ITTO990527A1 - EQUIPMENT FOR THE HUMIDIFIED TREATMENT OF THE SLEEP APNEA - Google Patents

Description

DESCRIPTION of the industrial invention entitled: "Equipment for the humidified treatment of sleep apnea",

DESCRIPTION

The present invention relates to a health care apparatus and in particular, although not only, to a humidified positive airway pressure (PAP) apparatus used in the treatment of obstructive sleep apnea (OSA) and to a process to control such equipment.

OSA is an estimated sleeping sickness that affects at least 5% of the population in which the muscles that normally keep the airways open relax and eventually collapse, closing the airways. The sleep pattern of a person with OSA is characterized by repeated snoring sequences, difficulty in breathing, shortness of breath, awakening at onset and then returning to sleep. Often those affected are not aware that this sequence occurs. People with OSA usually experience drowsiness and irritability during the day due to a lack of continuous good sleep.

In an attempt to treat those with OSA, a technique known as continuous positive airway pressure (CPAP) was devised. A CPAP device consists of a gas supply (or blower) with a conduit connected to deliver pressurized gases to a patient, normally through a nose mask. The pressurized air supplied to the patient effectively helps the muscles to keep the patient's airways open, eliminating the typical OSA sleep pattern.

The use of a CPAP system is known to have side effects such as dehydration of the airways and nasal passages which can lead to rhinitis (inflammation of the nasal passages). Side effects mean that the patient is less likely to accept their CPAP therapy and that the therapy itself can cause an increase in nasal resistance in response to high airflow, decreasing the level of pressure applied to the airways and thereby reducing the efficacy of therapy. Consequently, a humidified CPAP system could be an improvement. An improvement on the standard CPAP system is described in US Patent No. 5,537,997 sold to Respironics Ine., Where a humidifier is incorporated into the CPAP system so that the patient receives humidified gases.

However, a simple combination of a well known humidifier (in which gases are passed through water vapor from the water surface into a water humidification chamber on top of a heater plate) and a CPAP device, cannot maximize the benefit of humidified CPAP therapy to the patient. This is due to the heater plate taking some time to warm up so that the patient can, in certain cases (especially when heating the equipment), provide gases that have not been humidified. It should be noted that the sensitive tissues of the nasal passage can become swollen after receiving as little as 10 minutes of non-humidified gas flow. Consequently, it could be an advantage if the gases received by the patient could always be humidified (depending on the present or existing capacity of the humidifier) at any time.

An object of the present invention is therefore to provide respiratory assistance apparatus which somehow overcomes the foregoing disadvantages or which at least provides the public with a useful choice.

Consequently, in a first aspect, the invention consists of a breathing aid apparatus adapted to supply gas to a patient to contribute to the breathing of said patient, comprising:

gas supply means, comprising pressure regulating means adapted to supply gas at a required pressure with a resulting gas flow rate,

means for detecting the pressure of the gases for determining the pressure of said supplied gases and therefore the flow rates of the resulting gases, humidification means which receive and humidify said supplied gases before supplying them to said patient, said humidification means being able to humidify in controlled manner of said gases up to a necessary humidity level, channeling means which channel said humidified gases to said patient,

means for detecting the humidity of the gases for determining the humidity of the gases supplied to said patient, e

control means which, in response to said gas humidity information and said gas flow rate, provided by said gas humidity detection means and said gas pressure detection means, controls said gas supply means so that said gas pressure reaches said required pressure substantially at the same time as said required humidity level is reached.

In a second aspect, the invention consists of a method for operating the breathing assistance apparatus, said breathing assistance apparatus comprising gas supply means, gas pressure regulating means adapted to supply the gases at the required pressure. with flow rate of the resulting gases, gas humidification means capable of humidifying said gases in a controlled manner up to a required humidity level, means of transport and control means that memorize predetermined and programmed required pressure and humidity values to carry out the phases from:

a) activating said gas humidification means to humidify the gases coming from said gas supply means,

b) detect the pressure of said gases,

c) detecting the humidity of said gases, e

d) adjusting the pressure at which said gases are supplied to said patient so that said gas pressure and the resulting flow rate reach said required pressure and resulting flow rate substantially simultaneously with when the required humidity level is reached.

