ResMed's EasyBreathe -- What a Difference

I started using xPAP in June, and my first (and only) machine is the ResMed S8 AutoSet II. I found it very easy to adapt to using it, and didn't think much about it.

Yesterday, I went to my sleep doc's drop-in mask clinic, to look for a full-face mask to try. (I wound up with a ResMed Liberty.) But to try the mask, the tech hooked me up to a Respironics tank (pre-M-Series) machine on straight CPAP. She set it to 12, which is my minimum pressure on my APAP. C-Flex was off.

OMG! I thought I was hooked up to an Air Force wind tunnel. Exhalation was much more difficult. I then realized that the difference must have been the EasyBreathe technology in my APAP. Since I had been using it from the beginning, I didn't realized how spoiled I was. So much more natural. I've never even considered turning EPR (software exhalation relief) on.

For those who don't know, EasyBreathe is built into the ResMed S8 II series blower design -- it's hardware, not software. As such it has no software settings, and can't be turned off. ResMed claims that EasyBreathe has been shown in clinical studies to not decrease therapy effectiveness.

And for the record, my only connection to ResMed is a 2-meter-long hose.

i'm with ya there, jeff. mine is not an APAP...but I love, love my machine...for all the reasons you say....and apparently it is one of the quietest (if not THE quietest) machine out there.

jdm, we must be on the same wave length today.

I just finished reading the Eiken/McCoy paper titled "Performance of Auto-adjust cpap devices".
I also went back and read the comments from years ago when this report was discussed on the forum.
The first thing that was evident in reading the old posts was what a lose Snoredog(RIP) has been.

The next impression I came away with is the absolute necessity, for anyone using cpap,
to be educated and completely and totally involved in their own therapy.
As we are all aware, the sleep industry infrastructure is not
and will probably never will be able to provide the day to day
support that this therapy requires.

My next impression is why my S8 Auto is providing me much
better therapy than the Mseries auto was.
I have no scientific proof, color coded charts or graphs to
substantiate my findings. I believe the difference is
the algorithms of the two machines. I think the fact that
the S8 does not search or react to the hypopneas and apneas
the way the Mseries does, it is not disturbing my sleep as much.
Consequently, I am sleeping deeper and longer at a time.
Infact, I am having shoulder/back problems from lying in one position too long.
Also, as you point out, it is much more comfortable to breath with.

My day to day average AHI, before divide by 2, is also starting to come close to
what my average AHI was on my Mseries. I think I need to continue to play w/my min
pressure and I may be able to bring my "displayed" AHI down to if not lower than
what I had w/the Mseries.

Whatever the reason: contrived, imagined or by alien abduction,
I am sleeping better and absolutely feeling better since
I started using this machine.
Whatever the reason, please don't let it stop.

I have no experience with EasyBreathe but it does seem to have some software elements in addition to the dual-stage motor.

Whisper-quiet motor

Setting a new industry standard in quiet therapy and comfort, ResMed’s new sophisticated motor design delivers superior performance at a lower effort while cutting device noise significantly. By reducing noise, Easy-Breathe technology enables patients and their bed partners to sleep peacefully through the night.


--------------------------------------------------------------------------------

Easy-Breathe technology

Easy-Breathe technology combines new software, a quieter motor and improved EPR with Easy-Breathe for maximum comfort and a quiet night’s sleep.


--------------------------------------------------------------------------------

Pressure relief for more natural breathing

Featuring ResMed’s improved EPR with Easy-Breathe, the S8 Elite II offers pressure relief delivered in a smooth waveform that mimics patient breathing. With a choice of three different EPR comfort levels, the S8 Elite II with Easy-Breathe allows customized comfort for breathing that feels natural.


--------------------------------------------------------------------------------

Why prescribe EPR with Easy-Breathe?

Not all CPAP devices with pressure relief are the same. ResMed’s EPR with Easy-Breathe is supported by clinical studies, proving it equally as clinically effective as traditional fixed CPAP, but significantly more comfortable. EPR is preferred over traditional CPAP by 79% of patients.

ResMed Introduces Easy-Breathe Comfort Technology
San Diego, CA -January 9, 2008

"The September launch of Easy-Breathe at the European Respiratory Society conference created a sensation with its innovative, quiet motor technology," stated Michael Farrell, Senior Vice President, Sleep Strategic Business Unit. "We expect similar enthusiasm with the launch in the Americas market. The combination of whisper-quiet comfort in a compact system is truly a unique offering, and adding the ultra-comfortable Easy-Breathe waveform for the launch of the VPAP Auto in the Americas is icing on the cake. These features increase compliance, which benefits patients, HMEs and sleep specialists."

