What does EasyBreathe do?

[GuyScharf]

What does the EasyBreathe option in the S mode of a AirCurve 10 VAuto actually do? ResMed says "Easy-Breathe pressure waveform mimics the wave shape of normal breathing and replicates it for optimum breathing comfort." This sounds like it may be affecting the abruptness (or not) of how the pressure changes between inhalation and exhalation. Is that correct? Are there any graphs available showing the difference?

[Sleeprider]

Easybreathe™ shapes the transitions in bilevel machines fro square wave (on-off), to a wave-form that looks like the familiar cresting wave you see in the Oscar mask pressure chart. With easybreathe, the pressure rises very quickly from EPAP with the rate of increase decreasing near the apex of inspiration (IPAP). Pressure from IPAP drops off very quickly as expiration begins but slows near the nadir of expiration. These wave shapes actually nearly mirror each other. Easybreathe is used in both VPAP pressure support and CPAP EPR. It can be turned off in VPAP S-mode and is not available in ST.

[Sleeprider]

Note the mask pressure curve. That is EasyBreathe at work. I'm not certain but I think it is built into the motor control logic, and as you note it can be switched on or off.

[Crimson Nape]

I've been using Easy-Breathe for some time now and love it. It manages to match the rate, as well as the rise and fall, of your breathing pattern to the point that you can not tell if the unit is turned on. As good as the Vauto mode was, there was always an artifact in the air delivery that let you know it was on. With that said, I tend to march to a different drummer.

[jaswilliams]

This is an ST that can’t do easy breath and it’s like being kicked in the face with a brick of air look at the mask pressure i increased the rise time to make it more comfortable but it’s still pretty much a square wave.

[GuyScharf]

Thank you all. I had thought EasyBreathe was an option in S mode, but it appears that the option is really an option to turn it off. My mask pressure graphs on the VAuto and AutoSet with EPR all look the same. I tried turning off EasyBreathe on S mode and the result was ugly! I would think the square wave would be harder on the motor as it would require faster acceleration and deceleration.

My impression was that S mode with EasyBreathe on felt very slightly different than VAuto mode at the same pressures.

[ewriter]

Hi All,

I asked my sleep specialist about this and he said there's no data to support. However, I am beginning to wonder if use of PAP therapy conditions your pulmonary and cardiac circuits to become dependent on their preset cycles (which will change, of course, over time with weight gain, disease, alcohol and drug use, medications, etc.) to the point where you will NOT be able to breathe naturally anymore while sleeping without a CPAP/other PAP. And your cardiac rhythm and circulation support will become permanently altered (sometimes detrimentally) after many years of using PAP therapy. I have used CPAP and APAP for more than 12 years and i believe my natural breathing has been changed by the machine dependency.

If true, is that really a good thing?

Thanks

Paul

[Sleeprider]

Paul, most devices and all CPAP rely on spontaneous respiratory effort these machines are not ventilators. Good luck surviving if you are dependent on these machines to live.

[stevew77]

Although the pressure on OSCAR looks like a square wave, my ASV shows a much more gentle wave on Mask Pressure. I'm glad I did not let Lincare replace my ASV with an ST.

This is an ST that can’t do easy breath and it’s like being kicked in the face with a brick of air look at the mask pressure i increased the rise time to make it more comfortable but it’s still pretty much a square wave.

[ewriter]

Hi Sleeprider,

I've been hoping to gain any insight from you (I think you have probably the most knowledge and experience about PAP therapy on this board) for a long time. You may have seen my other posts (for about a year or more) on the board regarding a "flutter" which I get only when asleep, or falling asleep (to be precise, the second I begin to enter REM). I don't know what this "flutter" is but, if left uncontrolled it appears to lead to a rapid heart rate, RERAS, OAs and hypopneas.

My current doctor's approach since January (when i as getting 90 minutes' sleep a night then being woken up, unable to fall back to sleepm due to the "flutter" which, at that time, was either not palpable or not there) is to treat me with sedatives and/or antidepressants. These have definitely helped control my panic attacks and improved my mood and I am now mostly functional. But the troubling low-level "flutter" has not gone away -- in fact it has become persistent when i am sleeping (particularly when i fall asleep without the mask, due to the sedatives).

The strange thing about this "flutter" is that no Cardiologist (out of seven I have seen since 1997) has been able to detect it; and when i thump my chest when i get it, it disappears. My rhythm is sinus and i take 10+ mg Bystolic (prior to this, 120 mg oF Propranalol, tapered all the way down from 120 mg in 2007 to 20 mg in 2023; though it has been decades, i still get panicky when this occurs or when i wake up with it and/or a rapid heart rate and a BP of 165/89 (for example). My blood oxygen is generally good (usually above 97).

My theory is that excessive alcohol consumption, together with chronic marital stress and conditioning with Propranalol over the past 12 years and more, has softened my palate such that i am still getting some shallow breathing -- enough to trigger "flutter." The PAP therapy reduces my events to an AHI <1 at a pressure of 9 (Aire10 Autoset for Her, EPR of 3) but i'm thinking that i still get too much shallow breathing to completely prevent the "flutter." I'm also concerned that the PAP therapy itself may induce the "flutter" and I don't know how to resolve that unless i get Nightlase and/or try an oral appliance. I have been able to get AHI < 1 with a pressure of 5 so i don't believe my apneas are severe ON AVERAGE but, if they are, then i get the "flutter." I'm concerned about progression and would like to do everything i can to prevent this "flutter."

The problem is, to get adequate sleep (more than 4 hours) my doctor prescribed Clonazepam, Dayvigo, and/or Zopiclone and (previously) six different antidepressants in two months (Seroquel -- which I suggested; Trazadone, which i suggested because it allows REM sleep; Mertizapine (which my doctor suggested); Effexor (which I suggested); Clonazepam and Lorazepam) only the Clonazepam has proven to be helpful -- but these sedatives are most likely depressing my breathing (though the apneas do not show up in the AHI data).

So, to improve my shallow breathing and hopefully eliminate the "flutter" i would likely have to taper off the drugs completely and try to rely on Melatonin (which is very weak) and the beta blocker. To date, this has resulted in my getting 2 - 3 hours' sleep a night and panic attacks.

In all your experience with PAP therapy and these and other forums, have you come across a case remotely similar to mine and, is there anything you can suggest that might help me? I don't smoke and no longer drink; but the only thing that seems to dampen the "flutter" is the beta blocker (unless, somehow, it is actually causing it).

Note: i don't get the "flutter" during the day and i was originally prescribed BiPAP Auto (I still have the Respironics System One machine but it appears I was using it in CPAP mode only at a pressure of 13 for 9 years when in the last year or two before 2020 i should have dropped the pressure to 9). Because i lived and worked in 4 countries since 2000 my sleep therapy treatment has been lacking in continuity of care; and my cardiologists don't seem to make any connection between development of arrhythmias and disordered sleep breathing (or, not until it is patently obvious and/or severe).

Looking forward to any help you can give,

Paul