In a third aspect, the invention consists of a method for treating obstructive sleep apnea using breathing assistance apparatus comprising gas supply means, pressure regulating means adapted to supply gases at a required pressure with a resulting gas flow rate, gas humidification means capable of humidifying said gases in a controlled manner up to a required humidity level, transport means and control means which store predetermined and programmed pressure and humidity values required to perform the :

a) activating said gas humidification means to humidify the gases coming from said gas supply means,

b) detect the pressure of said gases,

c) detecting the humidity of said gases, e

d) adjusting the pressure at which said gases are supplied to said patient so that said gas pressure and the resulting flow rate reach said required pressure and resulting flow rate substantially simultaneously with when the required humidity level is reached.

A preferred form of the invention will now be described with reference to the accompanying drawings, in which:

Figure 1 is a block diagram of a continuous positive humidified airway pressure (CPAP) system according to a preferred embodiment of the present invention,

Figure 2 is a block diagram of a humidified CPAP system according to a further preferred embodiment of the present invention, Figure 3 is an example graph of air pressure (approximated by fan speed) versus time for the CPAP system humidified according to the first preferred embodiment of the present invention,

Figure 4 is an example graph (corresponding to Figure 3) of humidity (currently the heater plate temperature) versus time for the humidified CPAP system according to the second preferred embodiment of the present invention, and

Figure 5 is a graph of experimentally collected data versus time for a number of parameters in the humidified CPAP system according to the second preferred embodiment of the present invention.

Referring to Figure 1, a continuous positive humidified airway pressure (CPAP) system is shown in which a patient 1 receives humidified and pressurized gases through a nasal mask 2 connected to the humidified gas transport path or to the inspiration duct 3 It will be understood that the present invention, however, is not limited to CPAP gas distribution, but is also applicable to other types of gas distribution systems such as VPAP (Variable Positive Airway Pressure) and BìPAP (Bilevel Positive Airway Pressure). aerial). The inhalation duct 3 is connected to the outlet 4 of a humidification chamber 5 which contains a certain volume of water 6. The inhalation duct 3 can contain heating means or wires of a heater (not shown) which heat the walls of the duct to ensure a constant humidity profile along the duct and thus reduce the condensation of humidified gases within the duct. The humidification chamber 5 is preferably formed of a plastic material and may have a slightly conductive base (for example an aluminum base) which is in direct contact with a plate of the heater 7 of the humidifier 8. The humidifier is equipped with means control unit or an electronic controller 9 which may comprise a microprocessor-based controller that executes software commands of a computer stored in an associated memory.

The controller 9 receives input from sources such as user input means or a combiner 10 through which the user of the device can, for example, set a predetermined required value (preset value) of humidity or temperature of the gases supplied to the patient 1. The controller may also receive inputs from other sources, for example temperature, humidity and / or flow rate sensors 11 and 12, through the connector 13 and the heater plate temperature sensor 14. In response to the humidity or temperature value set by the user entered through the combiner 10 and other inputs, the controller 9 determines when (or at what level) to feed the plate of the heater 7 to heat the water 6 inside the humidification chamber 5. When the volume of water 6 inside the humidification chamber 5 is heated, water vapor begins to fill the volume of the chamber above the water surface and exits the humidification chamber 5 through the outlet 4 with the flow of gas (for example air) provided by means of supplying the gas or blower 15 entering the chamber through the inlet 16. It will be noted that it is possible to obtain the relationship between the humidity of the gases in the humidification chamber 5 and the heater plate temperature 7. Consequently, the heater plate temperature can be used in an algorithm or lookup table to determine the humidity of gases (eg Consequently, the temperature of the heater plate acts as an indication of the humidity of the gases and the two terms are used, in this description, interchangeably). The exhaled gases from the patient's mouth are passed directly to the environment around Figure 1. It will also be noted that in the preferred form of the present invention the heater plate temperature is used to represent humidity, however, any alternative can be used. suitable humidity sensor.

The blower 15 is equipped with means for adjusting the variable pressure or with a variable speed fan 21 which draws air or other gases through the inlet 17 of the blower producing a resulting gas flow. The speed of the variable speed fan 21 is controlled by further control means or electronic controller 18 (or, alternatively, the function of the controller 18 may be performed by the controller 9) in response to inputs from the controller 9 and a predetermined required value set by the user (pre-set value) of flow rate or pressure or fan speed (as previously mentioned with reference to the heater plate temperature and humidity, it is also possible to determine a relationship between fan speed, gas flow rate and gas pressure and the three terms are used, in this description, interchangeably) by the combiner 19.

