CyrusManz

Your Oscar chart shows an incredibly high number of CA events, highly unusual. A BiPap machine algorithm basically looks at the flow rate and if your airway is open but you are not exhaling, then there is no resistance on the flow rate and your machine algo registers this event (if it lasts more than 10 seconds) as a "central" event. I am guessing that you have been given a Resmed machine but without its model, I can't be much help on correcting the titration in order to get rid of the centrals because it could very well be that you are not having that many central events and the machine algo is incorrectly reporting it because of titration. Also, what was the result of your original sleep study? (was it 90% CSA and 10%OSA for example?) I am asking because your doctor should have prescribed a ASV machine instead of a bipap if your CSA events were higher than 20% of the time during your sleep study. The reason you need a ASV type is because the algorithm on an ASV is designed to monitor and react to your respiratory function, on a breath-by-breath basis, so it will constantly adjust its IPAP and EPAP pressures within a wide range in order to "stabilize" your "Minute Ventilation".

A non-ASV BiPAP is only designed to drop EPAP pressures to a preset limit at expiration and vice versa for inhalation. The algorithm does not otherwise attempt to stabilize Minute Ventilation or any other respiratory characteristics. It just provides positive pressure to keep your upper airway open in order to treat your OSA with the added comfort and precision of having a secondary pressure setting for exhalation.

Look up Adaptive Servo Ventilation (ASV) therapy online. There are a lot of very good articles about it. The machine itself looks exactly like a CPAP machine but the turbine and software are designed for ASV function.

Hahaha:-) Yes, I remember now.:-) Fact is that Philips has never once used the name SoClean in their findings, but yes they do say "Ozone cleaning equipment" can damage the sound abating foam... So they just have to prove that Ozone does in fact damage the foam (which I imagine they can, very easily and they have the US FDA findings on their side too). Fact is that SoClean's entire net worth is pocket-change in comparison to Philips Respironics, so they must know that they simply don't have the stamina to go the long way in a court battle and be able to prevail. A very ill advised move which will cost SoClean dearly at the end.

It will be interesting to find out the details. I wonder how SoClean was even licenced to sell these Ozone generators for home use? They are so seriously dangerous.

On what grounds would SoClean be able sue Philips? For having machines that SoClean destroyed with their SoClean ozone contraption and caused Philips hundreds of billions worth of damage?:-)

Agreed. I think that Phillips will eventually go after them.

All I know is that Boston based Respironics invented its first medical CPAP machine in the mid 70s and later was taken over by Philips in the 90s and then California based Resmed started under their current name in the 80s,long after CPAP already had a market , so I am pretty sure Resmed didn't have to reinvent the wheel:-)

I only use dawn and since I only use distilled pure water, I don't worry about mineral build up .

By the way medics advise against using tap water in CPAP in order to reduce chances of water solubles and water born pathogens, getting into the lungs.

SoClean is an ozone generator and circulates the ozone through the entire circuit of your gear, from the mask through the hose and then the machine's internal turbine chamber in order to sanitize it, but it leaves dry scum from rain-out in the tube and saliva in the mask, leaving a dry residue behind, which is most likely the flaky white stuff you see blowing out.

Ozone is also known to degrade inorganic compounds like foams, and materials used in insulation, the primary reason behind another company (philips) to make their historic recall of their equipment because they found that the sound abating foam inside their machines breaks down when exposed to ozone. It could be that materials inside your machine are being broken down by SoClean ozone OR somehow external debrie is getting inside of the air circuit which is then blown out, on startup. You may also wish to read up on the US FDA's take on equipment like soClean:

"The FDA performed some testing, and found that the devices claiming to clean CPAP machines and accessories generated unsafe ozone levels in the area (probably because it leaks into the room)"

Well there is a clear scientific observation that connects patients with CHF to CSA. So they believe that CHF can lead to CSA and vice versa. Some scientists want to start studies into whether or not the development of CSA is a natural response to CHF in order for the body to moderate its PaCO2 levels...THAT is way out in the woods for me:-)

Studies also show that "treatment emergent CSA" is a thing, meaning that the long term CPAP therapy for OSA, leads to the development of CSA. (Remember that CSA itself was only isolated as a disorder back in 2008 at Mayo clinic so it is a relatively new subject and under intense study, internationally.) BUT I have also seen studies that suggest " treatment emergent CSA" will go away by itself within 6-8 weeks, after OSA CPAP therapy stops, but who would stop their therapy, unless they get an "implant surgery", like "INSPIRE" at a cost of like $30 K.??

This being said, it does not mean that people can't just develop Central Apnea without CHF (I am an example of that). There is also a clear scientific consensus that "UNTREATED CSA or OSA" will eventually lead to all kinds of Cardiovascular issues, including and not limited to CHF, however it is believed that the long term use of opiates can also be a driver of CSA.

As to O2 therapy for patients with CHF and Centrals, it makes a lot of sense because CSA folks (again like me) can watch their blood oxygen saturation level (SpO2) drop significantly overnight, if they are not using ASV therapy. I would imagine that supplemental Oxygen used in conjunction with PAP therapy for this group (CHF+CSA) would be very efficient and beneficial because CJHF itself is a cause for lowered SpO2.

Right, so if the patient's breathing is all over the place due to a respiratory issue or sickness, then Resmed's algo will be calculating faulty backup:-) This is why a Dreamstation algo has BOTH choices, an Auto Backup calculation OR a manual backup breath rate, manual Inspiratory time and even manual setting for the "RISE time", the transition time between IPAP and EPAP. Clearly they have worked a lot more on Dreamstation algo than they have on Resmed and that's only understandable, given that Respironics INVENTED CPAP therapy back in the 70s:, some 10 years before Resmed started as a company-)