A small rant: Does anybody have any idea why even "smart APAP machines" are stupid?

[Terry]

After spending a few months with my shiny new APAP machine, I've come to the conclusion that it's one of the least intelligent devices I use.

When I initially got it, it was set for 7-20.

Every single night it would happily sit there and wait until I did something like "stop breathing" or "snore like a pig" or wake up from a flow limitation, and then it would gently raise the pressure and try to fix what was wrong, fix it, then notice that everything was fine and lower the pressure again, so the cycle can start over.

Even though I've never seen a home machine that was shared by more than one person, the next night would be "groundhog day" where everything starts over again at "7" with the snoring and the apneas.

"Why exactly can't the machine retain knowledge of the pressure required to let me breathe quietly all night?"

This isn't a huge issue for me personally, since I just moved the lower range to where it needs to be, it is a huge issue for people who don't know how/won't adjust their own machines. I'm honestly confused why a device that has a record of every breath I've ever taken while sleeping, wouldn't use this information to set a reasonable starting pressure, instead of every day, starting at "7".

Is there some logic behind this?

My car radio know what I listened to last, my oven remembers the temperature I make pizza at and my house knows when I come home, so it fires up the A/C. Why exactly does my APAP machine need to forget everything, every night, even though it has an entire memory card full of data?

Terry

[Ghandi]

Hi Terry

I have almost the same model. But i'm on fixed pressure even if it has the apap capability for a limited period. The algorithm for c-chek.,hat is supposed to ajust over 30 hours of sleep from 4-7 for me. Well even if at 7 my ahi was lower, it would go back to 6 and let my ahi raise for weeks. Then then doctor asked to removed c-chek. So i'm not an expert but the auto algorithm from respironic dont seem to be working so well. And the doctor seemed to agree with me on this point.

That may be why he is reluctant to auto cpap. They have to work with respironic products at the hospital.

[Peter_C]

Very real points. The reason why it starts over (like Groundhog day) is because it doesn't know what you need, and what you needed yesterday may not be what you need today.

I've been on CPAP for many years, and after tracking very completely for the last four months I have found that 95%+ of the time I am good at '13'. However, for whatever reason every so often I need my pressure raised to even as high as '18'. Again, not often, but totally random.

I believe (insert opinion here) that a machine used in APAP mode (auto, autoset, etc) should first be set wide open, then track the numbers for a month or two, where it will become very plain where your 95% number is. At that point, *I* (opinion) would then set the range from 1 or 2 points below my 95% number and leave the high end open. So, if your 95% number is (say) '12', with a few '11's, and a couple of '13's - I would then set the MIN to '11' and the MAX to '20' (some people believe in limiting the max, I do not)

This gives you the best of both worlds, as your machine will start very close to your normal usual number, but will have the ability to increase pressure if it is needed for any reason.

The problem is, many people (me included - look at my join date) don't bother to learn anything, you're just lucky if you get good compliance numbers, and, many Docs only look at compliance and do not (for whatever reason) bother to tweak the machine for greater comfort.

[retired_guy]

Yeah Terry, you're right!

I also think cars are pretty stupid. They reset themselves to zero every night!!!! You'd think they'd start out at 60 or something.

My S9 came defaulted to 4 and 20. Since I was not counting Blackbirds to put into a pie, I changed that the very first day. Or second day. Or something.

[JimZZZ]

I see your point but I prefer having control over the pressure range setting. In a world of dumbed down devices, it is comforting to have a device that is not messing with itself behind your back. I will probably never buy a car that slams on the brakes when it feels like it or (heaven forbid) drives itself.

[Terry]

I see your point but I prefer having control over the pressure range setting. In a world of dumbed down devices, it is comforting to have a device that is not messing with itself behind your back. I will probably never buy a car that slams on the brakes when it feels like it or (heaven forbid) drives itself.

You like having control, but 90%+ of CPAP users have no control over their machines.

I adjusted mine, but can't even begin to tell you how many people I know with auto machines that give them the same crappy night's sleep, every night, when it would be easy for the machine to average up/down the minimum pressure, within the prescribed range, so every night could be a little better than the last, until after a few days/weeks, the pressure would start out at "just about right".

I spent decades designing software including embedded systems, and it makes me crazy when someone decides to take the easy way out, making things difficult for millions of people, when doing it right would only be a little extra work.

Terry

[bwexler]

Amen Terry!
My BIL fits your description. I see him occasionally and take the data off his machine and share it with his doc. He is nice enough to collaborate with me, especially when he said he was not familiar with Sleepyhead format and I sent him the report in Encore. If it weren't for our interaction the doc would hardly ever get to see the data, since BIL forgets to bring the card or machine when he sees the doc.
Your idea would help people like him dramatically. Now if you could devise a foolproof way for him to now if the headgear needs to go in front or in back, and that ALL the straps need to be connected all night. He told me the mask was more comfortable with one strap disconnected. His leaks never got to 200.

[JimZZZ]

You like having control, but 90%+ of CPAP users have no control over their machines.

Sorry that I assumed everyone is like me. It's a lesson for those of us retired from careers in information technology. There are so many experts contributing to the forum that we tend to think everyone is a hands-on techie.