Abstract:
A gas compression and delivery device for treatment of sleep disorders. The device has a motor, at least one impeller, and two air pressure chambers, each receiving air at a different pressure, one pressure applied to a patient during inspiration and one for expiration. A mask having a dual pressure gas delivery hose and a selector for letting in either the high or low pressure gas depending on the breathing cycle of the patient. The gas pressures are adjustable by means of valves on the separate chambers in the device. At least one sensor on the patient sending data to a controller in the device as to the patient&#39;s physiological data which is used to determine the patients breathing treatment needs. The controller may be a microprocessor with memory capability to store patient data for diagnosis and treatment of the patient. Telecommunications by telemetry, or telephony to a remote site allows home use of the device rather than institutional use with health care providers on site. A data card may be used to input and or store data in the device. The controller is capable of instructing the device to treat the patient with a number of different protocols and record the patient&#39;s physiological data for diagnosis and treatment purposes.

Description:
BACKGROUND OF THE INVENTION 
     1. Field of the Invention 
     This invention relates to a dual pressure pump having at least one impeller producing two separate pressures in two separate chambers. The dual pressures are used for positive air pressure treatments in patients with sleep disorders. One pressure is used during inspiration and one pressure is used during expiration. 
     2. Description of the Related Art 
     There are many Bi-Positive Air Pressure (Bi PAP) devices used for treatment of sleep apnea, and other sleep disorders. These devices mostly use a variable speed motor with one blower to increase and decrease the air pressure applied to the patient or use valves to regulate the air pressure applied to the patient. 
     The devices with variable speed motors take a while to change the pressure applied to the patient, as the motor speed does not change instantaneously between the inspiration and expiration pressure settings. Similarly valves regulating the pressure in a chamber have a lag time while pressure is building up or reducing before it reaches the proper pressure to be applied to the patient. 
     U.S. Pat. No. 5,485,850 to Dietz issued Jan. 23, 1996 shows a Bi PAP device with two separate air supply sources at two different pressures. 
     A device is needed having one unit for supplying dual pressures to the patient such that there is always a ready supply of air at two different pressures to treat a patient. 
     SUMMARY OF THE INVENTION 
     The invention comprises a motor with at least one impeller. The impeller or impellers produce a different air pressure in different chambers. A hose transports the air from the chambers to the mask worn by the patient to deliver air at one pressure for use during inspiration and at another pressure during expiration. A valve selects which pressure to allow into the mask depending on if the patient is inhaling or exhaling. There is a means for detecting if the patient is inhaling or exhaling which regulates the valve. There are also means for measuring the airflow into and out of the patient. 
     A humidifier can adjust the humidity of the air being delivered to the patient. 
     Altitude adjustments are made to increase or decrease the impeller speed to deliver the correct air pressure to the patient. 
     The two chambers can have two pressures at adjustable ratios to adjust the inspiration and expiration pressures. 
     The patient can be monitored by a number of sensors for determining when the patient is inhaling or exhaling. The monitoring sensors can also measure a number of other parameters such as breathing rates, blood oxygen levels, stages of sleep, mask leaks, mask on or mask off, body position and movement of the patient, EEG, EKG, sounds such as snoring, and other information useful for sleep disorder diagnosis and treatment. The information obtained can be used in conjunction with adjusting pressures and times of delivery of air to the patient in real time, adjusting for mask leaks, storing information about the patient for diagnosis and long-term studies, or for alerting health care workers about the patent&#39;s condition requiring immediate action. 
     The sensors can trigger a mask off alarm or detect when the mask is put on to start the power for the motor to supply air to the patient. 
     A controller or microprocessor programmed to evaluate the data from the sensors on the patient, can make changes to the air pressure applied to the patient, and the timing thereof. The microprocessor can also store information for later reporting, transmit the data to recording equipment, or alert health care workers of the patient&#39;s condition. 
     Displays can provide data for the number of hours the motor has been on or other data of interest to the operator. 
     Data cards for input or output of data may be used. Data from the data card may be sent to a remote site by telemetry, telephony or by mailing the data card. 
     The device may be equipped with anti-rebreathing sensors and apparatus to ensure fresh air inspiration. 
     The device is portable, light weight and easy to use by a patient without the assistance of a health care provider such that the device can be used at home and monitored at a remote location. 
     OBJECTS OF THE INVENTION 
     It is an object of the invention to provide a dual air pressure pump with one motor having at least one impeller. 