An alternative preferred embodiment of a humidified CPAP system is shown in Figure 2, in which the humidifier has been incorporated into the blower 15 so that the system comprises only a main component connected to the patient through the same duct 3 and nose mask 2. In this embodiment only requires a controller 9. This humidified CPAP system may come in any preceding description including both "warm up" mode embodiments. All reference numerals common to Figure 1 represent the same features of the invention.

You can control how the heater plate and / or blower fan is powered during "warm up" (any time the heater plate has not reached its set or required temperature). The following are two preferred examples of control methodologies used during this period.

First preferred embodiment with "heating" mode

During use, the user of the humidified CPAP system determines a 'set' (or required) gas pressure value (P set) to be supplied by a blower 15 to patient 1. This set value is passed to the controller 18 via the dialer. 19. The user also determines a 'set' (or required) temperature value (Tset) for the heater plate 7, which is entered into the controller 9 via the dial 10. The user input dialer to set the temperature may be marked 'Moisture' for the convenience of the user. Controller 9 then determines the actual temperature of the heater plate 7 (Current) by the sensor 14 and the current gas pressure (Actual) / for example by the speed sensor 20. You will notice that it can take up to 30 minutes for the gases to reach their set humidity level, depending on environmental conditions, flow rates and any or obstruction in the patient's airways (e.g. inflammation). The current pressure value can be determined by means of a pressure or flow sensor inside the blower 15, the humidification chamber 5 or the ducts connecting the system or, alternatively, as already mentioned, the speed of the fan 21 (detected by the speed sensor 20 or, alternatively, the speed command sent to the fan by the controller 18 can be used as the current fan speed), can be used to represent the gas pressure.

Controller 9 then uses the set and current values of temperature (representing humidity) and pressure (or fan speed) to control the humidification and pressure of the gas flow to patient 1. However, the pressure and temperature (humidity) of the gases supplied to the patient may eventually reach their values set by the user, to ensure that the patient is always supplied with humidified gases that have been saturated with the maximum possible amount of water vapor (within the currently existing limits of humidifier, the controller 9 controls the speed of the fan 21 in phase with the humidity of the gases (or in phase with the temperature of the heater plate 7).

As an example (with reference to Figures 3 and 4), the following table indicates the temperature (initial) detected and set (or required) and pressure (relative) (equivalent to the fan speed) values detected at system start-up.

The controller 9 then determines the required pressure change (ΔΡ) and the required temperature change (ΔΤ) to obtain the required system pressure and set temperature respectively. In the present case:

Controller 9 then determines the necessary average rate of pressure increase with respect to temperature by dividing ΔΡ by ΔΤ. In the present case, this calculation is equal to 10 cmH2O / 30 ° C or 1/3 cmH20 per ° C.

Consequently, every 1 ° C increase in the temperature of the heater plate 7, the controller 9 will instruct the controller 18 to increase the speed of the fan 21 to obtain, in this example, a 1/3 cmH20 increase in pressure, in this mode, the temperature and pressure of the gases supplied to the patient will simultaneously reach the set values (ie at the time ta in Figures 3 and 4). Preferably, the heater plate will be powered after the humidified CPAP system is activated and its temperature will gradually increase to its set temperature (as shown in Figure 4), when the controller 9 will cut power to the heater plate and then re-energize. the heater plate continuously in an appropriate manner, to maintain the set temperature. It will be appreciated that the controller 9 can continuously monitor the temperature of the heater plate until the set temperature is reached and continuously determine the updated required average rate of the boost values or the initially determined required average rate of boost can be used during throughout the heating period. In this way, the patient will always receive only humidified gases because at start-up, when there is little water vapor in the humidification chamber 5, it will be carried away by a low gas flow, while when the heater plate reaches its required set value ( and therefore much more water vapor is generated in the humidification chamber), the blower will be controlled to generate a larger volume gas flow. Second preferred embodiment with "heating" mode

It will be noted that all integers shown and described with reference to Figures 1 and 2 are relevant to this second embodiment.

As in the previous preferred embodiment, the humidified CPAP system according to this preferred embodiment has a "heating" function which determines the way in which the motor speed (and hence the flow rate or pressure supplied) of the fan 21 increases with time after that the device has been activated. It is therefore desirable to increase the pressure and hence the resulting flow rate as the humidity increases and thus reaches the desired set pressure when the device's moisture output reaches its equilibrium or the required level.

