Deep sleep (Slow-wave-sleep) is estimated by respiratory stability, which also shows treatment is working. This sleep stage helps clean and prepare the brain for good daytime function. Furthermore, scoring slow-wave-sleep by looking for low breathing variability also indicates quality & tolerance of the night-time respiratory treatment. Research increasingly suggests SWS is when the brain’s glymphatic system is most engaged, carrying out processes of ‘detox’ and biochemistry distribution.

Accurate detection and differentiation of events is a prerequisite to treating SDB correctly. Alongside high accuracy, natural shallow breaths (central hypopnea) are left alone to avoid provoking discomfort. Correct classification of central hypopnea is a leap forward in technology in avoiding unnecessary increases that will overly stimulate sympathetic tone in the CNS and create a negative loop gain following pressure elevation. Furthermore, it provides for prediction of comorbidities that may be present.

The device algorithm is leading edge as it responds adaptively or intelligently by considering pressure level at time of obstruction, pressure range, and severity of obstruction. This adaptive pattern of dynamically modifying according to pressure setpoints offers new scope to tailor an auto adjusting response that suits the differing extents of adjustment required during different sleep stages, according to the individual’s sleep architecture.

“Std” modality helps promote tolerance for new users, moving to “Dyn” which is more responsive to mild flow limitations is generally helpful, but not for some patients. The “Std” refrains from pressure increases for each mild flow limitation beyond the first quarter of the set pressure range (which may be prevalent for new unaccustomed users, or may occur during the ‘delicate’ SWS or REM phases). “Dyn” can deliver an edge in timely treatment as it is responsive to mild flow limitations for the first 3 quarters of set pressure range. Which setting is ‘best’ depends on a variety of factors pertaining to the individual, which can be derived from the data outputs.

The device treatment properties are geared towards efficiency of pressure to avoid gradual problems from overly shocking the brain and even heart and lungs. It is well-balanced to avoid both under and over shooting. This logically contributes towards good sleep quality. Any medical intervention which has side-effects should be delivered with the lowest amounts possible to still achieve the desired correction. The external stimulus of pressure into airways is intrusive and overcompensation is liable to stimulate the brain & CNS, becoming deleterious to fully recuperative sleep. Pressure overcompensation is common place but less readily observed as data may show normalised AHI, this equipment offers a masterful therapeutic balance through the algorithm’s adaptive and epoch-based response ensuring unnecessary fluctuation, if any, is kept minimal.

The device treatment properties, following on from the efficiency, result in less pressure variability. This lowers arousals and explosive leaks, therefore contributing to overall sleep quality. Mastering the therapeutic balance is best achieved through stability rather than large, repeated fluctuations up or down. Some fluctuation is generally beneficial for keeping pressure levels at a low yet sufficient level as the required pressure needs naturally change depending on sleep stage or position. Hence, fixed pressure is only an option for some. The treatment structure is very oriented towards precise adjustments only when needed. This logically lowers arousal, leakage, and deeper effects within the body of sudden changes in brain activity or nervous system activation.

SoftPAP is an intelligent pressure relief as it returns to prescribed pressure level at the end of expiration, whilst still offering decent relief at start of expiration. Hence this allows extra comfort whilst avoiding any compromise of treatment. The underlying conflicting challenges of pressure relief is the lowering of current or prescribed pressure level provoking events or respiratory instability, and the compliance desire of patient’s to receive a good amount of relief for a pleasant expiration and CO2 clearance. This device has the property of ‘dropping’ a decent amount of relief at the immediate start of expiration followed by smoothly returning or ‘ramping’ during expiration, reaching the current/prescribed pressure level at the end of expiration, an essential yet surprisingly rare methodology which satisfies both challenges of pressure relief.