     It is an object of the invention to provide accurate pressure control for inspiration and expiration gas delivery pressures. 
     It is an object of the invention to provide fast transitions between inspiration and expiration pressures delivered to the patient. 
     It is an object of the invention to provide a portable BiPAP device. It is an object of the invention to provide a multiple purpose device for BiPAP, CPAP, VPAP, SPAP, PPAP and AutoPAP applications. 
     It is an object of the invention to add humidity to the pressurized air. 
     It is an object of the invention to monitor the patient. 
     It is an object of the invention to measure airflow to and from the patient. 
     It is an object of the invention to record patient data for diagnosis and treatment. 
     It is an object of the invention to provide data storing cards for use in the device. 
     It is an object of the invention to communicate patient condition to remote monitoring equipment and personnel. 
     It is an object of the invention to treat a variety of sleep disorders with a variety of treatments with one device. 
     It is an object of the invention to provide options for several different treatment protocols on one device. 
     It is an object of the invention to provide adjustable settings for individual patient needs and comfort while using the device. 
     It is an object of the invention to provide long term monitoring data of one or more patients for medical studies. 
     It is an object of the invention to display data about the patient or devise for ease of reference. 
     It is an object of the invention to provide variable ratios of air pressure for inspiration and expiration. 
     Other objects, advantages and novel features of the present invention will become apparent from the following detailed description of the invention when considered in conjunction with the accompanying drawings. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a schematic showing the device with two separate air intakes and two separated impellers. 
     FIG. 2 is a schematic of a second embodiment showing the device with one air intake and two coaxial impellers. 
     FIG. 3 is a top view of the control panel. 
     FIG. 4 is a side view of a coaxial dual impeller blower in a housing as used in the schematic of FIG.  2 . 
     FIG. 5 is a cross sectional side view of one impeller in a housing with a bleed off slot. 
     FIG. 6 is a cross sectional side view of a movable position impeller in a housing. 
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     In treating patients having sleep disorders it is frequently required to administer a Bi-Positive Air Pressure (Bi PAP). In this treatment a first air pressure on the order of 20 cm H 2 O is applied to the patient during inspiration and a second pressure on the order of 3 cm H 2 O is applied to the patient during expiration. Preferably these pressures are adjustable for the needs of each individual patient. Referring to FIG. 1 a schematic of the system is shown wherein a gas delivery device  10  supplies gas at two different positive air pressures to a patient  100 . The gas delivery device  10 , preferably is small enough and light weight enough to be portable. The gas delivery device  10  has a carrying handle  11  to aid in transporting the device. 
     A portable gas delivery device may have a battery  150  for an internal power supply, a power cord  155  for an outside source of power, or both. The battery  150  may be rechargeable from the outside power source. 
     A motor  20  receiving power from the battery  150  or an outside power source through the power cord  155  turns shaft  22 . The motor  20  is preferably a brushless DC motor. Motor with brushes and a commutators produce ozone or NOx and other related particles which would be detrimental if added to the air of the breathing apparatus. The shaft  22  enters the pump housing  25  having a high pressure chamber  45  and a low pressure chamber  35  which are adjacent, having a barrier  40  therebetween. The shaft  22  turns high pressure impeller blades  46  in the high pressure chamber  45  and turns low pressure impeller blades  36  in the low pressure chamber  35 . The air intake aperture  142  for the high pressure chamber  45  has air filter  90  for filtering intake air stream  43  entering the high pressure chamber  45 . Similarly air intake aperture  132  for the low pressure chamber  35  has air filter  92  for filtering intake air stream  33 . 
     Alternatively the air intake can be a common air intake if the impellers  36  and  46  in FIG. 1 are turned around such that the air intake is between them and the air output would be to chambers which are separate. 
     The ratio of the high pressure in chamber  45  to the low pressure in chamber  35  is fixed by the relative size or position of the impeller blades. The ratio can be changed by varying a number of parameters including the relative size of the impellers, the gaps between the impellers and the housings, the size of the openings in the housings for admitting air from the impellers, or by other variables. The ratios may be adjustable or fixed. Generally for one patient the ratio of the inspiration pressure to the expiration pressure can remain fixed. It may be necessary to adjust the ratios for different patients or adjust the ratios for the same patient over time. 