The controller 9 uses a closed loop temperature control of the heater plate 7 to reach the desired humidity level as quickly as possible. Tests have indicated that the heater plate temperature alone (as used in the previous embodiment) is not necessarily a very good indicator of the humidity provided to a patient and that a much better indication of the humidity is the temperature of the water in the chamber. 5. It will also be noted that the rise of the water temperature is much slower than that of the heater plate 7 as the water transfers energy quite poorly. Therefore, by controlling the fan speed only based on the temperature of the heater plate, excessive flow rates can be obtained too quickly in the heating cycle. Although the water temperature is not measured directly (it may not be practical, though not impossible, to include a temperature sensor inside the humidification chamber 5), it is possible to reasonably estimate how much the water temperature in the chamber is of humidification is increased, as will be described later.

The specific heat capacity of water describes the amount of heat (or energy) that is needed to increase a unit mass of water by one degree. After activation of the humidified CPAP machine according to this preferred embodiment of the present invention, the controller 9 measures the current temperature of the heater plate 7 (assuming it equal to the steady water temperature) and also receives an input of the set (or required) temperature of the heater plate from a user (via a user interface including, for example, buttons, switches or combiners). Controller 9 then determines the required temperature change to reach the set (or required) humidity value. Preferably, the controller 9 uses 90% of the required temperature change since the temperature of the water in the humidification chamber 5, in steady state, always reaches only 90% of the temperature value of the heater plate 7. Using the required change of the temperature value (or a percentage of this) and knowing the mass of water in the chamber (assuming that the humidification chamber 5 has been filled with 400 ml of water equivalent to a mass of 400 g), the amount of energy can be calculated required to bring the water to the set temperature.

Since the controller 9 also controls the power supply of the heater plate 7, for example by controlling the operating cycle (time on / (time on time off)) of the element, the amount of energy transferred to the water by the heater plate 7 is known. For example, for an 85 Watt heater plate element at a 60% duty cycle, 51 Joules of energy is transferred to the water every second. Energy is drawn from the water by two dominant means, conduction and convection.

Conduction losses are transferred through the walls of the chamber and duct. During constant-state heating, the amount of energy lost through conduction losses is directly proportional to the temperature gradient between the water and the environment (air temperature). Knowing the water temperature and the ambient air temperature (through, for example, a sensor 22 of the ambient air temperature or, more preferably, evaluating a fixed temperature of, for example, 20 ° C), it is possible to evaluate energy losses by conduction (Econd) during heating. In this embodiment, the water temperature is not measured directly, however tests have indicated that during heating the difference between the average water temperature and the environment is approximately 68% of the difference between the heater plate temperature. and the environment, that is

(Twater <-> Tambient) ~ 0.68 X (Trheater <-> Tambient) This approximation of the water temperature was found by sampling the temperature of the heater plate and the water during the heating period, dividing the water temperature by the temperature of the plate of the heater and then calculating the average of the resulting values during the time period of the heating (from start up until the gases are distributed to their required humidity).

Losses by convection are due to the passage of air through the water in the humidification chamber 5. For the average flow of a CPAP user, the flow rate (Q) in liters per minute is directly proportional to the speed (υ) of the engine of the fan 21 in revolutions per minute (revolutions / minute) for a given limitation (assuming, for example, a standard 6 foot long duct) and such that convection losses are approximately directly proportional to the flow rate. From the experimentation, appropriate proportionality constants were determined and these were incorporated into the following equation. Hence, energy losses by convection (Econv) can be estimated. Consequently, the net amount of energy transferred (Etrasf) to the water in the humidification chamber 5 can be calculated at any time.

In use (and with reference to Figure 5), the heating algorithm according to the second preferred embodiment of the present invention is as follows:

A Ignoring the losses

1. After switching on the humidified CPAP device, the controller 9 reads the fan speed and the temperature (which represent the pressure and humidity of the gases) required or set by the user inputs 19 and 10 respectively and also the temperature current (T start) of the heater plate 7, remembering that the water temperature is approximately 90% of that of the heater plate 7. The fan 21 is powered at a low starting speed, for example 3000 rpm, to create an initial pressure and the resulting flow rate of, for example, 16 liters per minute (assume that the flow rate (Q), in liters per minute, is directly proportional to the speed of the fan motor (υ) in rpm in a CPAP system, such that Q = υ / 186,2). The amount of energy required (Eri-requested) to increase the temperature of the mass (m) of water inside the humidification chamber 5 by an amount (ΔΤ = Triquest - Start) x 0, 9) up to the set temperature is then calculated as follows (where ks is the specific heat capacity of the water):

The controller 9 then supplies the heater plate 7 so that (e.g. a closed loop control system by adjusting the duty cycle of the voltage applied to the heater element) a predetermined required heater plate temperature (e.g. approximately 60 ° C), is obtained as soon as possible with little or no excess of correction.