"The VPAP Auto offers comfortable bilevel therapy in ResMed's compact S8 platform," stated Drew Terry, Director of Product Management. "With our new Easy-Breathe technology, the VPAP Auto is able to deliver nearly silent therapy and greater pressure stability so patients sleep comfortably throughout the night. The VPAP Auto synchronizes with the patient's normal respiration so that breathing feels more natural and comfortable."

The Easy-Breathe Pressure Profile
The Easy-Breathe pressure profile was originally developed for ResMed's advanced VPAP Adapt SV to deliver comfortable therapy for complex sleep disorders. The same comfortable pressure profile is ideal for all CPAP patients because, unlike the traditional square bilevel waveform, Easy-Breathe's smooth pressure profile recreates a patient's natural breathing pattern for a more comfortable breath. Like natural breathing, Easy-Breathe fills the lungs gradually, leaving patients relaxed.

The Easy-Breathe Motor
Easy-Breathe features a dual-stage motor that delivers superior performance at half the effort, cutting device noise to less than 25 dB. The advanced Easy-Breathe motor delivers whisper-quiet comfort and unprecedented pressure stability. This makes ResMed's devices with Easy-Breathe technology the quietest, compact range of CPAP and bilevel products available.
........

In order to maintain a certain pressure or pressures throughout one breathing cycle (inhalation and exhalation) a CPAP machine must vary its output. I don’t know, but I suspect that the EasyBreathe advantage lies in how smoothly the motor and algorithm maintain the pressure during each breathing cycle.

It could also be that there is a smaller advantage of EasyBreathe over Respironics due to “less searching”. Echoing carbonman, I wish Snoredog were here to help us understand EasyBreathe.

I'm not experiencing as much success with the ResMed auto algorithm. I picked up a ResLink module on cpapauction.com so that I can see snores and flow limitations.

I can see that the algorithm responds agressively to snores. I has raised my pressure on a few occasions by 3 or 4 cm in about a minute or so. Hasn't bothered me. But above 10 cm (my min is 12) is does not respond to apneas, and responds gently to flow limitations. From my data, it looks like I have clumps of apneas without preceding flow limitations or snores, so the machine does not respond. Very frustrating. I'm having some intermittent leak problems so I haven't raised my pressure yet. I just picked up a Mirage Liberty to try to rule out mouth leaks. (My goatee doesn't allow me to try taping.) I'll see what happens when I get it adjusted. The tech was clueless and to wanted tighten the straps until my eyes were forced out of their sockets. And they didn't have a medium Quattro or UMFF in stock.

Now if you could find a way to me on my bike!

And I stand corrected on the software component of EasyBreathe. Don't believe everything a manufacturer's rep says.

jdm2857 wrote: Now if you could find a way to me on my bike!

I think you meant to say,
"Now if you could find a way to get me on my bike!"

You got'a want it.

It's my new green program
.
I'm saving characters.

jdm2857 wrote: . . . the difference must have been the EasyBreathe technology in my APAP. . . . . I've never even considered turning EPR (software exhalation relief) on.

Jeff,

OK, now I'm REALLY confused. What the heck does Easy-Breathe do if the EPR isn't on? I always thought Easy-Breathe was something added to EPR (or to the bilevel waveform in a bilevel) to smooth out the transition. What is there to smooth if nothing ain't changin' with breathe in and breathe out? I always assumed Easy-Breathe is off whenever EPR is off in an APAP, since an APAP with no EPR running has no waveform for Easy-Breathe to modify.

Have I got that all wrong?

the other jeff

ps-Toss the green program. We need as many characters like you and carbonman around here as we can get.

http://www.resmed.com/us/assets/documen ... sa_eng.pdf

if you really want to go green, don't use capital letters.

rooster wrote:I have no experience with EasyBreathe but it does seem to have some software elements in addition to the dual-stage motor.

Whisper-quiet motor

Setting a new industry standard in quiet therapy and comfort, ResMed’s new sophisticated motor design delivers superior performance at a lower effort while cutting device noise significantly. By reducing noise, Easy-Breathe technology enables patients and their bed partners to sleep peacefully through the night.


--------------------------------------------------------------------------------

Easy-Breathe technology

Easy-Breathe technology combines new software, a quieter motor and improved EPR with Easy-Breathe for maximum comfort and a quiet night’s sleep.