     A humidifier  55  may be used to adjust the humidity of the air being supplied to the patient. The humidifier  55 , as shown in the dual pressure gas delivery device  10 , is in front of the high pressure air intake aperture  142  to supply moisturized air for inspiration. The humidifier  55  may be placed in other locations for supplying high pressure and/or low pressure moisturized air to the patient. A humidity control  140  to select the desired humidity is located on the control panel  110  and works in conjunction with humidity sensors  141  in housing  25  and the controller or microprocessor  82  to keep the humidity at a desired setting. 
     In a second embodiment shown in FIGS. 2 and 4 the motor  20  has a shaft  22  with impellers  136  of a first radius and impellers  146  of a second radius coaxially mounted on the shaft  22 . There is one air intake  144  to the impellers  136 ,  146  for producing two streams of air, one at a high pressure, air stream  47  in chamber  45  and one at a low pressure, air stream  37  in chamber  35 . Since this embodiment has only one air intake  144  only one air filter  91  and one humidifier  55  are required. FIG. 4 shows a more detailed view of the motor  20 , high pressure impeller  146  and low pressure impeller  136  on shaft  22  in relation to housing  25 . The intake air  43  enters housing  25 . The low pressure impeller  136  discharges low pressure air  37  into low pressure chamber  35  and the high pressure impeller  146  discharges high pressure air  47  into the high pressure chamber  45 . 
     In a third embodiment, as shown in FIG. 5, the motor  20  has shaft  22  attached to impeller  146 . The housing has an annular slot  30  in the housing adjacent to impeller  146  to let air of a lower pressure into chamber  35 . Intake air  43  is acted on by impeller  146  creating a high pressure air  47  in chamber  45  and low pressure air  37  in chamber  35 . The annular slot  30  may be continuous or divided into sections. 
     The motor  20  in the three embodiments turns one or more impellers on shaft  22  for steadily supplying a high pressure air in the high pressure chamber  45  and a low pressure air chamber  35 . On one embodiment the motor speed is fixed to supply a constant pressure in the high and low pressure chambers  45  and  35 . In another embodiment a variable speed motor can be used to such that as the motor  20  speeds up or slows down a higher or lower volume of air is pumped and both the high pressure and low pressure are simultaneously adjusted upward or downward. A change in the motor speed can be used to make a pressure adjustment to the high pressure chamber  45  or low pressure chamber  35  when the ratio of the pressures is fixed but a variation or adjustment of the pressures in the chambers is called for. In this manner the high pressure and/or low pressure can be varied with changes in motor speed. Devices having one impeller and one pressure chamber would have to make large changes in motor speed and have a lag time to change speed and thereafter the pressure in the pressure chamber. A dual pressure impeller or two impellers with two pressure chambers do not require any motor speed change to change the pressure from high to low. However, adjustments to the pressure can still be effected by changing the motor speed. 
     In a fourth embodiment shown in FIG. 6 an actuator  300  moves actuation rod  310  up or down by a small distance as shown by arrows  315 . Actuator rod  310  is attached to slider  320  which moves up or down in housing  325 . Slider  320  carries motor  20  and impeller  346  up and down adjusting the clearance distance  350  between the impeller and housing  325 . With a larger clearance distance  350  the leakage rate of compressed air goes up reducing the air pressure in chamber  345 . With a smaller clearance distance  350  the air pressure in chamber  345  goes up. The air intake  43  supplies air for the impeller  346  to pump up to the desired pressure in chamber  345 . The actuator  300  can quickly and accurately adjust the clearance  350  between the impeller  346  and housing  325  thus quickly adjusting the pressure chamber  345  without changing the motor  20  speed. 
     The actuator  300  may be hydraulically, mechanically, electrically, electromechanically, or piezoelectrically driven. Any means for quickly and accurately moving the actuator rod  310  will allow the invention to be practiced. 
     The embodiment in FIG. 6 shows motor  20  on slider  320  however other embodiments where the motor is fixed and the actuator  300  only moves the impeller  346  are within the scope of the invention. 
     In all of the embodiments shown the motor  20  has shaft  22  connected to impeller an impeller, however in other embodiments the impellers can be on the outside of a rotating motor housing eliminating the need for a shaft  22 . 
     Altitude compensation is required for the impeller speed to increase or decrease to bring the pressure up to the desired level. A pressure altitude sensor  85  senses the altitude and reports it to the controller  82 , the controller then adjusts the motor speed accordingly. Altitude compensation can be controlled by a pressure transducer. 
