Innovation and technology

Algorithms

 

AutoSet for Her

The pioneering new algorithm in the AirSense™ 10 AutoSet for Her isbased on ResMed’s proven AutoSet algorithm and delivers therapeuticresponses that have been tailored to the characteristics of obstructivesleep apnea (OSA) in women.

Research has shown that women with OSA have more upper airway resistance and flow limitation than the general OSA population1, which is why the AutoSet for Her algorithm has been designed to be more sensitive to flow limitation.

In addition, the algorithm provides more subtle changes in therapy pressure to minimize sleep disturbance. The AutoSet for Her algorithm also automatically adjusts the minimum AutoSet pressure if multiple apneas are occurring below a certain threshold.

Available in the AirSense 10 AutoSet for Her device.

 

AutoSet 

ResMed’s AutoSet algorithm continually monitors each patient’s unique breathing pattern on a breath-by-breath basis – every hour, every night.

When AutoSet detects an event, it doesn’t just apply a fixed pressure response. Instead, AutoSet assesses the severity of each event – whether it is flow limitation, snoring or an apnea – before determining and delivering the ideal, lowest pressure solution to treat the event.

Once the event is treated and the patient’s breathing stabilizes, AutoSet gradually decreases the pressure, while continuously monitoring for recurring events. Patients remain comfortable through it all, and receive the therapy pressure that is just right for treating their OSA – no more and no less.

Available in the AirSense 10 AutoSet and AirSense10 AutoSet for Her devices.

 

CPAP 

Continuous positive airway pressure (CPAP) is a type of therapy that delivers pressurized air at one fixed pressure throughout the night to keep your patient’s airway open so that they don’t stop breathing in their sleep.

Available in all AirSense 10 and AirCurve™ 10 devices.

 

 

VAuto

In VAuto mode, the AutoSet algorithm automatically adjusts pressure in response to flow limitation, snore and apneas and is for patients who need greater pressure support. For related features see triggering and cycling, TiControl™ and central sleep apnea detection.

Available in the AirCurve 10 S and AirCurve 10 VAuto device.

 

S

In S mode, you can set two treatment pressures – one for inspiration (IPAP) and one for expiration (EPAP). The device senses when the patient is inhaling and exhaling and supplies the appropriate pressures accordingly. For related features see triggering and cycling, TiControl and Easy-Breathe.

Available in the AirCurve 10 S and AirCurve 10 VAuto device.

Technological features

 

Ramp

Designed to make the beginning of treatment more comfortable, ramp is available in all modes. Ramp time is the period in which the pressure gradually increases from a lower, more comfortable start pressure to the prescribed treatment pressure.

Available in all AirSense 10 and AirCurve 10 devices.

 

AutoRamp™

The new AutoRamp feature with sleep onset detection helps make therapy comfortable from the moment the patient turns on the therapy device. Built into ResMed’s AirSense 10 series, this ramp feature is activated automatically, so you’ll no longer need to spend time adjusting each patient’s ramp setting.

As soon as the patient turns on the device, AutoRamp begins – delivering a low start pressure to help patients fall asleep with ease. Then, using its unique sleep onset detection capability, AutoRamp responds by comfortably ramping up to the patient’s prescribed pressure the moment it detects the patient has fallen asleep – giving your patients the therapy they need, from the moment they need it.

With ramp times automatically adapting to each patient’s individual sleeping patterns, AutoRamp gives your patients a tailored start to therapy, and makes the most of every valuable moment of therapy time.

Available in the AirSense 10 Elite, AirSense 10 AutoSet for Her and AirSense 10 AutoSet devices.

 

Cheyne-Stokes respiration (CSR) detection

ResMed’s new Cheyne-Stokes respiration detection feature helps you identify patients on fixed or auto-adjusting pressure devices who may present with CSR breathing patterns. Throughout the night, the intelligent algorithm continually monitors a patient’s breathing patterns, checking cycle lengths and searching for indications of CSR.

Cheyne-Stokes respiration is a form of sleep-disordered breathing characterized by a periodic waxing and waning of respiration.

Available in the AirSense 10 Elite, AirSense 10 AutoSet for Her, AirSense 10 AutoSet therapy devices.

 

Respiratory Effort Related Arousals (RERA) reporting

RERAs are periods of increased respiratory effort leading to an arousal.2 These flow-based RERA events are logged and stored as summary and/or detailed data and can then be viewed in AirView™, ResMed’s cloud-based patient management system.

RERA reporting is available on the AirSense 10 AutoSet for Her in all modes.  

