CPAP INTERFACE AND BACKUP DEVICES

• US 20090194109A1
• Filed: 02/02/2009
• Published: 08/06/2009
• Est. Priority Date: 02/01/2008
• Status: Abandoned Application

• Current Assignee: Theravent, Inc
• Original Assignee: Theravent, Inc
• Inventors: Doshi, Rajiv, Lai, Danny Yu-Youh, Sather, Elliot, Ferdinand, Arthur, Favet, Michael L., Mino, Toru
• Application Number:
  US12/364,264
• Publication Number:
  US 20090194109A1
• Time in Patent Office: Days
• US Class Current: 128/204.23
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/0066 Blowers or centrifugal pumps
• CPC Class Codes: A61M 16/021 operated by electrical means A61M16/202 – A61M16/205 take precedence
• CPC Class Codes: A61M 16/0666 Nasal cannulas or tubing devices for improving normal breathing through the nose A61F5/08; nose filters A62B23/06; outside holding devices A61M25/02
• CPC Class Codes: A61M 16/0683 Holding devices therefor
• CPC Class Codes: A61M 16/0816 Joints or connectors
• CPC Class Codes: A61M 16/0866 Passive resistors therefor
• CPC Class Codes: A61M 16/205 used for exhalation control
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2205/0216 Materials providing elastic properties, e.g. for facilitating deformation and avoid breaking

Abstract

Described herein are combined active PAP/passive EPAP interface devices to transmit positive air pressure from a PAP source to the user, but provide passive EPAP when the PAP source is disabled. These interface device may continue to provide benefit to the user even if the PAP source becomes disconnected or otherwise fails. The interface devices described herein include a passive EPAP airflow resistor configured to provide expiratory positive airway pressure (“EPAP”). These interface devices may also include quick connects and/or disconnects for releasably connecting to the source of pressurized breathable gas, a quick release for disconnecting from the source of pressurized breathable gas, and an adhesive user interface region that connects the device the user'"'"'s face. Also described are adapter for converting a PAP interface devices into combined active PAP/passive EPAP interface devices, and methods of using these devices.

Claims

1. A combined active PAP/passive EPAP interface device to be worn by a user to transmit positive air pressure from a PAP source to the user and to provide passive EPAP when the PAP source is disabled, the device comprising:

an interface body configured to be secured in communication with the user'"'"'s airway and to connect to the PAP source;

a passive EPAP airflow resistor in communication with the interface body and configured to passively produce expiratory positive airway pressure when the PAP source is disabled.

2. The device of claim 1, further comprising a quick release mechanism configured to disconnect the PAP source from the interface body.

3. The device of claim 2, wherein the quick release mechanism comprises a pull cord.

4. The device of claim 1, further comprising a releasable connector configured to releasably connect the interface body to the PAP source for delivering pressurized breathable gas.

5. The device of claim 1, further comprising a PAP leak pathway in communication with the interface body, through which air may be exhaled when the PAP source is enabled and providing positive air pressure though the interface body.

6. The device of claim 1, further comprising an EPAP leak pathway in communication with the interface body, through which air may be exhaled when the PAP source is disabled, further wherein the EPAP leak pathway permits less airflow through the interface body during exhalation than a PAP leak pathway permits during exhalation when the PAP source is enabled and providing positive air pressure through the interface body.

7. The device of claim 1, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

8. The device of claim 1, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the interface body.

9. The device of claim 8, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the interface body.

10. The device of claim 1, further comprising a user interface surface configured to contact the user'"'"'s face.

11. The device of claim 10, wherein the user interface surface is configured as a face mask, nasal pillow, nasal mask, or nasal prong.

12. The device of claim 1, wherein the interface comprises an adhesive surface configured to adhesively secure the interface body to the user.

13. The device of claim 1, further comprising a strap or frame for securing the interface body to the user'"'"'s head.

14. The device of claim 1, wherein the interface is configured to communicate with the user'"'"'s nose but not the user'"'"'s mouth.

15. The device of claim 1, wherein the interface is configured to communicate with the user'"'"'s nose and mouth.

16. The device of claim 1, wherein the passive EPAP airflow resistor comprises a flap valve.

17. The device of claim 1, wherein the passive EPAP airflow resistor includes a valve that is selected from the group consisting of:

ball valve, flap valve, membrane valve, hingeless valve, balloon valve, duck-bill valve, PEEP valve, threshold valve and stopper valve.