     In the embodiments shown in FIGS. 1 and 2 if the pressure in the high pressure chamber  45  is kept at a pressure higher than needed for the patient  100  and the pressure in the low pressure chamber  35  is kept at a pressure higher than needed for the patient then a high pressure adjustment valve  49  and a low pressure adjustment valve  39  may be used to adjust the pressure of the air being delivered to the patient. The high pressure air flow  47  from the high pressure chamber  45  and the low pressure air flow  37  from the low pressure chamber  35  may thereby be regulated. The high and low pressure valves  49  and  39  respectively may be controlled by a controller or microprocessor  82  or set manually on control panel  110  as inspiration pressure control  120  and expiration pressure control  125 . Alternatively in another embodiment the motor  20  speed is adjusted to provide the desired pressure in the high pressure chamber  45  and in the low pressure chamber  35  eliminating the need for valves. 
     The outlet nozzle  48  is a split nozzle extending from the housing  25  over the housing barrier  40  such that both high pressure air  47  the adjacent low pressure air  37  flow in their respective halves of the nozzle to a split coupler  58  having two sides. 
     A dual pressure hose  50  connects to the coupler  58 . The dual pressure hose  50  has a high pressure side  51  and a low pressure side  52  for transporting the high pressure gas  47  and low pressure gas  37  to the mask  70 . 
     Alternatively the dual pressure  50  hose can be a small diameter hose inside of a larger diameter hose for transporting the separate pressures from the housing to the mask, or two separate hoses can be used. 
     A valve  60  at the entrance to the mask  70  alternately selects the high pressure air  47  or low pressure air  37  to be supplied to the patient  100  depending on if the patient is inhaling or exhaling. When the patient  100  is inhaling the valve  60  selector  62  blocks the low pressure air in the low pressure portion  52  of hose  50  and admits the high pressure from the high pressure portion  51  of hose  50 . Similarly when the patient  100  is exhaling the valve  60  selector  62  blocks the high pressure portion  51  of hose  50  and admits low pressure air. An actuator  63  moves the selector  62  based on information about the patient&#39;s breathing obtained from sensors  71  in the mask  70  and or sensors  80  placed on the patient  100 . The controller or microprocessor  82  determines when the patient  100  is inhaling or exhaling from the data provided and positions the actuator  63  accordingly by sending it signals over lead  83 . 
     The valve  60  may be a split butterfly valve, a gate valve or any other type of valve for selectively admitting only one pressure. 
     In one embodiment for controlling the pressure to the mask  70  a valve  60  such as a butterfly valve can be partially open to the high pressure chamber  45  and partially open to the low pressure chamber  35  simultaneously, resulting in a mix of between 0 and 100% of each pressure to select an intermediate pressure to the mask. The valve  60  can be quickly activated to any setting to provide any pressure between the high pressure in the high pressure chamber  45  and the low pressure in the low pressure chamber  35 . 
     Alternatively a hose  50  with one lumen can be used and the valve  60  for selecting high or low pressures can be at the outlet nozzle  48 . The hose  50  will then contain either a high pressure air flow  47  or a low pressure air flow  37  to the mask  70 . 
     The sensors  71  used for supplying information about the patient&#39;s breathing to the controller or microprocessor  82  may be imbedded in the perimeter of the mask  70  or on the mask surface. Such a mask  70  and the types of sensors used are described in the applicant&#39;s copending patent application titles Bio-Mask Ser. No. 09/465,054 filed Dec. 16, 1999 which is hereby made a part hereof and incorporated herein by reference. 
     In one embodiment a sensor  71  on the mask or in the dual pressure gas delivery device  10  can detect when breathing into the mask begins or when mask  70  is donned by a patient to automatically turn on the power to the motor  20 . 
     The sensors  71  can detect leaks or drops in pressure and send signals to microprocessor  82  to increase the pressure sent to the mask  70  to compensate for the leaks. 
     Sensors  71  can also detect the expiration gases to see if the patient is rebreathing his breath. The microprocessor  82  is programmed to adjust valves in the mask or pressures to the mask to prevent rebreathing. 
     Other sensors on the patient such as sensor  80  on the patient&#39;s chest may be used for supplying information about the patient&#39;s breathing to the controller or microprocessor  82 . 
