The effects of CPAP tube reverse flow
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CPAP is the most common treatment for moderate to severe sleep apnea in adults. Despite its efficacy, patients’ safety, comfort and compliance are issues to be considered and improved in CPAP design. The issues include condensation, carbon dioxide in inhaled air, humidity and temperature of inhaled air. When a CPAP user breaths deeply, there will be some air not fully expelled and may be driven back into the heated air delivery tube (HADT). An interest has existed in what impacts this so called reverse flow may bring about to the CPAP use. The main objectives of this research are to quantify the reverse flow and its influence on carbon dioxide re-breathing, delivered humidity to the patient and condensation in the HADT. Within this thesis, two computer models of the CPAP system have been constructed on Simulink™ in the Matlab™ environment. One is about the CPAP fluid dynamic performance and carbon dioxide re-breathing and the other is on thermodynamic performance. The models can predict the dynamic behaviour of the CPAP machine. They are able to mimic the breath induced airflow fluctuation, and flow direction changes over wide real working ranges of ambient conditions, settings and coefficients. These models can be used for future analysis, development, improvement and design of the machine. The fluid dynamic and thermodynamic models were experimentally validated and they have proved to be valuable tool in the work. The main conclusions drawn from this study are: • Reverse flow increases when breaths load increases and pressure setting decreases. • Reverse flow does not definitely add exhaled air to the next inhalation unless the reverse flow is relatively too much. • Mask capacity does not influence the reverse flow. • The exhaled air re-breathed is mainly due to that stays in the mask, therefore larger mask capacity increases the exhaled air re-breath and the percentage of exhaled air in next inhalation drops when the breath load increases. • Deep breathing does not significantly change the total evaporation in chamber. • When deep breathing induced reverse flow occurs, condensation occurs or worsens in the HADT near the mask. This happens only when the humidity of the airflow from the CPAP is much lower than that of the exhaled air and the tube wall temperature is low enough for condensation to occur. • The deep breathing and reverse flow do not significantly influence the average inhaled air temperature. • The overall specific humidity in inhaled air is lower under deep breathing. • Mask capacity does not influence the thermal conditions in the HADT and the inhaled air specific humidity. Also the mask capacity does not significantly influences the inhaled air temperature.