Next Generation of Machine Deisgn: PR S2's and Resmed S10's

To: VP's of Product Design for Respironics, Resmed & others
Fr: BiPaP User/Architect/Product Designer
Re: Next Generation of Machines - Broadening Accessibility

The intention here is to provide:
- a truly portable machine for those able to travel (i.e., packing up, airplane. hotel-staff issues, camping, etc.);
- a machine suitable for the injured or disabled or for seniors who sleep in multiple locations;
- a preferable machine design for hospitals for easier delivery to patients, for keeping masks off the floor(!) and for keeping machine and components safer and cleaner.

It's an incorrect assumption that all people want to show-off their medical equipment on their night tables as they would a Tiffany lamp. Some love to celebrate their maladies and chat about them continuously. Some prefer more modesty and enjoy a greater dignity in discussing more interesting topics. For those who prefer modesty it is important not to be queried about a medical device by visitors, relatives and children.

I've done some design work for nursing homes and for individuals using wheelchairs. A story that might interest you is about a quadriplegic ('triplegic', actually) who wanted a second and more comfortable wheelchair that he might use while he was at home. I bought an off-the-shelf, very handsome, classic bentwood and rattan rocker. I added exotic wheels that you would see during FDR's time. He thought it was a ridiculous idea as if the 'ambulatory look' of medical equipment was a badge of honor. For a few months it sat around and he wouldn't even try it. When he finally did get in the chair he never wanted to get out of it. There is a role for beauty, for dignity.

Many people have injuries, infirmities and disabilities that result in them sleeping in several locations at home on the same day - bed, recliner, guest room or couch. Others travel with both machines and humidifiers. Some camp. Others find themselves in hospitals or nursing homes. The market would benefit from a portable machine that would operate WITHIN a highly-breathable fabric bag. For example, shoulder bags and team bags, can be quite handsome and are recognized worldwide. Think of the design hoopla and enormous pricing regarding hand bags, fine shoulder bags, attache cases; even backpacks may be exorbitant in price. Such bags do not look like medical equipment. The bag style that is needed here would not up the cost of a current machine since our machines already come with bags. The suggested bag should have a flat bottom to rest on a table and the carrying handles would encourage the bag to remain flat. It need not be expensive - just as many bags are reasonably priced and made from off-the-shelf materials. Resmed bag designers would find this right up their alley. Respironics would need to engage a more sophisticated design firm.

A practical idea would be to use a one liter water bottle for the humidifier tank. Plug it in, pop up the bottle vertically and put on the mask. Done. Machines that sit on night tables pretending to look like radios don't address the fact that the tube/mask must be connected, managed and put somewhere. Moving the machine from room to room is difficult for many, particularly because of the large power supply 'brick' and additional wiring. Traveling requires packaging everything up.

About 7 years ago I did take a breathable-fabric bag, put in a peg-board bottom and 1" feet on the bottom of the bag, added many extra holes around the sides of the bag and provided a larger cut-out for the air-intake area of the Resmed S8. When I acquired a PR 760 I cut a new, air-intake area for that machine and its modem. With the hose and mask removed for use, and the bag open fully open, there is no functional degradation of any kind. No overheating - plenty of airflow. It is because this idea works so well that I brought it to this forum. I empty the water tank and wash the mask daily with vinegar/water. I allow these to dry in a cabinet though a mesh area on the back of the bag would sometimes be preferred. The bag is zipped up during day and remains perfectly clean with neither dust nor anything else invading the bag. Wonderful for travel as well.

