 22mm size hose to a heated 15mm size hose.
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