SleepRes™, Inc.

👍TOMORROW FREE WEBINAR [Obesity Hypoventilation Syndrome for the Clinician] Dr. Peter Gay will explore the epidemiologic, physiologic, and prognostic factors that influence the management of patients with Obesity Hypoventilation Syndrome (OHS). FREE CEs: MD, DO, NP, PA, DDS, DMD, RPSGT, CPSGT, RRT, CRTT Register Here: https://hubs.li/Q02XWZPG0 This webinar sponsored by SleepRes https://hubs.li/Q02XXGxM0

CPAP Trick or Treat THE TRICK: Because snoring and hypopneas are inspiratory phenomena, we got tricked decades ago into believing inspiratory pressure (IPAP) is important to OSA therapy. It’s not. The increased IPAP with bilevel PAP merely forces air over the obstruction we worsened when we lowered the expiratory pressure (EPAP) (1-3). Increasing IPAP above EPAP also increases central apneas (4,5). Then came the evil bilevel offspring: expiratory pressure reduction algorithms (Flex, EPR, etc.). Does this small amount of pressure support increases the TECSA (treatment emergent central sleep apnea) goblins and aerophagia gremlins? Then the trick got worse. They added mask compensation algorithms to further increase inspiratory pressure and turn nasal pillow masks into nasal torture devices. We must end this trick, bury the inspiratory monsters, and focus on the future. THE TREAT: Reducing inspiratory pressure may reduce leak (6,7) and provide more comfort (6). KairosPAP™ or KPAP™ reduces inspiratory pressure by as much as 5 cmH2O and maintains the same therapy as traditional CPAP (6). KPAP™ is not available till next year. But V-Com® is available now. Click links below to read KPAP™ and V-Com® studies. For more information email info@SleepRes.com Note: V-Com® is not for patients who need ventilation in addition to treatment of OSA and KPAP™ is not yet cleared by the FDA. References: 1. Gugger, M., & Vock, P. (1992). Effect of reduced expiratory pressure on pharyngeal size during nasal positive airway pressure in patients with sleep apnoea: evaluation by continuous computed tomography. Thorax, 47(10), 809-813. https://lnkd.in/gZKjH-yP 2. Sériès, F., & Marc, I. (1998). Effects of inspiratory and expiratory positive pressure difference on airflow dynamics during sleep. Journal of Applied Physiology, 85(5), 1855–1862. https://lnkd.in/gipsNaVk 3. Lévy, P., Pépin, J. L., & Ferretti, G. (1994). Dynamique des structures pharyngées au cours des apnées obstructives (en ventilation spontanée, pression positive continue et BiPAP). Neurophysiologie Clinique/Clinical Neurophysiology, 24(3), 227–248. https://lnkd.in/gjbiBrGZ 4. Johnson KG, Johnson DC. Bilevel Positive Airway Pressure Worsens Central Apneas During Sleep. Chest. 2005;128(4):2141-2150. doi:10.1378/chest.128.4.2141 5. Meza S, Mendez M, Ostrowski M, Younes M. Susceptibility to periodic breathing with assisted ventilation during sleep in normal subjects. Journal of Applied Physiology. 1998;85(5):1929-1940. doi:10.1152/jappl.1998.85.5.1929 6. D.P. White et al. KPAP equals continuous PAP in effectiveness, and offers superior comfort for obstructive sleep apnea treatment. Vol. 124, Dec 2024, Pages 268-275. https://lnkd.in/gpAeSnyg 7. R.J. Farney et al. Reducing IPAP to Treat OSA Provides Equivalent Therapy, Improves Comfort, and Reduces Unintentional Leak. https://lnkd.in/gVFnExKq

[CENTRAL APNEA WEBINAR] Get a comprehensive understanding of central apnea, focusing on its etiology, risk factors, and the complex relationship between central and obstructive sleep apnea. FREE CEs: MD, DO, NP, PA, DDS, DMD, RPSGT, CPSGT, RRT, CRTT Register Here: https://hubs.li/Q02RR_jy0 This webinar sponsored by SleepRes™, Inc. https://hubs.li/Q02RR-Xp0