A good design for some:

- A plain, handsome, easily opened bag with huge zipper pulls. The zippers should be openable with one hand because some of us have had strokes or injuries. The bag should be available in several muted colors such as black, navy and forest green. The bag should NOT have logos on it. It should be visually interpreted as a simply a carry-all.
- Un-zip the bag, pop up the water bottle to use the machine.
- The machine must be able to operate and breathe within the bag itself; yet, the machine must not be visible through the bag.
- A fancy plastic machine case is not needed in this design concept. Thin, protective foam is required for travel purposes. Impact testing is required, in particular, for overhead luggage compartments on airplanes.
- The humidifier should be a tiny component supplied by a good-sized, standard water bottle such as a liter bottle. When the bottle is lifted vertically it flows into the tiny humidifier compartment.
- The water bottle must be removable easily for refilling.
- The bag must be sized for a 10-foot tube, the largest mask and nothing else - no books or other compartments. Size and weight matter - the smaller the machine the better.
- Two power cords should be supplied. The power cord should plug in on the TOP of the machine. This may seem odd but for those of us who sleep in multiple locations in the same night this would be an advantage. Too many of us also have back problems. Too many of us would prefer not to be fumbling around in order to find low receptacles located behind furniture.
- The machine needs to have built-in wifi for browser access so we can download our own data ourselves if we use proprietary software.
- Built-in wifi should also enable automatic uploading to central databases. We should be granted database access of our own accounts just like we have for banks, investment accounts, hospitals and government websites.
- A standard battery needs to be built in to sound an alarm if there is a power failure; therefore, an on switch is probably required for the machine. Consider using the water-bottle lift-assembly for the on/off switch.
- An excellent, high-quality, easily-replaceable surge-suppressor must be built-in. Many are on the market.
- When the bag is unzipped a flap inside the bag must provide an easy to read label with all of the medical equipment information required for national and international flights. Several languages are required.
- An on/off option is required to alert users if no SD Card is installed.
- A quick-disconnect with 360 swivel on the humidifier itself to make it easier to remove andwash hoses.
- Mesh pocket in the back of the bag to dry mask and any humidifier components.

Several users of this forum have offered good, thoughtful ideas. I've incorporated as many as possible. I have not addressed good ideas such as Zeo, Clock Radios, Android/iPhone Ports and Oximeter options since these are beyond my own experience. The issue of batteries is a very separate one because of weight.

UPS Systems (Uninterupted Power Supplies) are ideal for normal use and should always be used if affordable. Inverters with additional support from sealed car batteries can provide extended power. However, all of these devices are extremely heavy for many and cannot be included in this concept of a portable, accessible machine. Various generators of many styles, sizes and fuel sources are also on the market.

Please remember that Industrial Design is a sophisticated art these days so the technical issues that some of you have addressed represent 'easy workarounds'. Breathability, air source, heat, materials for humidification, etc are all the arena of good designers and by no means a difficult task. For my company's products we still use the tried-and-true method of good drawings, mockups and multiple prototypes.

In the case of xPAP machines the cost of production does not determine price. The gravy-train of the medical market is the determining factor in machine cost. Production costs for a machine in a bag, whether less expensive or more expensive to manufacture, is not going to affect market price.

One last story. In my design experience with the disabled one woman in particular influenced me lifelong. This woman had multiple strokes and used a wheelchair for 11 years. She never, ever, complained of her maladies no matter how severe - and I've seen her screaming in pain. She lived to be 100.

I would like to see more convenience built into our machines, cases, and acccessories,
but medical equipment identity helps get them onto airplanes--FREE.
I am not ashamed of my machine.
Other people may see it and be curious.
Discussion ensues, and someone's life may be saved.
Hiding the machine is not for me.
I would consider that selfish and vain, rather than modest.
But that is just me.

IMO...So few people would utilize a contraption like this that it would not be practical to produce...OR...it would be very expensive. Nothing wrong with the carrying case that currently exists.

My hearing aid is bright metallic blue,
state of the art, in full public view.
It cost even more than my CPAP.
If FSA would cover it I'd have a steampunk skin for my Autoset.
Maybe I'm a geek.
If you must shoot me, please use a blunderbuss.

Wakanda wrote:If you agree with this design suggestion kindly post a note of encouragement to manufacturers.

To: VP's of Product Design for Respironics, Resmed & others
Fr: Anonymous Product Designer
Re: More useful machines designs.

