What I Wish CPAP Were

It is well understood that CPAP and its derivatives do not perform well[1]. I think much of this is caused by an inadequate base of research which is using unscientific underdeveloped methods[2,3]. And so I believe that why CPAP is ineffective stems from a blind disconnect between what the doctors and designers produce and what the people who need the help actually need to help them.

Someday, out of necessity, I may find myself driven to make my own CPAP machine. What I want is pretty simple. I wish they would make it. Start with:

QUIET PLEASE! :

Oh they will have specifications showing a Sound Pressure Level near the threshold of hearing. And I pretty well know how they made that measurement. Sound absorbing room, machine on a small platform almost suspended in space, hose going to outside the room.

DID ANYONE CONSIDER THAT WHAT WE MOST HEAR IS COMING UP THE TUBE?!!!

I can almost discern every fan blade passing near the hose inlet!! The changes in speed are apparent to me. My brother who is a musician using BiPAP finds it necessary to run two fans in the room to somewhat mask the noise of the “tone changes” as the machine changes pressure with each breath! Can you guess, you doctors and designers, why there are so many arousals while using CPAP?

KEEP THE PRESSURE SIMPLY CONSTANT! :

If memory serves (and I have been looking into this specifically for a while now) every comparison study done between strait CPAP and other more automated kinds shows strait CPAP causing less arousals. And indeed consistent sleep is what sleep is about. “Do Not Disturb” the signs say. May this be a “hint” to you, you doctors and designers, why there are so many more arousals while using xPAP?

I think the whole “pressure dance” idea to try to deal with breathing instability is simply a bad direction.

Most of the efforts which are using changes in pressure are attempting to deal with variance in inflammation, muscle tone, and/or respiratory gain. I find it better to follow my data and manage my lifestyle to deal with changes in inflammation. Modified EERS[4] helps me to deal with occasional times of respiratory gain problems while causing I do believe no increase in arousals. Simply I find that there are much better ways of dealing with these issues than “dancing the pressure all around”. Why are the doctors and designers of xPAP unable to implement these simple cheap and overall better solutions as I have? Probably every CPAP system made should be delivered with modified EERS “just in case” rather than letting intermittent times of hypocapnia harm the brain.

But even with “strait CPAP” somehow they find it necessary to “test” for “Clear Airway Apnea” using a short pressure burst. I find these most annoying. Often when I am just about to go to sleep my respiratory rate falls to the point where the pressure burst to test for “clear airway” meets my start of inhale – and – the resulting much larger breath wakes me up! Can you guess, you doctors and designers, why there are so many arousals while using CPAP?

The pressure changes I feel while using my machine are very fast so the motors must be very powerful I suppose. But another thing I find annoying while trying to use a stock strait CPAP is that every breath you take as you start to exhale there is a little nasty pressure increase apparently due to your outgoing breath meeting a fan which was spun up to meet the airflow needs of when you were breathing in. I do find that adding some “compressible air space” does help with this. Can you guess, you doctors and designers, why there are so many arousals while using CPAP[5]?

[1] https://honesttocpap.wordpress.com/2014/08/27/how-usable-is-cpap/

[2] https://honesttocpap.wordpress.com/2015/01/22/why-sleep-testing-fails-to-work-in-real-life/

[3] https://honesttocpap.wordpress.com/2015/01/27/sleep-testing-as-it-should-be/

[4] https://honesttocpap.wordpress.com/2014/09/28/now-using-modified-eers/

[5] http://www.sleepreviewmag.com/2014/01/a-missing-link-dr-barry-krakow-s-research-on-insomnia-and-sdb/

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