18. The device of claim 1, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

19. The device of claim 1, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

20. The device of claim 1, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

21. The device of claim 1, further comprising an airflow resistor bypass configured to transiently decrease the resistance to air exhaled through the passive EPAP airflow resistor for a delay period, after activation of the airflow resistor bypass.

22. A combined active PAP/passive EPAP interface device to be worn by a user to transmit positive air pressure from a PAP source to the user and to provide passive EPAP when the PAP source is disabled, the device comprising:

an interface body having an air channel, wherein the interface body is configured to secure the air channel in communication with a user'"'"'s airway;

a connector configured to connect the air channel to a PAP source; and

a passive EPAP airflow resistor configured to inhibit exhalation through the interface device more than inhalation through the interface device when the PAP source is not providing pressurized breathable gas through the interface device, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface device that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 m/sec.

23. The device of claim 22, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface device when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

24. The device of claim 22, wherein the passive EPAP airflow resistor provides a resistance to exhalation through the interface device when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

25. The device of claim 22, further comprising a user interface surface configured to contact the user'"'"'s face, wherein the user interface surface is configured as a face mask, nasal pillow, nasal mask, or nasal prong.

26. The device of claim 22, wherein the interface device is configured to communicate with the user'"'"'s nose but not the user'"'"'s mouth.

27. The device of claim 22, wherein the interface device is configured to communicate with the user'"'"'s nose and mouth.

28. The device of claim 22, further comprising a strap or frame for securing the interface body to the user'"'"'s head.

29. The device of claim 22, wherein the connector comprises a quick release connector.

30. The device of claim 22, wherein the passive EPAP airflow resistor comprises a flap valve.

31. The device of claim 22, wherein the passive EPAP airflow resistor includes a valve that is selected from the group consisting of:

ball valve, flap valve, membrane valve, hingeless valve, balloon valve, duck-bill valve, PEEP valve, threshold valve and stopper valve.

32. The device of claim 22, further comprising an EPAP leak pathway in communication with the interface body, through which air may be exhaled when the PAP source is disabled, further wherein the EPAP leak pathway permits less airflow through the interface body during exhalation than a PAP leak pathway permits during exhalation when the PAP source is enabled and providing positive air pressure through the interface body.

33. The device of claim 22, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

34. The device of claim 22, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the interface body.

35. The device of claim 34, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the interface body.

36. A combined active PAP/passive EPAP interface device to be worn by a user to transmit positive air pressure from a PAP source to the user and to provide passive EPAP when the PAP source is disabled, the device comprising:

an interface body having an air channel that is configured to be secured in communication with a user'"'"'s airway;

a connector configured to connect to a PAP source in communication with the air channel;

a PAP leak pathway through which air is exhaled when the PAP source is connected in communication with the air channel;

a passive EPAP airflow resistor configured to inhibit exhalation through the air channel more than inhalation through the air channel when the PAP source is disabled; and

an EPAP leak pathway through which air is exhaled when the PAP source is disabled, wherein the PAP leak pathway allows greater airflow than the EPAP leak pathway.

37. The device of claim 36, further comprising a user interface surface configured to contact the user'"'"'s face, wherein the user interface surface is configured as a face mask, nasal pillow, nasal mask, or nasal prong.

38. The device of claim 36, wherein the interface is configured to communicate with the user'"'"'s nose but not the user'"'"'s mouth.

39. The device of claim 36, wherein the interface is configured to communicate with the user'"'"'s nose and mouth.

40. The device of claim 36, further comprising a strap or frame for securing the interface body to the user'"'"'s head.

41. The device of claim 36, wherein the connector comprises a quick release connector.

42. The device of claim 36, wherein the passive EPAP airflow resistor comprises a flap valve.

43. The device of claim 36, wherein the passive EPAP airflow resistor includes a valve that is selected from the group consisting of:

ball valve, flap valve, membrane valve, hingeless valve, balloon valve, duck-bill valve, PEEP valve, threshold valve and stopper valve.

44. The device of claim 36, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

45. The device of claim 36, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

46. The device of claim 36, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

47. The device of claim 36, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

48. The device of claim 36, further comprising an EPAP activator configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the interface body.

49. The device of claim 48, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the interface body.

50. A combined active PAP/passive EPAP interface device to be worn by a user to transmit positive air pressure from a PAP source to the user and to provide passive EPAP when the PAP source is disabled, the device comprising:

an interface body having an air channel, wherein the interface body is configured to secure the air channel in communication with a user'"'"'s airway;

a connector configured to connect the air channel to a PAP source;

a passive EPAP airflow resistor in communication with the air channel; and

an EPAP activator configured to activate the passive EPAP airflow resistor when the source of PAP is disabled and to inactivate the passive EPAP airflow resistor when the source of PAP is enabled.

