S A N T È • LÖW E N S T E I N S L E E P T H E R A PY D E V I C E S
Appendix 6 Pgs. 4-5
New OSA Patient Simulator for Testing PAP Devices
Table 1. Description of the patient simulation implemented in the bench test model. Stage Duration AHI
Features
Sleep onset
45 min
-
16 breaths/min V T 500 mL Random insertion of changes in breathing rate and V T , and swallowing
Non-REM cycle 1
60 min
15/h
Body position: side Apneas (0 – 5 cmH 2 O): event length 12 sec Hypopneas (5 – 7 cmH 2 O): event length 16 sec
Flow limitation (7 – 9 cmH 2 O) Normal breathing ( > 9 cmH 2 O)
REM cycle 1
15 min
30/h
Apneas (0 – 8 cmH 2 O): event length 18 sec Hypopneas (8 – 10 cmH 2 O): event length 16 sec
Flow limitation (10 – 12 cmH 2 O) Normal breathing ( > 12 cmH 2 O)
Non-REM cycle 2
45 min
15/h
Body position: side Apneas (0 – 5 cmH 2 O): event length 12 sec Hypopneas (5 – 7 cmH 2 O): event length 16 sec
Flow limitation (7 – 10 cmH 2 O) Normal breathing ( > 10 cmH 2 O)
REM cycle 2
25 min
30/h
Apneas (0 – 7 cmH 2 O): event length 18 sec Hypopneas (7 – 9 cmH 2 O): event length 16 sec
Flow limitation (9 – 11 cmH 2 O) Normal breathing ( > 11 cmH 2 O)
Non-REM cycle 3
30 min
15/h
Apneas (0 – 5 cmH 2 O): event length 18 sec Hypopneas (5 – 7 cmH 2 O): event length 16 sec
Flow limitation (7 – 10 cmH 2 O) Normal breathing ( > 10 cmH 2 O)
REM cycle 3
30 min
30/h
Body position: supine Apneas (0 – 9 cmH 2 O): event length 18 sec Hypopneas (9 – 11 cmH 2 O): event length 16 sec
Flow limitation (11 – 13 cmH 2 O) Normal breathing ( > 13 cmH 2 O)
Awake
5 min
-
Normal breathing
AHI: apnea-hypopnea index; REM: rapid eye movement; V T : tidal volume.
doi:10.1371/journal.pone.0151530.t001
Breathing normalization with a residual AHI < 5/h was only achieved with devices A, B and D; devices E, H, I and J were associated with more than five residual events per hour. Pressure changes of each device throughout the whole test are displayed in Fig 1. Considering the 45-minute wake period, there was significant variation in the behaviour of the different devices. Table 3 shows the pressure values reached by each tested device at the end of the simulated wake period. Device C did not increase the pressure during wake periods.
PLOS ONE | DOI:10.1371/journal.pone.0151530 March 15, 2016
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