Many people sleep in multiple locations at home on the same day - bed, guest room, couch, recliner. We also travel with our machines and our humidifiers. We need a machine that would operate WITHIN a Gym Bag. Gym Bags are used worldwide and do not look like medical equipment. They have a flat bottom to rest on a table. Plug it in, pop up a standard water bottle vertically and put on the mask. Machines that sit on night tables don't address the fact that the tube/mask must be connected, managed and put somewhere. Moving the machine from room to room is a pain particularly because of the large power supply 'brick'. Modesty is an important issue. It's an incorrect assumption that people want to show off their medical equipment on their night tables as they would a Tiffany lamp.

We need:

- A plain, easily opened Gym Bag with huge zipper pulls. The zippers should be openable with one hand because some of us have had strokes or injuries. The bag should be available in several muted colors such as black, navy and forest green. The bag should NOT have logos on it. It should be interpreted as a standard gym bag.
- Only the water bottle section needs to be unzipped or un-velcro'd to use the machine.
- The machine must be able to operate and breathe within the bag itself. The plastic machine case is irrelevant to this design concept.
- The humidifier should be a tiny compartment supplied by a good-sized water bottle. When the bottle is lifted vertically it flows.
- The water bottle should be easily removed for refilling.
- The bag must be sized for a 3' Meter tube and your largest mask and nothing else - no books or other compartments. Weight matters.
- Two power cords should be supplied. The power cord should plug in on the TOP of the unit. This may seem odd but for those of us who sleep in multiple locations in the same night this would be an advantage. Too many of us also have back problems.
- Power to the SD Card must be maintained at all times when the machine is plugged in so that a Wifi SD Card can be used to download data.
- A battery needs to be built in to sound an alarm if there is a power failure; therefore, an on switch may be required for the machine.
- An excellent quality surge suppressor must be built-in.

And, what if we totally DISAGREE???

That list is absolutely absurd!.


Den

.

I wouldn't want this version either. I would not want to worry about my machine having trouble with airflow. How on earth would the bag not show the machine, yet still get adequate airflow?

My machine does not embarrass me. I am a little uncomfortable wearing my MASK in front of friends for the first time. But that is completely impossible to hide.

A 3' hose would be too short for me.

I can't really think of anything that I would want as a big improvement to my machine. Wifi to my computer would be nice with an automatic download. But It's not a big deal for me to download my card. I do wish it would beep or give me a message to remind me to put the card back in

I travel once or twice a month, and I have no problem with it. I put my laptop and my cpap machine into a totebag together, and they travel great. Next month, I will be going with a group of friends to California (from Seattle). We will stop at a hotel on the way down, then get there and stay 2 nights in a hotel, and then another hotel on the way home. No big deal. When I traveled last year with my sister, we did 2 hotel stops on the way to our destination, as well as 2 hotel stops on the way home. I have no problem setting it up and packing it up.

Replies to Comments:

"Medical equipment identity helps get them onto airplanes--FREE."
- - - I've added a design parameter to aid this suggestion.

"I am not ashamed of my machine. Other people may see it and be curious. Discussion ensues, and someone's life may be saved. Hiding the machine is not for me."
- - - Leave your tube and mask out of the bag and then you can discuss it with your friends. For those who are embarrassed the machine design and packaging should not preclude humility or modesty.

"So few people would utilize a contraption like this that it would not be practical to produce...OR...it would be very expensive. Nothing wrong with the carrying case that currently exists."
- - - This design would be of no more expense to produce than current designs. It may be less expensive.

"And, what if we totally DISAGREE??? That list is absolutely absurd!."
- - - I design furniture for wheelchair users - both para's and quads. Many of the incorporated design suggestions in this post are for this important segment of the population. Furthermore, those who have had strokes and continue to live independently require a more convenient solution for moving the machine from place to place and home to hospital.

"How on earth would the bag not show the machine, yet still get adequate airflow?
- - - Airflow is easily achieve with breathable fabrics and strategically placed openings in the bag. This is easily achieved.

"A 3' hose would be too short for me."
- - - The reference to hose size was 3 meters - that's 10 feet." Shorter hoses would of course still fit in the bag.

" I do wish it would beep or give me a message to remind me to put the card back in."
- - - I have added this suggestion.

"I have no problem setting it up and packing it up."
- - - Others, such as seniors and the disabled have a great deal of difficulty with machine setup and particularly the power supplies. For those who do not sleep through the night and move from place to place this is particularly problematic.