--------------------------------------------------------------------------------

Pressure relief for more natural breathing

Featuring ResMed’s improved EPR with Easy-Breathe, the S8 Elite II offers pressure relief delivered in a smooth waveform that mimics patient breathing. With a choice of three different EPR comfort levels, the S8 Elite II with Easy-Breathe allows customized comfort for breathing that feels natural.


--------------------------------------------------------------------------------

Why prescribe EPR with Easy-Breathe?

Not all CPAP devices with pressure relief are the same. ResMed’s EPR with Easy-Breathe is supported by clinical studies, proving it equally as clinically effective as traditional fixed CPAP, but significantly more comfortable. EPR is preferred over traditional CPAP by 79% of patients.

ResMed Introduces Easy-Breathe Comfort Technology
San Diego, CA -January 9, 2008

"The September launch of Easy-Breathe at the European Respiratory Society conference created a sensation with its innovative, quiet motor technology," stated Michael Farrell, Senior Vice President, Sleep Strategic Business Unit. "We expect similar enthusiasm with the launch in the Americas market. The combination of whisper-quiet comfort in a compact system is truly a unique offering, and adding the ultra-comfortable Easy-Breathe waveform for the launch of the VPAP Auto in the Americas is icing on the cake. These features increase compliance, which benefits patients, HMEs and sleep specialists."

"The VPAP Auto offers comfortable bilevel therapy in ResMed's compact S8 platform," stated Drew Terry, Director of Product Management. "With our new Easy-Breathe technology, the VPAP Auto is able to deliver nearly silent therapy and greater pressure stability so patients sleep comfortably throughout the night. The VPAP Auto synchronizes with the patient's normal respiration so that breathing feels more natural and comfortable."

The Easy-Breathe Pressure Profile
The Easy-Breathe pressure profile was originally developed for ResMed's advanced VPAP Adapt SV to deliver comfortable therapy for complex sleep disorders. The same comfortable pressure profile is ideal for all CPAP patients because, unlike the traditional square bilevel waveform, Easy-Breathe's smooth pressure profile recreates a patient's natural breathing pattern for a more comfortable breath. Like natural breathing, Easy-Breathe fills the lungs gradually, leaving patients relaxed.

The Easy-Breathe Motor
Easy-Breathe features a dual-stage motor that delivers superior performance at half the effort, cutting device noise to less than 25 dB. The advanced Easy-Breathe motor delivers whisper-quiet comfort and unprecedented pressure stability. This makes ResMed's devices with Easy-Breathe technology the quietest, compact range of CPAP and bilevel products available.
........

In order to maintain a certain pressure or pressures throughout one breathing cycle (inhalation and exhalation) a CPAP machine must vary its output. I don’t know, but I suspect that the EasyBreathe advantage lies in how smoothly the motor and algorithm maintain the pressure during each breathing cycle.

It could also be that there is a smaller advantage of EasyBreathe over Respironics due to “less searching”. Echoing carbonman, I wish Snoredog were here to help us understand EasyBreathe.

Rooster

Easybreathe is a name given by Resmed to cover two significant developments.

1) They introduced a new blower derived from the advanced design employed in the Vpap Adapt SV. One might ask why is that blower so unique ?. What Resmed did was to put a blower fan on each end of the motor shaft so in effect there are 2 fans on one motor. The significance of this is that prior designs required a counterweight at one end and a fan at the other, this tended to cause whine as the fan speed needs to be higher for the same volume of air that the dual impeller version can do. Also, by using two fans, they can control the acceleration of the motor to a far greater degree (without the whine). Also the counter weight caused lost energy but by replacing it with a fan, that lost energy gets harnessed.

2) The new blower assembly was thus far more efficient and could accelerate faster without side effects that the old design had (whine & hum). This has meant that Resmed could control the waveform produced by the blower assembly. It is the waveform that really provides the 'easy breathe' effect. This waveform is shark fin in shape which as the advertising blurbs say, better mimics a natural breathing pattern. Prior to the shark fin waveform, the waveform produced tended to be squared off & people don't breathe in square wave patterns.

And, as JNK pointed out, the waveform changes as the pressure switches between ipap & epap (which is what EPR delivers). BUT, If the machine is in straight CPAP mode (or Auto cpap mode), a fluctuation in pressure still occurs though as when the sleeper breathes out the fan speed drops as the pressure detection transducer signals the motor to slow down when the pressure caused by the breathing out superimposes itself on the pressure being delivered by the fan. Try it, breathe into the hose & listen to the fan speed drop (if you can hear it). As the fan speed resumes, it does so with a sharkfin waveform, so that easy breathe feature does actually get applied anytime pressure changes & for whatever reason be it EPR or be it by naturally breathing out.