     Some means for the detection of inspiration and expiration are shown in applicant&#39;s PCT applications WO 98/50095, entitled Controlling Gas of Drug Delivery to a Patient, international filing date May 7 1997, and in WO 97/16216 entitled Apparatus for Gas Delivery, international filing date Oct. 31, 1996. Other patents teaching breathing measurements are U.S. Pat. Nos. 4,440,177 and 4,463,764. All of the above patents and applications are attached hereto and incorporated herein by reference. 
     Other means for detecting breathing are by measuring air flow movements to the mask  70  from the air supply such as sensors like  195  placed at the entrance to the mask  70 . The sensors  195  may be laser sensors, radar Doppler sensors, ultrasonic sensors, ultrasound techniques, pitot tubes, or other electronic or mechanical means for measuring the air passing the sensor. Other means for measuring air flow rates and breathing are available such as shown in U.S. Pat. No. 5,038,733 entitled Flow Meter System issued Aug. 13, 1991 and U.S. Pat. No. 4,796,639 entitled Pulmonary Diagnostic System, issued Jan. 10. 1989 both of which are attached hereto and made a part hereof by reference. 
     The dual pressure gas delivery device  10  can be used to select only high pressure gas at all times to provide treatment of Continuous Positive Air Pressure (CPAP) with CPAP protocols. Similarly, with suitable programming of the controller  82 , the dual pressure gas delivery device  10  can be used for Variable Positive Air Pressure (VPAP) treatment protocols, Sleep linked Positive Air Pressure (SPAP) treatment protocols, Proportional Positive Air Pressure (PPAP) treatment protocols, Auto Positive Air Pressure (AuotPAP) or other treatment protocols by using the protocol selection feature  175  on the control panel  110  and having the controller  82  programmed for delivering gas at the proper gas pressures at the proper times. 
     In some treatment protocols there is a ramp time where the pressure is slowly increased to the desired pressure for treatment over time as the patient falls asleep. The dual pressure gas delivery device  10  has a controller/microprocessor  82  which can be programmed for ramp times and pressures as required by the patient. A ramp time control knob  130  on the control panel can also be used to select the ramp times. Ramp delay times are used in conjunction with ramp times. The ramp delay times allow a time before the ramp up of pressure begins, allowing the patient to fall asleep before the treatment begins. The ramp delay times can be selected on the control panel  110  by ramp delay time control selector  135 . 
     The ramp times, ramp delay times and other parameters can be programmed into the controller/microprocessor  82  by means of information stored on a data card  210  inserted into a data card port  115 . Alternatively the controller/microprocessor  82  may be programmed by a computer  200  and the information transferred to the controller/microprocessor  82  through computer input output plug  118 . The computer  200  may be remotely located at a hospital or sleep clinic and connected through the internet by wire or wireless phone systems or positioned adjacent the dual pressure gas delivery device  10 . 
     Alternatively a keypad  173  can be used to enter data into the microprocessor/controller  82  for patient data information, or to select times, pressures or other parameters for running the dual pressure gas delivery device. A menu on display  170  driven by controller  82  may prompt the user to enter data for settings by use of the keyboard  173 . 
     Other settings on the control panel  110  are for comfort settings  180  in which the temperature, pressure, humidity and timing of the application of pressurized air to the patient is controlled. The comfort setting may also be stored on the data card  210  or in the controller  82 , or computer  200  to provide the best comfort setting for the type of treatment individualized for the patient. 
     The control panel  110  or other portion of the device can have an on off switch  190  easily accessible by the patient for turning the device  10  on and off. 
     The control panel can have a display panel  170  such as an LCD for displaying information about the patient, the performance parameters of the dual pressure gas delivery device  10 , such as an hour meter for how long the motor  20  has been on, an elapsed time at pressure meter, an elapsed running time meter or other information. Such information can be selected for display by a selection button on the control panel  110 , by a touch screen LCD or by other means. The information selected can be transmitted from the controller/microprocessor  82 , to the display panel  170  or can be recorded or stored on a smart card  210  or the microprocessor  82  and can be transmitted to a computer  200 . 
     Different sleep disorder treatments use different trigger points to start the application of the high pressure during inspiration. A spontaneous trigger point measures the patient&#39;s spontaneous respiratory effort to trigger the application of gas to the patient when he starts to inhale. A timed trigger point uses a predetermined rate to trigger the application of gas to the patient. 