2. At predetermined time intervals (tf), for example every 30 seconds, the net amount of energy (Transferred) that has been transferred to the water in that interval by the element of the heater 7 (having a power nominal of Pr watts and with a duty cycle of D (%)).

This value is then subtracted from the total energy required to heat the water up to the set temperature, obtaining the energy needed (from this time point) to reach the set temperature. So initially:

3. Using the net energy transferred to the water during the last 30 seconds or, rather, the average amount of net energy transfer (Ptransfer), and a new calculated value for the energy needed to reach the set temperature, a time estimated (ts) to reach the set temperature can be calculated as follows:

B Considering the losses

However, as mentioned above, the amount of energy lost to the water inside the humidification chamber by conduction and convection losses must also be taken into account. Losses for conduction and convection can be calculated as follows:

and also

4. Using this calculated time and the difference between the set speed and the actual speed, an average speed increase (γ) can be calculated:

The current motor speed will then be adjusted accordingly to produce the calculated acceleration.

5. Steps 2 to 4 are repeated every 30 seconds (in which the required Etotaie value is reduced by the net amount of energy transferred, and transferred, to the water in the previous 30 seconds) making sure that the time to reach the set temperature and the required average increase in engine speed are continuously calculated as the ratio of changes in net energy transfer and humidification chamber. This step is repeated until the time to reach the set temperature (ts) is zero and the set speed is reached, then the water temperature in humidification chamber 5 should also reach its required or set temperature.

It will be noted that the above-described algorithm assumes that the humidification chamber contains 400 ml of water. If the chamber contains less than 400ml, the heating time will be longer as the smaller amount of water will take less time to reach the set temperature, causing the element's duty cycle to stabilize at a lower level first, leading to at a lower net energy transfer rate (Enetto Etrasferita - ECOnd _ Econv) to water. Under experimental conditions, the warm-up times for the humidified CPAP machine vary between approximately 15 and 25 minutes depending on the operating conditions.

It will also be noted that in the above preferred embodiment, the fan speed is essentially controlled on the basis of the indirectly determined water temperature. However, as explained above ,. it is desirable to control the pressure of the gases supplied to the patient based on the humidity of those gases. The pressure (P) and flow rate (Q) in the above system (fitting length of approximately 6 feet, etc.) can be approximated by the following equation:

Consequently, the pressure increases with the square of the fan speed. However, with the above equation it is possible to use the fan speed as an indication of the pressure to calculate the gas pressure from it. Similarly, it is possible to produce a relative equation of the relationship between temperature and humidity, for example by determining the mass of water evaporated per second and dividing this value by the actual flow. Thus, although this preferred embodiment of the present invention has been described with reference to ventilator speed and temperature, the system still ensures that gas pressure is controlled, to provide the patient with only adequately humidified gases. The known relationships between fan speed and pressure and temperature and humidity can also be used in step 1 described above so that the user can enter the required pressure and humidity values directly into the device. The controller 9 can then calculate the required fan speed and temperature values and execute the remaining steps accordingly.

The graphs shown in Figure 5 show that the heater plate temperature reaches its set temperature quickly and that, due to the control system described above with reference to the second preferred embodiment, the fan speed (rpm in Figure 5) increases more gradually in line with the increase in water temperature.

Other considerations

In cases where the heater plate temperature is close to the set temperature at system startup (for example, when the patient is using the device, but has temporarily moved away and turned off the device or placed it in an emergency mode). wait), the controller can proceed by keeping the temperature and pressure at successive values during the increase. In this case, the controller can first determine whether the actual heater plate temperature is close to or greater than about 75% of its set target value or, alternatively, within, for example, 5 ° C of its set value. If this occurs, the speed of the fan 21 is controlled to increase linearly from a certain low initial value to the required set value over a predetermined period of time (e.g. 15 minutes). Alternatively, the controller can determine if the actual heater plate temperature is within a range, for example a range of about 10 ° C, of the required set temperature value and then control the fan speed 21 to reach the set value of the heater plate. fan speed over a predetermined period of time.