Cheers

DSM

jnk wrote:

jdm2857 wrote: . . . the difference must have been the EasyBreathe technology in my APAP. . . . . I've never even considered turning EPR (software exhalation relief) on.

Jeff,

OK, now I'm REALLY confused. What the heck does Easy-Breathe do if the EPR isn't on? I always thought Easy-Breathe was something added to EPR (or to the bilevel waveform in a bilevel) to smooth out the transition. What is there to smooth if nothing ain't changin' with breathe in and breathe out? I always assumed Easy-Breathe is off whenever EPR is off in an APAP, since an APAP with no EPR running has no waveform for Easy-Breathe to modify.

Have I got that all wrong?

the other jeff

ps-Toss the green program. We need as many characters like you and carbonman around here as we can get.

http://www.resmed.com/us/assets/documen ... sa_eng.pdf

Hi Jeff

Just thought it worth adding this extract from Resmeds data sheet on EasyBreathe. The
wording sort of says EasyBreathe is seperate to EPR as here they combined it with Easy-Breathe
technology to produce EPR with EasyBreathe.

Cheers Doug


>>
ResMed has taken the clinically effective and patient-preferred
comfort of EPR and combined it with Easy-Breathe technology
to create EPR with Easy-Breathe, an exceptional pressure relief
system that offers natural breathing comfort in a compact,
whisper-quiet device. Easy-Breathe technology includes our
smooth waveform that intelligently recreates a patient’s individual
breathing pattern, so breathing feels more natural. All the
advantages of EPR—now improved with Easy-Breathe technology.
<<

PS - on reflection, EasyBreathe really is self explanatory -- with the sharkfin waveform it becomes 'easier to breathe' when compared to the traditional squarish waveform of delivered air. The new blower is the enabling technology that allows the sharkfin waveform to be delivered. Easy breathe will
deliver its best results the more the delivered pressure varies. For the new Resmed machines, on a breath by breath basis (rather than when in Auto mode it changes pressure), the delivered pressure varies when the user breathes out, when EPR is activated and on bilevel machines.

D

[quote="jdm2857"]I'm not experiencing as much success with the ResMed auto algorithm. I picked up a ResLink module on cpapauction.com so that I can see snores and flow limitations.

I can see that the algorithm responds agressively to snores. I has raised my pressure on a few occasions by 3 or 4 cm in about a minute or so. Hasn't bothered me. But above 10 cm (my min is 12) is does not respond to apneas, and responds gently to flow limitations. From my data, it looks like I have clumps of apneas without preceding flow limitations or snores, so the machine does not respond. Very frustrating. [quote]

Jeff, I've always wondered what we've been missing with the Resmed Autoset. But I know from my husband's Encore data that his apnea events are not preceded by FL or snores, they are "frank" apneas.(I got that from wulfman) and his pressure is 12cms also, so he might have that same frustration too. It amazes me how complicated OSA can be. Dori

dsm wrote:

jnk wrote:

jdm2857 wrote: . . . the difference must have been the EasyBreathe technology in my APAP. . . . . I've never even considered turning EPR (software exhalation relief) on.

Jeff,

OK, now I'm REALLY confused. What the heck does Easy-Breathe do if the EPR isn't on? I always thought Easy-Breathe was something added to EPR (or to the bilevel waveform in a bilevel) to smooth out the transition. What is there to smooth if nothing ain't changin' with breathe in and breathe out? I always assumed Easy-Breathe is off whenever EPR is off in an APAP, since an APAP with no EPR running has no waveform for Easy-Breathe to modify.

Have I got that all wrong?

the other jeff

ps-Toss the green program. We need as many characters like you and carbonman around here as we can get.

http://www.resmed.com/us/assets/documen ... sa_eng.pdf

Hi Jeff

Just thought it worth adding this extract from Resmeds data sheet on EasyBreathe. The
wording sort of says EasyBreathe is seperate to EPR as here they combined it with Easy-Breathe
technology to produce EPR with EasyBreathe.

Cheers Doug


>>
ResMed has taken the clinically effective and patient-preferred
comfort of EPR and combined it with Easy-Breathe technology
to create EPR with Easy-Breathe, an exceptional pressure relief
system that offers natural breathing comfort in a compact,
whisper-quiet device. Easy-Breathe technology includes our
smooth waveform that intelligently recreates a patient’s individual
breathing pattern, so breathing feels more natural. All the
advantages of EPR—now improved with Easy-Breathe technology.
<<

PS - on reflection, EasyBreathe really is self explanatory -- with the sharkfin waveform it becomes 'easier to breathe' when compared to the traditional squarish waveform of delivered air. The new blower is the enabling technology that allows the sharkfin waveform to be delivered. Easy breathe will
deliver its best results the more the delivered pressure varies. For the new Resmed machines, on a breath by breath basis (rather than when in Auto mode it changes pressure), the delivered pressure varies when the user breathes out, when EPR is activated and on bilevel machines.