SleepRes™, Inc. Introducing New CPAP Devices with KPAP™ in 2025 Since I told my AASM colleagues, I should also tell my LinkedIn friends (before the official announcement by SleepRes™). The launch of the SleepRes™ line of PAP devices and patient interfaces, as well as their cloud-based platform, is “Koming in 2025.” These PAP devices will be the first and only to have the KairosPAP™ (KPAP™) algorithm. “Kairos” means "the precise time," and KairosPAP™ provides pressure only at the optimal time to treat OSA. This allows up to 5 cmH2O lower pressure for most of the respiratory cycle compared to traditional CPAP. Less pressure means less leak (50% less) and much greater comfort. Click the link to see recent study results in SLEEP MEDICINE. https://lnkd.in/gz_AKGCk Overall, 93-95% of new patients chose the “K” in KPAP™ over the “C” in CPAP. A sleep medicine physician recently posted on the AASM Forum: “In the future, why would anyone script a CPAP device without KPAP as an option on the device?” I tend to agree. There are over 3 million PAP devices sold each year in the US alone and our manufacturing facilities are expanding to prepare. It’s not just economics; it’s also physics: The HIGHER PRESSURE of CPAP should FORCE the market to FLOW TOWARDS the LOWER PRESSURE of KPAP™. For inquiries email info@SleepRes.com Note: SleepRes® devices and interfaces are not yet cleared by the FDA.

The Fairytale of Auto-PAP (APAP): The Emperor has no Clothes Interscorer reliability. Physician review of each epoch. Accreditation. AASM titration guidelines. Though time-consuming, costly, and in need of update, these requirements provide a standard of care for patients treated with PAP therapy. They provide what is needed most in science: an independent observer. Unfortunately, these requirements protect less than 10% of patients. More than 90% of patients in the US are treated with an APAP device where the filtered flow signal is analyzed by and treatment adjusted by only software. There is no independent observer. If the software misses an event, the pressure does not increase, and the event is not recorded. The software can also react to and record flow signal variations that are not events. If the device is under titrating, the download index (AHI-FLOW) will be low, falsely suggesting excellent therapy and not revealing the problem. If the device is over titrating, there will be recorded events that did not occur, suggesting under treatment. In the hands of experienced sleep clinicians who understand this paradox, most patients may still be reasonably managed, but there is a huge opportunity for improvement. Yet, a larger problem may be that > 60% of APAP devices are ordered by non-sleep medicine providers using an HSAT company for the diagnosis who mostly have no concept of the limitations. Therefore, it is no coincidence that the leadership of national DMEs tell me > 60% of patients on APAP are left on 4 or 5-20cmH2O long term (despite algorithms on devices to address this). This is more appalling than a naked emperor in a fairytale. The main double standard is that while < 10% patients on PAP are treated with standards, there are no standards for APAP and each device manufacturer has their own "secret" algorithm. However, by using a simulator (or even PSG) one can easily determine the algorithm and see the weaknesses. To protect our patients, we need transparency and not trust “black box” engineering that may work for some but not others. We should have standards for APAP. We need to stop believing in fairytales. I am not suggesting increasing in-lab titrations with more costs and inconvenience, but we should end this double standard. We have had the technology for years. We can put clothes on the emperor. For a much deeper look at this paradox, long-time leader in our field, Richard Berry, MD, will present "Auto-PAP (APAP): Challenges and Opportunities" on both September 18th and 19th. This will be the third webinar in our "Discoveries in Sleep Apnea" series (the first by Dr. David White, second by Dr. Dan Gottlieb).   To register for Dr Berry's presentation on APAP:  https://lnkd.in/grdPTVYf To watch Dr Dan Gottlieb's presentation on CVD and OSA: https://lnkd.in/gT6fJ7Zx To Watch Dr. David White's presentation on KairosPAP (KPAP): https://lnkd.in/g3FWSpUG SleepRes SleepWorld Magazine

Can CPAP increase Cardiovascular events? This is a major question in our field. Dr Gottlieb will be presenting both tonight and tomorrow. Those who register for either (just takes a minute) have access to the recording to watch at their leisure. Tonight August 13 at 8pm eastern US time and again tomorrow August 14 at 1pm eastern US time Tonight, Drs. Richard Berry and David P. White will provide post presentation discussion before the Q and A session. Tomorrow, Drs. Sanja Jelic and Richard Berry will provide discussion. Click link to register: https://lnkd.in/g_HMVdrX This is the second webinar in our “Discoveries in Sleep Apnea” series. To learn more about the series and the speakers: https://lnkd.in/g4SeysXa The first was "Introducing KairosPAP(KPAP) - The Future of PAP Therapy for OSA." Watch the recording here: https://lnkd.in/gNVvdC-9