The alternative steps mentioned above are necessary due to the fact that when the heater plate is already hot, it will immediately reach its set temperature (before the patient goes back to sleep) and therefore the maximum fan speed must be delayed for a period set to allow the gases to be humidified within the capacity of the humidifier, to humidify the gases and / or allow the user to go back to sleep before obtaining the maximum flow rate. The predetermined period of time can be set by the manufacturer before the device is sold or, alternatively, this value can be controlled by the user, for example by adding a further combiner and an input to the controller 9.

The controller preferably also checks the calculated net energy transfer value (Enetto) and if it finds that it is zero or negative (for example for a period of 30 seconds), it then decides that the warm-up must be complete (due to the fact that it is necessary less energy from start-up than calculated due to the fact that there is less water than expected in the chamber). In this situation, the fan speed is automatically increased up to the set fan speed. Another feature can be the heating period control, whereby if the heating is still running after about 25 minutes, the fan speed can then be increased up to the set fan speed as the heating period should be finished.

A further addition can be a pushbutton with an input to controller 9. The pushbutton can be pressed by the user to initiate the previous fixed period of linear increase in fan speed. When the warm-up is complete (the temperature and pressure have reached their required values), the user may find that he is unable to fall asleep and therefore requests that the fan speed be temporarily reduced. In this case, the user can simply press the aforementioned button again and in this case another linear increase in fan speed occurs (although the water temperature may already be at its required set temperature) starting at a predetermined speed. low and linearly increasing it to the required set speed.

Accordingly, the present invention provides a humidified breathing aid system in which the patient is provided with humidified gases in a useful manner during the time the humidifier is warming up and also when the humidifier is in operation (and at its temperature). set). In addition, the humidity of the gases supplied to the patient is maintained during both of these periods within the limits of the humidifiers' ability to humidify these gases for the benefit of the patient. This is extremely useful for the patient as even an insufficiently humidified or unhumidified flow of gas to the patient for a short period of time (e.g. 10 minutes) can cause harmful swelling of the nasal passages and even greater discomfort if distributed. orally.

Claims (30)