D

Doug,

My point was that if the purpose of Easy-Breathe is to smooth the transition from one pressure to another, would not one then need to actually have one pressure and another in order for Easy-Breathe to do anything? As far as I know, the only way to get two pressures out of an APAP is to engage some sort of EPR, right? Thus my confusion about a post praising Easy-Breathe but saying EPR is not engaged. Hey, I'm easily confused, though. My question for you is can you find anywhere in the literature where it says Easy-Breathe does anything when EPR is off in a ResMed APAP?

the other jeff

jdm2857 wrote:I started using xPAP in June, and my first (and only) machine is the ResMed S8 AutoSet II. I found it very easy to adapt to using it, and didn't think much about it.

Yesterday, I went to my sleep doc's drop-in mask clinic, to look for a full-face mask to try. (I wound up with a ResMed Liberty.) But to try the mask, the tech hooked me up to a Respironics tank (pre-M-Series) machine on straight CPAP. She set it to 12, which is my minimum pressure on my APAP. C-Flex was off.

OMG! I thought I was hooked up to an Air Force wind tunnel. Exhalation was much more difficult. I then realized that the difference must have been the EasyBreathe technology in my APAP. Since I had been using it from the beginning, I didn't realized how spoiled I was. So much more natural. I've never even considered turning EPR (software exhalation relief) on.

For those who don't know, EasyBreathe is built into the ResMed S8 II series blower design -- it's hardware, not software. As such it has no software settings, and can't be turned off. ResMed claims that EasyBreathe has been shown in clinical studies to not decrease therapy effectiveness.

And for the record, my only connection to ResMed is a 2-meter-long hose.

I love the Easy Breath, I was scared to death when the Dr didn't go for BiPap, after having a horrible time exhailing at my titration. I don't even have EPR turned on and I have no problems exhaling even with COPD. Breathing feels VERY natural and pressure changes through the night do not wake me up like they did at the sleep lab. The only thing that happened was dreaming I was back in Ks fighting a tornado

katiemo wrote:

jdm2857 wrote:I started using xPAP in June, and my first (and only) machine is the ResMed S8 AutoSet II. I found it very easy to adapt to using it, and didn't think much about it.

Yesterday, I went to my sleep doc's drop-in mask clinic, to look for a full-face mask to try. (I wound up with a ResMed Liberty.) But to try the mask, the tech hooked me up to a Respironics tank (pre-M-Series) machine on straight CPAP. She set it to 12, which is my minimum pressure on my APAP. C-Flex was off.

OMG! I thought I was hooked up to an Air Force wind tunnel. Exhalation was much more difficult. I then realized that the difference must have been the EasyBreathe technology in my APAP. Since I had been using it from the beginning, I didn't realized how spoiled I was. So much more natural. I've never even considered turning EPR (software exhalation relief) on.

For those who don't know, EasyBreathe is built into the ResMed S8 II series blower design -- it's hardware, not software. As such it has no software settings, and can't be turned off. ResMed claims that EasyBreathe has been shown in clinical studies to not decrease therapy effectiveness.

And for the record, my only connection to ResMed is a 2-meter-long hose.

I love the Easy Breath, I was scared to death when the Dr didn't go for BiPap, after having a horrible time exhailing at my titration. I don't even have EPR turned on and I have no problems exhaling even with COPD. Breathing feels VERY natural and pressure changes through the night do not wake me up like they did at the sleep lab. The only thing that happened was dreaming I was back in Ks fighting a tornado

Your experience is very valid and as previously explained, breathing out against the machine changes the pressure and as you breath in again the motor speeds up and a pressure increase (from the machine) is offset against the sudden drop when the user's exhalation ends. That smoothness is 'easy breathe' and it is noticable (Hence your post).

This is what Jeff is also talking about. So to Jeff, yes pressure changes breath-by-breath as the user breathes out against the machine. The change in pressure is delivered as a sharkfin waveform. EPR is a further pressure adjustment delivered by the machine. Jeff, my question to you is, by how much do you think a cpap drops pressure when the user breathes out against the machine flow & how is that in its own way different from changing pressure like EPR does ?

DSM