51. The device of claim 50, further comprising a user interface surface configured to contact the user'"'"'s face, wherein the user interface surface is configured as a face mask, nasal pillow, nasal mask, or prong.

52. The device of claim 50, wherein the interface is configured to communicate with the user'"'"'s nose but not the user'"'"'s mouth.

53. The device of claim 50, wherein the interface is configured to communicate with the user'"'"'s nose and mouth.

54. The device of claim 50, further comprising a strap or frame for securing the interface body to the user'"'"'s head.

55. The device of claim 50, wherein the connector comprises a quick release connector.

56. The device of claim 50, wherein the passive EPAP airflow resistor comprises a flap valve.

57. The device of claim 50, wherein the passive EPAP airflow resistor includes a valve that is selected from the group consisting of:

ball valve, flap valve, membrane valve, hingeless valve, balloon valve, duck-bill valve, PEEP valve, threshold valve and stopper valve.

58. The device of claim 50, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

59. The device of claim 50, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

60. The device of claim 50, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the interface body when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

61. The device of claim 50, wherein the EPAP activator is configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the interface body.

62. The device of claim 50, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the interface body.

63. An adapter device for a PAP interface that connects to a PAP source, the adapter device capable of converting the PAP interface into a combined active PAP/passive EPAP interface that provides passive EPAP when the PAP source is disabled, the device comprising:

a passive EPAP airflow resistor configured to be placed in communication with an airway through the PAP interface to passively inhibit exhalation more than inhalation, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

64. An adapter device for a PAP interface that connects to a PAP source, the adapter device capable of converting the PAP interface into a combined active PAP/passive EPAP interface that provides passive EPAP when the PAP source is disabled, the device comprising:

a passive EPAP airflow resistor configured to be placed in communication with an airway to passively inhibit exhalation more than inhalation through the PAP interface and produce expiratory positive airway pressure; and

an EPAP actuator configured to activate the passive EPAP airflow resistor when the PAP source is disabled and to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

65. The adapter device of claim 64, further comprising an adapter body having an air passage that is configured to be placed in communication with the airway through the PAP interface.

66. The adapter device of claim 64, wherein the EPAP actuator is configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the PAP interface.

67. The device of claim 64, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the PAP interface.

68. The device of claim 64, wherein the EPAP activator comprises a sensor to determine when the flow of positive pressure from the PAP source has been discontinued.

69. The device of claim 64, further comprising an EPAP leak path regulator configured to reduce the exhalation leak pathway through the device when the PAP source is disabled.

70. The device of claim 64, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

71. The device of claim 64, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

72. The device of claim 64, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(mil/sec) when the resistance is measured at 100 ml/sec.

73. An adapter device for a PAP interface that connects to a PAP source, the adapter device capable of converting the interface into a combined active PAP/passive EPAP interface that provides passive EPAP when the PAP source is disabled, the device comprising:

a passive EPAP airflow resistor configured to be placed in communication with an airway to passively inhibit exhalation more than inhalation through the PAP interface and produce expiratory positive airway pressure when the PAP source is disabled;

an EPAP leak path regulator configured to reduce the exhalation leak pathway through the device when the PAP source is disabled; and

an EPAP actuator configured to activate the passive EPAP airflow resistor and the EPAP leak path regulator when the PAP source is disabled and to inactivate the passive EPAP airflow resistor and the EPAP leak path regulator when the PAP source is enabled.

74. The adapter device of claim 73, further comprising an adapter body having an air passage that is configured to be placed in communication with the airway through the PAP interface.

75. The adapter device of claim 73, wherein the EPAP actuator is configured to inactivate the passive EPAP airflow resistor when the PAP source is connected to the PAP interface.

76. The device of claim 73, wherein the EPAP activator comprises a displaceable member configured to be displaced when the PAP source is connected to the PAP interface.

77. The device of claim 73, wherein the EPAP activator comprises a sensor to determine when the flow of positive pressure from the PAP source has been discontinued.

78. The device of claim 73, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

79. The device of claim 73, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

80. The device of claim 73, wherein the passive EPAP airflow resistor is configured to provide a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

81. A method of treating a respiratory or sleeping disorder, the method comprising:

providing an active PAP therapy by placing a PAP source in communication with a user'"'"'s airway through an active PAP/passive EPAP interface connected to the PAP source; and

passively creating EPAP in the user using the active PAP/passive EPAP interface when the PAP source is disabled.