CLAIMS 1. Breathing aid apparatus adapted to deliver gas to a patient (1) to assist in the breathing of said patient, comprising: gas supply means (15), comprising pressure regulating means (21) adapted to supply gases at a required pressure with a resulting gas flow rate, means for detecting the pressure of the gases for determining the pressure of said fed gases and therefore the resulting flow rate of the gases, humidification means (8) which receive and humidify said fed gases before distributing them to said patient (1), said humidification means (8) being able to humidify said gases in a controlled manner up to a required humidity level, channeling means (3) which convey said humidified gases to said patient (1), means for detecting the humidity of the gases for determining the humidity of the gases supplied to said patient (1), e characterized by the fact that control means (9, 18) control said gas supply means (15) in response to information about said gas humidity and gas pressure and the resulting flow rate, provided by said gas humidity detection means and said gas pressure detection means, so that said gas pressure and the resulting flow rate reach said required pressure and resulting flow rate substantially at the same time as said gas humidity reaches the required humidity. Breathing aid apparatus according to claim 1, wherein said humidification means (8) comprise humidification chamber means (5) adapted to receive a volume of water (6) and augmentable heating means (7) for heating said volume of water (6) for producing water vapor within said humidification chamber means (5), said gases which pass through said water vapor in said humidification chamber means (5) being then humidified. Breathing aid apparatus according to claim 1 or 2, wherein said pressure regulating means (21) comprises a variable speed fan and said pressure sensing means comprises a speed sensor which detects the speed of said fan to provide said control means (9, 18) with an indication of the flow rate of said gas flow. 4. Breathing aid apparatus according to claim 2 or 3, wherein said means for detecting the humidity of the gases are part of said control means (9, 18) and comprise means for detecting the temperature of said heating means which can be fed (7) in which the humidity of said gases is estimated on the basis of said detected temperature of said feedable heating means (7). 5. Breathing aid apparatus according to claim 2 or 3, wherein said means for detecting the humidity of the gases are part of said control means (9, 18) and comprise means for detecting the temperature of said heating means which can be fed (7) wherein the humidity of said gases is estimated on the basis of a calculated value for the temperature of said volume of water (6) within said humidification means (8), said calculated temperature value being determined by adding an amount which it depends on the amount of energy which has been added to said volume of water (6) at said detected temperature of said augmentable heating means (7). Breathing aid apparatus according to any one of claims 1 to 5, wherein said control means (9, 18) is a programmable processor which stores a program which when executed in said processor performs the steps of: i) determining the total amount of energy required to be transferred to said humidification means (8) to reach said required humidity level, ii) determining the current amount of energy transferred to said humidification means (8), iii) calculating a time to reach said required humidity level by dividing said total amount of required energy determined in step (i) by said determined amount of transferred energy in step (ii), e iv) controlling said pressure regulating means (21) to distribute said gases from said gas supply means (15) at a pressure which is substantially similar in proportion to said required pressure when said humidity of said gases is at said level humidity required, wherein steps (i) to (iv) are repeated until said fed gases are substantially humidified to said required humidity level and are substantially at said required resulting pressure and flow rate. Breathing aid apparatus according to claim 6, wherein said amount of energy transferred in said step (ii) is estimated by determining the amount of energy transferred to said humidifying means (8) during a predetermined period of time and dividing said quantity of energy determined for said predetermined period of time. The breathing aid apparatus according to claim 7, wherein a first quantity equal to the estimated convection energy losses in said breathing aid apparatus and a second quantity equal to the estimated conduction energy losses in said breathing aid apparatus respiration, are added to said determined quantity to calculate said time to reach said humidity level required in step (iii). Breathing aid apparatus according to any one of claims 6 or 8, wherein a first quantity equal to the estimated convection energy losses in said breathing aid apparatus and a second quantity equal to the estimated conduction energy losses in said breathing aid apparatus, are subtracted from said total energy quantity transferred to said humidification means (8) to calculate said time to reach said humidity level required in step (iii). Breathing aid apparatus according to any one of claims 7 to 9, wherein said predetermined time period is about 30 seconds. Breathing aid apparatus according to any one of claims 6 to 10, wherein said step (i) provides for the calculation of an initial quantity of energy required and subtraction of the quantity of energy subsequently transferred to said humidification means (8) in the previously accumulated predetermined time periods. Breathing aid apparatus according to any one of claims 1 to 11, wherein said transport path means (3) contains within it a path of heating means which are adapted to be supplied in a controlled manner by said means of transport. control (9, 18) to reduce condensation along the length of said transport path means (3). Breathing aid apparatus according to any one of claims 1 to 12, which further comprises variable insertion means for the user which, in response to an insertion by an operator, cause said control means (9, 18 ) control said gas supply means (15) to obtain a predetermined pressure profile of said fed gases, independent of said humidity of said gases, for a period of time determined by said insertion of said operator. 14. Breathing aid apparatus according to claim 13, wherein said predetermined pressure profile is a linear increase of said supplied gases from a lower initial pressure to a final pressure equal to said required pressure. 15. A method for operating a breathing aid apparatus, said breathing aid apparatus comprising gas supply means (15), pressure regulating means (21) adapted to supply gas at a required pressure with a resulting gas flow rate , gas humidification means (8) capable of humidifying said gases in a controlled manner up to a required humidity level, transport means (3) which transport said humidified gases to said patient (1) and control means (9, 18) which store required predetermined values of pressure and humidity, said procedure comprising the steps of: a) activating said gas humidifying means (8) to humidify the gases coming from said gas supply means (15), b) detect the pressure of said gases, c) detect the humidity of said gases, characterized by the fact that d) the pressure at which said gases are supplied to said patient (1) is controlled so that said gas pressure and the resulting flow rate reach said required pressure and resulting flow rate, substantially simultaneously with when said required humidity level is reached. 