 

Central sleep apnea (CSA) detection 

CSA detection uses the forced oscillation technique (FOT) to determine whether a patient’s airway is open or closed during an apnea. When an apnea has been detected, small oscillations in pressure (1 cm H2O peak-to-peak at 4 Hz) are added to the current device pressure. The CSA detection algorithm uses the resulting flow and pressure (determined at the mask) to measure whether the airway is open or closed.

CSA detection is available in the Airsense 10 AutoSet, AirSense 10 AutoSet for Her and the AirSense 10 Elite devices.

 

Expiratory Pressure Relief (EPR)

Designed to make therapy more comfortable, expiratory pressure relief (EPR) maintains optimal treatment for the patient during inhalation and reduces the delivered mask pressure during exhalation.

Available in all AirSense 10 devices.

 

Easy-Breathe

The Easy-Breathe waveform intelligently recreates a patient’s individual breathing pattern, so breathing feels more natural and therapy is more comfortable.

Available in all AirSense 10 and AirCurve 10 devices.

 

Vsync

Vsync is a leak management algorithm and the product of ResMed’s extensive experience in noninvasive ventilation (NIV). Vsync monitors and compensates for unintentional mask leak, so that patients receive their prescribed therapy pressure. Working in sync with TiControl, Vsync ensures reliable breath detection (patient–device synchronization) even in conditions of high leak.

Available in all AirCurve 10 devices.

 

Triggering and cycling

Under normal conditions, the device triggers (initiates IPAP) and cycles (terminates IPAP and changes to EPAP) as it senses the change in patient flow. Patient breath detection is enhanced by ResMed’s automatic leak management. In addition, the device has adjustable trigger/cycle sensitivity to optimize the sensing level according to patient conditions.

Available in the AirCurve 10 VAuto and AirCurve 10 S devices.

 

TiControl - inspiratory time control

Unique to ResMed bilevel devices, TiControl allows the clinician to set minimum and maximum limits on the time the device spends in IPAP. The minimum and maximum time limits are set at either side of the patient’s ideal spontaneous inspiratory time, providing a window of opportunity for the patient to spontaneously cycle to EPAP.

The minimum time limit is set via the Ti Min parameter and the maximum time limit is set via the Ti Max parameter.

TiControl’s Ti Max and Ti Min parameters play a significant role in maximizing synchronization by effectively intervening to limit or prolong the inspiratory time when required. This ensures synchronization even in the presence of significant mouth and/or mask leak.

Available in the AirCurve 10 VAuto and AirCurve 10 S devices.

 

Climate Control

Climate Control is an intelligent system that controls the HumidAir™ heated humidifier and the ClimateLineAirTM heated air tubing to deliver constant, comfortable temperature and humidity levels during therapy.

 

Climate Control Auto

With Climate Control’s enhanced Auto option, both temperature and humidity are pre-set at levels designed to deliver optimal comfort.  So patients can now receive comfortable humidification by simply attaching the ClimateLineAir™ heated tube and pressing Start. There are no settings to change and no complicated menus to navigate.

 

Climate Control Manual

For patients who want greater control over settings, Climate Control Manual lets the patient adjust the temperature and humidity to the setting that is most comfortable for them.

In Climate Control Manual, the Tube Temperature and Humidity Level can be set independently, however rainout protection is not guaranteed. 

 

Tube temperature

If the air in the mask feels too warm or too cold, the patient can adjust the temperature to find what is most comfortable, or turn it off completely. The tube temperature can be set to anywhere between 60-86°F (16-30°C).

The temperature sensor located at the mask end of the ClimateLineAir heated air tube enables the system to automatically control the temperature of the air delivered to the patient. This ensures the temperature of the air delivered to the patient does not fall below the set minimum temperature, therefore maximizing breathing comfort.

 

Humidity level

The humidifier moistens the air and is designed to make therapy more comfortable. If the patient is getting a dry nose or mouth, turn up the humidity. If the patient is getting moisture in their mask, turn down the humidity.

The humidity level can be set to Off or between 1 and 8, where 1 is the lowest humidity setting and 8 is the highest humidity setting.

For each humidifier setting, the Climate Control system delivers a constant amount of water vapor, or absolute humidity (AH), to the patient’s upper airway.

Available in all AirSense 10 and AirCurve 10 devices.

 

Leak management

Devices in the AirSense 10 and AirCurve 10 series monitor and compensate for leak by continuously and automatically adjusting the baseline flow. In AirCurve 10 devices, this enables reliable delivery of therapy pressure while maintaining patient-ventilator- synchrony. For relevant algorithms, see Vsync.

Available in all AirCurve 10 devices.

For a fully integrated approach to patient care, prescribe ResMed Air Solutions products for your sleep apnea patients.

References

  • 01

    Mohsenin V. Gender differences in the expression of sleep-disordered breathing: role of upper airway dimensions. Chest 2001; 120(5):1442-7.