What I would love to see in the next generation of machines is integration with Zeo's sleep monitoring technology. We've seen over and over that OSA gets worse during REM sleep. If a headband similar to the ones used by the Zeo Bedside or Zeo Mobile was available that sent sleep stage data to the APAP machine, the machine could preemptively increase pressure when the user entered REM sleep, and decrease it after exiting REM. Furthermore, the sleep stage data could then be logged to the SD card and synchronized with the rest of the data.

Zeo is out of business and hasn't found a buyer. ResMed or another one of the CPAP machine companies should purchase their assets to get their technology. It would be fairly trivial to build this into the CPAP and wouldn't raise the machine cost very much since 80% of the hardware is already there (microprocessor, memory, programming, SD card interface). The only thing to add into the machine is the wireless receiver chip to communicate with the headband. The headband itself could be separately purchased as an option, similar to the oximeter option, or the mask manufacturers can build the headband into the mask designs.

Absolute bollocks. The latest machines are fine. Any custom features only used by the few adds to the cost for all of us.
The current machines provide the much needed therapy along with the required comfort features that give you your life back. I'm grateful the current machines even exist, but some people will never be happy.

Wakanda wrote: It's an incorrect assumption that people want to show-off their medical equipment on their night tables as they would a Tiffany lamp. Modesty is an important issue for many of us who would prefer not to be queried about our sleep disorders.

I have no problem with it being seen. It is a medical condition and nothing to be shameful of.

Importantly, many people sleep in several locations at home on the same day - bed, recliner, guest room or couch. We also travel with both our machines and our humidifiers. We need a machine that would operate WITHIN a Gym Bag. Gym Bags are recognized worldwide and do not look like medical equipment. Gym Bags have a flat bottom to rest on a table. Plug it in, pop up a standard, one liter water bottle vertically and put on the mask. Done. Machines that sit on night tables pretending to look like radios don't address the fact that the tube/mask must be connected, managed and put somewhere. Moving the machine from room to room is difficult particularly because of the large power supply 'brick' and additional wiring.

That would actually look worse than the machine sitting on a nightstand. I also don't think that even with vents in the bag, that the machine wouldn't be able to get enough air to keep cool and provide adequate therapy. There are plenty of alternate ways to deal with the machine and hose if you don't want them to be seen.

- A plain, easily opened Gym Bag with huge zipper pulls. The zippers should be openable with one hand because some of us have had strokes or injuries. The bag should be available in several muted colors such as black, navy and forest green. The bag should NOT have logos on it. It should be interpreted as a standard Gym Bag.
- Only the water bottle section needs to be un-zipped or un-velcro'd to use the machine.
- The machine must be able to operate and breathe within the bag itself; yet, the machine must not be visible through the bag.
- A fancy plastic machine case is not needed in this design concept. Thin, protective foam is required for travel purposes.

Again I don't think that it could function in such conditions.

- The humidifier should be a tiny component supplied by a good-sized, standard water bottle such as a liter bottle. When the bottle is lifted vertically it flows into the tiny humidifier compartment.
- The water bottle must be removable easily for refilling.

I have actually thought about something like this but then in the actual world it won't work. A humidifier heats a large amount of water slowly to achieve steam. Using a small amount of water would require a higher heating temperature to achieve the same result because you have to heat the cool water coming in faster to maintain the humidification. Not feasible when the design calls for it to be lightweight. You would have to use glass and metal to make it work.

-
- Two power cords should be supplied. The power cord should plug in on the TOP of the machine. This may seem odd but for those of us who sleep in multiple locations in the same night this would be an advantage. Too many of us also have back problems. Too many of us would prefer not to be fumbling around in order to find low receptacles located behind furniture.

A properly sized extension cord takes care of that problem but so would multiple machines.

- The machine needs to have built-in wifi for browser access so we can download our own data ourselves if we use proprietary software.
- Built-in wifi should also enable automatic uploading to central databases. We should be granted database access of our own accounts just like we have for banks, investment accounts, hospitals and government websites.

I could agree with that. However I would rather to see built in bluetooth and wi-fi.