16. Process according to claim 15, wherein said humidification means (8) comprise humidification chamber means (5) adapted to receive a volume of water (6) and a heating means that can be fed (7) to heat said volume of water (6) to produce water vapor within said humidification chamber means (5), said gases passing through said water vapor into said humidification chamber means (5) being then humidified. Method according to claim 15 or 16, wherein said pressure regulating means (21) comprises a variable speed fan and said step of detecting the pressure and the resulting flow rate of said gases comprises the step of detecting the speed of said fan to provide said control means (9, 18) with an indication of the pressure and the resulting flow rate of said gas flow. 18. Process according to claim 16 or 17, wherein said step of detecting the humidity of said gases comprises the evaluation of the humidity based on the temperature of said feed heating means (7). 19. Process according to claim 16 or 17, wherein said step of detecting the humidity of said gases comprises the evaluation of the humidity on the basis of a value calculated for the temperature of said volume of water (6) within said humidification means (8), said temperature value calculated by determining by detecting the temperature of said increasing heating means (7) and adding to this an amount which depends on the amount of energy that has been added to said volume of water (6). Process according to any one of claims 15 to 19, wherein step (d) further comprises the steps of: 1) determining the total amount of energy required to be transferred to said humidification means (8) for said gas humidity to reach said required humidity level, 2) determining the amount of energy transferred to said humidification means (8), 3) calculating the time to reach said required humidity level by dividing said total amount of required energy determined in step (1) by said amount of transferred energy determined in step (2), 4) controlling said pressure regulating means (21) to distribute said gases from said gas supply means (15) at a pressure which is substantially similar in proportion to said required pressure when said humidity of said gases is at said level humidity required, and wherein steps (1) - (4) are repeated until said fed gases are substantially humidified to said required humidity level and are substantially at said required pressure level and resulting flow rate. 21. Process according to claim 20, wherein said step (2) provides for determining the quantity of energy transferred to said humidification means (8) in a predetermined period of time and dividing said quantity of energy determined by said period of predetermined time. The method of claim 21, wherein a first amount equal to the estimated convection energy losses in said breathing aid apparatus and a second amount equal to the estimated conduction energy losses in said breathing aid apparatus, are added to said quantity determined to calculate said time to reach said humidity level required in step (3). A method according to any one of claims 20 to 22, wherein a first quantity equal to the estimated convection energy losses in said breathing aid apparatus and a second quantity equal to the estimated conduction energy losses in said breathing aid apparatus respiration, are subtracted from said total amount of energy transferred to said humidification means (8) to calculate said time to reach said humidity level required in step (3). 24. A method according to any one of claims 21 to 23, wherein said predetermined time period is about 30 seconds. 25. Process according to any one of claims 20 to 24, wherein said step (1) provides for the calculation of an initial quantity of energy required and the subtraction of the quantity of energy subsequently added to said humidification means in the previously accumulated predetermined time periods . Method according to any one of claims 15 to 25, wherein path heating means contained within said transport means (3) are controllably supplied by said control means (9, 18) to reduce condensation in the direction of length of said means of transport (3). Method according to any one of claims 15 to 26, wherein said breathing aid apparatus further comprises variable insertion means for the user, and wherein said control means (9, 18) controls said feeding means (15 ) of the gases to obtain a predetermined pressure profile of said fed gases, independent of said humidity of said gases for a period of time in response to an input from an operator, wherein said predetermined time being determined by said input of said operator . 28. A method according to claim 27, wherein said predetermined pressure profile is a linear increase of said fed gases from a lower initial pressure up to a final pressure equal to said required pressure. 29. A method of treating obstructive sleep apnea in a patient (1) using breathing aid apparatus comprising gas supply means (15), pressure regulating means (21) adapted to supply gas at a required pressure with a resulting gas flow rate, gas humidifying means (8) capable of humidifying said gases in a controlled manner to a required humidity level, transport means (3) transporting said humidified gases to said patient (1) and control means (9, 18) which memorize required predetermined values of pressure and humidity, said process comprising the steps of: A) activating said gas humidification means (8) to humidify the gases coming from said gas supply means (15), B) detect the pressure of said gases, C) detect the humidity of said gases, characterized by the fact that D) the pressure at which said gases are supplied to said patient (1) is controlled so that said gas pressure and the resulting flow rate reach said required pressure and resulting flow rate, substantially simultaneously with when said required humidity level is reached. A process for treating obstructive sleep apnea according to claim 29, wherein said step (D) further comprises the steps of: I) determining the total amount of energy required to be transferred to said humidification means (8) to reach said required humidity level, II) determine the amount of energy transferred to said humidification means (8), III) calculate a time to reach said required humidity level by dividing said total amount of required energy determined in step (I) by said amount of transferred energy determined in step (II), IV) controlling said pressure regulating means (21) to distribute said gases from said gas supply means (15) at a pressure which is substantially similar in proportion to said required pressure when said humidity of said gases is at said level humidity required and wherein steps (I) - (IV) are repeated until said fed gases are substantially humidified to said required humidity level and are substantially at said required resulting pressure and flow rate.