Technologies FAQs

What is Ambient Tracking™ Plus and how does it work? Ambient Tracking™ Plus is a unique technology that has been incorporated into Fisher & Paykel Healthcare’s CPAP machines to allow the automatic adjustment of humidity as external conditions change throughout the night or between seasons. As a result, the level of humidity is maximized and condensation is minimized. Ambient Tracking™ Plus compensates for changing room temperatures. For example, as the room temperature drops during the night, the heater-plate temperature will adjust accordingly (i.e. will also drop), so that the appropriate level of humidity will be delivered while minimizing the likelihood of water condensing in the tube. Ambient Tracking™ Plus also compensates for humidity loss during high leak periods. When mouth or mask leaks occur, the heater-plate temperature is automatically increased to compensate for the loss of humidity that results during these periods.

To ensure accurate sensing of the room temperature, the CPAP unit should not be placed in a constant cold draft, in front of a heater or in an enclosed box, as this will affect the performance of the Ambient Tracking™ Plus technology.

A feature of Ambient Tracking™ Plus is to compensate for humidity loss during leaks – so what is the difference between Ambient Tracking™ Plus and Leak Compensation (or HC234 vs HC238 CPAP models)? Ambient Tracking™ Plus registers an increase in flow which is indicative of leak, and automatically increases the temperature of the heater-plate to compensate for moisture stripping during leaks. Leak Compensation registers a drop in pressure (caused by the leak) and will therefore increase the motor speed (RPM) of the device to maintain the set pressure. Models with Leak Compensation (HC238, HC240/HC250 Series and HC608) therefore have an additional Pressure Sensor for this purpose.

What is SensAwake™? SensAwake™ is a unique technology that is integrated into Fisher & Paykel Healthcare’s SleepStyle™ 200 AutoCPAP devices. Using the flow signal alone, SensAwake™ senses the changes in the breathing patterns that occur at the transition from sleep to awake states. Once it detects this transition it promptly reduces the pressure toward the minimum set pressure to aid the transition back to sleep.

Why was SensAwake™ developed? Patients on CPAP therapy commonly arouse from sleep and experience periods of wakefulness. Pressure is not required during awake states and can impact on a patient’s ability to get back to sleep. Comfort during this time is therefore critical. SensAwake™ detects the transition from sleep to awake and automatically lowers the pressure to the minimum set pressure to help facilitate the return to sleep. Once sleep has resumed, the auto-adjusting algorithm will determine the appropriate pressure delivery for the patient.

What are the benefits of SensAwake™? Ultimately what matters most to a patient is comfort. With SensAwake™, patients receive effective and comfortable treatment that adjusts to suit their needs during both sleep and awake states. Fisher & Paykel Healthcare feels that SensAwake™ will help providers ensure that their patients are as comfortable as possible and give them every chance of therapy success and acceptance from day one.

How long does it take for the pressure to drop to the minimum set pressure when SensAwake™ is activated? Between 30 seconds and 2 minutes. This will depend on the pressure the device was at when SensAwake™ was activated, the minimum set pressure and the frequency of awake detections.

Does the SleepStyle™ 200 AutoCPAP have pressure relief? Yes. Pressure relief has traditionally been provided in the form of expiratory pressure relief – Fisher & Paykel Healthcare offers a different, more advanced form of pressure relief. Given patients are only intolerant of pressure when they are awake, SensAwake™ ensures relief is provided during these critical times. When a patient wakes up, SensAwake™ drives the pressure towards the minimum set pressure for enhanced comfort.

What is ThermoSmart™? ThermoSmart™ technology combines a unique breathing tube and algorithm to deliver higher customized humidity levels that are maintained throughout the night regardless of ambient temperature changes. However, the Climate setting should only be adjusted in extreme situations (refer to Humidity FAQs for guidance).

Why was ThermoSmart™ developed? The effectiveness of conventional humidification is limited by ambient temperature. As air travels from a conventional humidifier it cools, causing condensation to form in the breathing tube. As a result it fails to deliver optimal humidity levels to the patient.

What are the benefits of ThermoSmart™? ThermoSmart™ alleviates upper airway dryness and congestion by delivering heated humidification to the patient. ThermoSmart™ also alleviates the build-up of condensation in the heating breathing tube caused by ambient temperature changes. Condensation in the tube causes disruptive gurgling noises and pressure fluctuations and may adversely affect sleep quality.

Which patients will benefit the most from ThermoSmart™? • Patients over 60
• Patients on medication
• Patients who prefer a cold room
• Patients with pre-existing nasal conditions

Can I use my device without a heated breathing tube? It is possible, but you will not gain the optimum humidity performance the device offers. The device will then not display the heated breathing tube symbol.

Is there any clinical evidence that supports the use of ThermoSmart™ technology over conventional heated humidification? Yes, four independent studies have been conducted on ThermoSmart™. The key findings of these four studies are:

Almasri: Heated Wall Tubing Provides More Humidity and Comfort than Standard CPAP Units with Heated Humidifiers

KEY FINDINGS:
Compared to conventional humidification:

ThermoSmart™ significantly decreases nasal symptoms.
ThermoSmart™ significantly decreases condensation and therefore increases humidity delivery.
ThermoSmart™ provides a more comfortable CPAP experience.

Almasri E & Kline LR. Sleep 2007; 30(S): 0562

Nilius: Impact of a Controlled Heated Breathing Tube Humidifier on Sleep Quality during CPAP Therapy in a Cool Sleeping Environment

KEY FINDINGS:
When compared with conventional humidification in this study ThermoSmart™ showed:

Improvement in patient sleep quality.
Reduction in patient side effects.
Virtually eliminated condensation, even in a cool sleeping environment.

Nilius G, Domanski U, Franke K-J, Ruhle K-H. European Respiratory Journal 2008; 31: 830-6.

Virag: Evaluation of the Performance of CPAP Heated Humidifier for use in Sleep Apnea Therapy; A Comparative Study of Humidification Effectiveness

KEY FINDINGS:

ThermoSmart™ is the only CPAP humidifier in this study to deliver average absolute humidity greater than 27 mg/L.
ThermoSmart™ is the only CPAP humidifier in this study to deliver higher levels of humidity, without causing any condensation.

Virag R. Sleep 2008; 31(S): 1159.

Massengill: Effect of Humidification on Titration Pressures in Obstructive Sleep Apnea

KEY FINDINGS:

The use of ThermoSmart™ Technology led to a titrated pressure 10% lower than conventional humidification.
The lower titrated pressures seen in this study could be explained by the higher levels of absolute humidity, leading to a reduction in nasal airway resistance.

Massengill JS & Lewis KL. Sleep 2009; 32(S): 0666.

What is the difference between the HC604 and HC608 CPAP models? Both the HC604 and HC608 CPAP models have ThermoSmart™ technology. ThermoSmart™ will register an increase in flow (due to leak) and will increase the heater-plate and the heated breathing tube temperatures to add moisture back into the air-path. The HC608 provides additional Leak Compensation as it has a Pressure Sensor and so will increase the motor speed of the device to maintain the set pressure during leaks.

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