- A standard battery needs to be built in to sound an alarm if there is a power failure; therefore, an on switch is probably required for the machine. Consider using the water-bottle lift-assembly for the on/off switch.

I do believe that you can buy a small device that you can plug in to an outlet that sounds an alarm for a minute when the power goes out. No need for it to be built in.

- An excellent, high-quality surge-suppressor must be built-in.

You can't build it in on that. A good quality surge device basically self-destructs rendering the downstream devices useless until replaced. Hubbell used to make a surge device with replaceable MOV's which would be possible with your idea but the main device was for protecting a whole electrical panel and was pretty big. The smaller surge devices that you are thinking of are pretty useless. Any electrician will tell you that the best protection is at the panel not the device.

- When the bag is unzipped a flap inside the bag must provide an easy to read label with all of the medical equipment information required for national and international flights. Several languages are required.

A nice idea but impractical. A better solution is to print one off the internet in the languages of the countries you are traveling to and keeping the info with your passport.

- An on/off option is required to alert users if no SD Card is installed.

Not a bad idea but would rather it was an alarm when you turn the machine on. It could be programmed to shut off after 30 seconds.

I agree completely.
The idea of hiding the cpap in a gym bag is on a level with a wino taking swigs out of a paper bag,
or an 80% comb-over. JUST RIDICULOUS!
If "embarassment" is reason enough to not use cpap, the denial-baby
will only find a dozen more "reasons" to avoid therapy.
Dozens of people die every year of embarassment--via colon or prostate cancer.
Suck it up, please.

Yes, I am very satisfied with the S9 line the way it is.

I would only suggest making the ResMed travel case out of strong light-weight plastic instead of cloth, so as to protect its contents from the people who like to jam their hard suitcases into the side of my softcase when I trust it to the overhead bin in planes. Until then, I will keep it under the seat.

But if we are dreaming about the next series, I will wait until they shrink the whole thing down to the size of a cell phone with a clip, so I can slip it into the pocket of my pajama tops or shirt.

Regards, Nate

I suppose Trancend was trying for something like that; but the trade off is unacceptable.

My machine does not embarrass me. I have a medical condition that requires a machine. This is nothing to be ashamed of. I see no reason to hide my machine in a bag. Plus - wouldn't my 3 foot tall oxygen concentrator look funny in a bag! LOL

Wakanda wrote:

- - - Leave your tube and mask out of the bag and then you can discuss it with your friends. For those who are embarrassed the machine design and packaging should not preclude humility or modesty.

If you are embarrassed about how it looks, then I might suggest that you go make your funeral arrangements now so you won't be embarrassed by what casket you are buried in.

And if you use the search function at the top, you can find a few posts that deal with how to hide your cpap while not in use. A couple of them really do look nice.

Wakanda wrote: - - - This design would be of no more expense to produce than current designs. It may be less expensive.

Actually it would be more expensive. Your designs would probably raise the price an extra 50-60%.

Wakanda wrote: - - - I design furniture for wheelchair users - both para's and quads. Many of the incorporated design suggestions in this post are for this important segment of the population. Furthermore, those who have had strokes and continue to live independently require a more convenient solution for moving the machine from place to place and home to hospital.

And I design electrical systems. What is your point? There are a lot of things are nice in theory but are never practical in the real world.

I also just had a 2 level lumbar fusion that isn't going so well. I was wheelchair bound for the first month. The last thing on my mind was how portable my cpap was.

If someone is having to move their cpap around a lot, then they might want to consider a travel cpap like the Ascend.

Wakanda wrote: - - - Airflow is easily achieve with breathable fabrics and strategically placed openings in the bag. This is easily achieved.

No it isn't. Fabric doesn't breathe as much as the machine would need. The electronics need to be kept cool as well as certain parts of the humidifier. This takes air flowing around it as well as into it.

Wakanda wrote: - - - Others, such as seniors and the disabled have a great deal of difficulty with machine setup and particularly the power supplies. For those who do not sleep through the night and move from place to place this is particularly problematic.

Again a small segment of the total amount of cpap users. The better solution is to find out why they are moving from place to place during the night and remedy that.