82. The method of claim 81, further comprising securing the active PAP/passive EPAP interface in communication with the user'"'"'s mouth and nose.

83. The method of claim 81, further comprising securing the active PAP/passive EPAP interface in communication with the user'"'"'s nose.

84. The method of claim 81, wherein the step of passively creating EPAP in the user using the active PAP/passive EPAP interface when the PAP source is disabled comprises passively creating EPAP in the user using the active PAP/passive EPAP interface when the PAP source is removed from the active PAP/passive EPAP interface.

85. The method of claim 81, wherein the step of passively creating EPAP in the user comprises activating a passive EPAP airflow resistor when the PAP source is disabled.

86. The method of claim 81, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.001 and about 0.5 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

87. The method of claim 81, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.005 and about 0.25 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

88. The method of claim 81, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.01 and about 0.25 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

89. A method of treating a respiratory or sleeping disorder, the method comprising:

placing an active PAP/passive EPAP interface device in communication with a user'"'"'s airway;

applying a positive air pressure through the interface device by placing the interface device in communication with a PAP source; and

passively creating EPAP in the user by inhibiting exhalation more than inhalation through the interface device when the positive air pressure from the PAP source is disabled.

90. The method of claim 89, wherein the step of placing an active PAP/passive EPAP interface device in communication with a user'"'"'s airway comprises securing the active PAP/passive EPAP interface in communication with the user'"'"'s mouth and nose.

91. The method of claim 89, wherein the step of placing an active PAP/passive EPAP interface device in communication with a user'"'"'s airway comprises securing the active PAP/passive EPAP interface in communication with the user'"'"'s nose.

92. The method of claim 89, wherein the step of passively creating EPAP in the user by inhibiting exhalation more than inhalation through the interface device when the positive air pressure from the PAP source is disabled comprises passively creating EPAP in the user using the active PAP/passive EPAP interface when the PAP source is removed from the active PAP/passive EPAP interface.

93. The method of claim 89, wherein the step of passively creating EPAP in the user comprises activating a passive EPAP airflow resistor when the PAP source is disabled.

94. The method of claim 89, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.001 and about 0.5 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

95. The method of claim 89, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.005 and about 0.25 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

96. The method of claim 89, wherein the step of passively creating EPAP in the user comprises providing a resistance to exhalation through the PAP interface when the PAP source is disabled that is between about 0.01 and about 0.25 cm H2O/(ml/sec) when the resistance is measured at 100 ml/sec.

97. A method of converting a PAP interface device into a combined active PAP/passive EPAP interface device, the method comprising:

providing a PAP interface device configured to connect to a PAP source; and

attaching a passive EPAP airflow resistor in communication with an airway so that the passive EPAP airflow resistor passively inhibits exhalation more than inhalation to create EPAP in a user when a PAP source is not applying positive air pressure through the interface to the user.

98. The method of claim 97, further comprising attaching an EPAP actuator to the PAP interface device, wherein the EPAP actuator is configured to activate the passive EPAP airflow resistor when the PAP source is disabled and to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

99. The method of claim 97, further comprising attaching a leak path regulator to the PAP interface device, wherein the leak path regulator is configured to reduce the exhalation leak pathway through the device when the PAP source is disabled.

100. The method of claim 97, wherein the step of attaching a passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

101. The method of claim 97, wherein the step of attaching a passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

102. The method of claim 97, wherein the step of attaching a passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

103. A method of converting a PAP interface device into a combined active PAP/passive EPAP interface device, the method comprising:

attaching a passive EPAP airflow resistor in communication with an airway so that the passive EPAP airflow resistor passively inhibits exhalation more than inhalation when a PAP source is not applying positive air pressure through the PAP interface device; and

attaching an EPAP actuator to the PAP interface device, wherein the EPAP actuator is configured to activate the passive EPAP airflow resistor when the PAP source is disabled and to inactivate the passive EPAP airflow resistor when the PAP source is enabled.

104. The method of claim 103, further comprising attaching a leak path regulator to the PAP interface device, wherein the leak path regulator is configured to reduce the exhalation leak pathway when the PAP source is disabled.

105. The method of claim 103, wherein the step of attaching the passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.001 and about 0.5 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

106. The method of claim 103, wherein the step of attaching the passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.005 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.

107. The method of claim 103, wherein the step of attaching the passive EPAP airflow resistor in communication with an airway comprises securing a passive EPAP airflow resistor that its configured to provide a resistance to exhalation when the PAP source is disabled that is between about 0.01 and about 0.25 cm H₂O/(ml/sec) when the resistance is measured at 100 ml/sec.