     Adjustable trigger points can be set in the controller  82  or on the control panel  170  to vary the pressures at which the patient begins to receive air either during inspiration or expiration 
     Poor synchronization between the patient&#39;s and the machine&#39;s ‘breathes’ lead to an unwanted increase in the work of breathing by the patient, reduced comfort and, subsequently detrimental/reduced therapy. Therefore it is important to have sensors  71 ,  80  providing data to a controller  82  for application of the proper pressure at the proper time to treat the patient  100 . It is also important in BiPAP applications for the air supply to be at the right pressures in the mask  70  at the right time. In order to accomplish this one motor  20  spinning at one rate can supply two pressures to a mask  70  with a selector  62  alternating between the high and low pressures as the patient inhales and exhales. The motor speed can be increased or decreased to provide higher or lower pressures for inhaling and exhaling. 
     Communications from the sensors  71 ,  80  can be by leads  83 ,  81  respectively or by telemetry to the controller  82 . 
     The controller  82  can be programmed remotely by telemetry, through transmitter receiver  87 , or by wire to a port  118  to plug in a data line from a computer  200  to the controller  82 . The controller  82  can also be programmed by a data card  210  inserted into data card port  115  to transfer instructions to the controller  82 . 
     The port  118  can also be used to receive data from the controller  82  obtained from the sensors  71 ,  80  and send it to the computer  200  for use by health care workers. 
     For example the sensors  71 ,  80  may collect data about breathing volumes, breathing rates, breathing times, blood oxygen, EEG, EKG, EOG, EMG, patient pulse, patient temperature, snoring, position of the patient, sleep stages, patient movement, mask pressures, mask leakage, and other relevant data such as would be collected for a Polysomnogram (PSG). Such data for treating the patient may be sent by leads or by telemetry to the controller  82  for processing and storage. Patient data may be used to treat the patient in real time or be stored and studied at a later time. The data may be transmitted to a computer  200  at a remote location such as a doctor&#39;s office or hospital for remotely monitoring the patient. The computer  200  can store data about the patient which can be presented to a health care provider to diagnose or treat the patient. The data stored about a patient can be used over long term studies and can print out progress reports about the patient. Further is a patient is taking part in a study with a group of other patients the data is readily available to be used in the data for the study. 
     Connections to the computer  200  can be by telemetry such as by Blue Tooth®, a cell phone data transmittal protocol, or over telephony networks through data port  118 . 
     Telemetry devices used to transmit and store multiple channels of data are available under the trade name Siesta® by Compumedics Inc. Abbotsford, VIC, Australia. 
     The dual pressure gas delivery device  10  is preferably compatible with Telemed® or other remote medical systems such that the patient can use the dual pressure gas delivery device  10  at home and still have the support of health care providers located remotely. This device will help free sleep disorder patients from having to be at a hospital or other health care facility while being treated or tested. 
     Other means for data storage are by a data card or smart card  210  which can store data about a patient, or provide data about the patient or for programming the controller  82 . The data card or smart card is inserted into card port  115  to access the dual pressure gas delivery device  10 . 
     Input means for data or selections to control the dual pressure gas delivery device  10  through control panel  110  can be by selecting settings from any array of control knobs on the control panel  110 , by a menu driven touch screen on display  170  in conjunction with controller  82 , or by other input/output devices as are currently known and used in the art. 
     A sensor or sensors in or on a mattress the patient is on may be connected to the controller  82  to provide data about patient movements and activity rates. 
     There is a need for a mask off alarm or mask leak alarm to tell the patent or health care worker that the mask is not delivering air to the patient properly. Such detectors are taught in the patents incorporated herein by reference. When the mask off or mask leak alarm  165  is activated the mask should be checked and the alarm deactivated. Sensors  71  in the mask  70  can detect if the mask has come off of the patient and send a signal to the microprocessor  82 . The microprocessor can sound an alarm  165  or alert a health care worker that the mask is off. The microprocessor  82  may shut down the motor  20  if mask  70  is off. 
     The dual pressure gas delivery device  10  can be used for monitoring and treatment of many sleep disorders. The computer  200 , microprocessor  82  or data card  210  can store date about the duration, start times and stop times of the treatment, the pressures used, air flow rates and patient data such as heart rates, blood oxygen rates, snoring, patient movement and other polysomnogram data useful in diagnosing and treating patients. 
     Obviously, many modifications and variations of the present invention are possible in light of the above teachings. It is therefore to be understood that, within the scope of the appended claims, the invention may be practiced otherwise than as specifically described.