CPAP machine with data features

Hi everyone,

Just want to get some of your opinion on this. Our fourth year biomedical engineering design project at University of Toronto involves improving on CPAP machines and this is one of the idea we brainstormed. We would definitely love some user feedback on this.

From previous feedbacks on our posts, it seems that data is a high priority for many users. What do you think?
a) What kind of useful data would you like to see?
b) How much more are you willing to pay for a machine with showing these data? (This is used to rank the priority of this idea)
c) What do you think of incorporating a LCD screen that allow you to quickly view your sleep pattern the next morning? Data will still be stored on a SD card that would allow you to analyze long term sleep pattern.
d) How much more are you willing to pay for a machine with feature mentioned in c? (This is used to rank the priority of this idea)
e) Current CPAP machines store data on a SD card. Would you be interested in having a wireless transfer of data? If so, how much more are you willing to pay for this? (This is used to rank the priority of this idea)

Thank you so much for your help!! Much appreciated!!

(Any feedback would be awesome since we've been getting mixed feedback regarding this and we would really like to key down a design to help improve CPAP therapy. )

lindalq wrote:Hi everyone,

Just want to get some of your opinion on this. Our fourth year biomedical engineering design project at University of Toronto involves improving on CPAP machines and this is one of the idea we brainstormed. We would definitely love some user feedback on this.

From previous feedbacks on our posts, it seems that data is a high priority for many users. What do you think?
a) What kind of useful data would you like to see?
b) How much more are you willing to pay for a machine with showing these data? (This is used to rank the priority of this idea)
c) What do you think of incorporating a LCD screen that allow you to quickly view your sleep pattern the next morning? Data will still be stored on a SD card that would allow you to analyze long term sleep pattern.
d) How much more are you willing to pay for a machine with feature mentioned in c? (This is used to rank the priority of this idea)
e) Current CPAP machines store data on a SD card. Would you be interested in having a wireless transfer of data? If so, how much more are you willing to pay for this? (This is used to rank the priority of this idea)

Thank you so much for your help!! Much appreciated!!



(Any feedback would be awesome since we've been getting mixed feedback regarding this and we would really like to key down a design to help improve CPAP therapy. )

I think you have a partially incorrect premise. A lot of us get our machine via insurance, and the insurance pays the same for a machine with NO date and a machine WITH data. That meas that if we used insurance to get our machine, we didn't have to pay a higher amount for features. We can simply demand the better machine and get it, or find a differnt place to sell us the machine.

a - already have the data I want. I can't imagine what other data it could possibly collect. So, this question makes no sense to me.
b - nothing. As mentioned above, the insurance pays the standard rate for a cpap machine. I want the best machine in that category. Personally, I believe ALL machines should have data. Bricks should be discontinued.
c - not sure what you mean by sleep pattern. Are you talking about sleep cycles? Seems like that would be a separate piece of equipment. My LCD screen already tells my ahi, sleep time, and leak. What more are you suggesting? Rather than vaguely ask us what we want, why not suggest what is possible and see if we want it.
d - again, insurance pays the same for all machines in the category. If this system is changed, then only rich people would get good machines. It would be better to simply eliminate bricks and make sure that everybody gets a machine with useful data.
e - wireless would be great. Is it worth paying extra to save me from the act of putting the card in the computer. Not unless it is really cheap. Maybe a one time $20 gadget to add to my machine. But honestly, I usually don't pay for things I can do easily myself. I usually only download my data once a month or so. It only takes a few minutes.

zoocrewphoto wrote: I think you have a partially incorrect premise. A lot of us get our machine via insurance, and the insurance pays the same for a machine with NO date and a machine WITH data. That meas that if we used insurance to get our machine, we didn't have to pay a higher amount for features. We can simply demand the better machine and get it, or find a differnt place to sell us the machine.

a - already have the data I want. I can't imagine what other data it could possibly collect. So, this question makes no sense to me.
b - nothing. As mentioned above, the insurance pays the standard rate for a cpap machine. I want the best machine in that category. Personally, I believe ALL machines should have data. Bricks should be discontinued.
c - not sure what you mean by sleep pattern. Are you talking about sleep cycles? Seems like that would be a separate piece of equipment. My LCD screen already tells my ahi, sleep time, and leak. What more are you suggesting? Rather than vaguely ask us what we want, why not suggest what is possible and see if we want it.
d - again, insurance pays the same for all machines in the category. If this system is changed, then only rich people would get good machines. It would be better to simply eliminate bricks and make sure that everybody gets a machine with useful data.
e - wireless would be great. Is it worth paying extra to save me from the act of putting the card in the computer. Not unless it is really cheap. Maybe a one time $20 gadget to add to my machine. But honestly, I usually don't pay for things I can do easily myself. I usually only download my data once a month or so. It only takes a few minutes.

Hi,

Thank you for your feedback and for clarifying our misconception.

From our research, we thought that insurance only pay partially the cost, whereas the patients would pay the rest. I guess that's not the case.

From other general surveys, it seems like users want data. But we honestly had no idea what data information patients would want. Others also mentioned how only their physicians have access to those data and they want to be able to view the data themselves. It seems like this is different from your case?

I guess a better topic for us to target would be wireless transfer of data. As opposed to presenting more data or a bigger LCD to present the data.

Regarding wireless transfer of data, it would definitely be a one time cost. We thought this would prevent the monthly procedure of extraction data, as well as prevent accidents such as forgetting the SD in the computer. Please let us know what you think.

Transferring the data with an SD card takes very little effort. Wireless transfer, e.g. Bluetooth, would require me to bring my laptop into the bedroom for the transfer. The alternative would be to go the WiFi route, which then pretty much requires a router in the house. Of course, SD cards will probably eventually be phased out as the next development comes to cameras, but they work quite well for now.

One type of data that most of us wish we had but that is not currently available is a parameter that indicates wake vs. sleep. Even better would be something that shows the stages of sleep. The obvious problem is that NO one is going to put up with a full EEG rig on their head at night. The masks are bad enough. If you search for Zeo sleep machine, you will see one approach that was taken in a similar project. I have also seen where someone has a smartphone app that uses the accelerometer in your phone to detect small movements of the bed.

My insurance certainly does not pay for my machine, so cost is a factor for me. On the other hand, so is ease of use. I do read my data on Encore. But I would prefer a simple screen attached to the machine which showed all of the data that I currently get from my encore download on my computer. Including long term trends. I have Encore basic so I may not be getting as much info as others.
The advantage of my current 'download onto my computer from my card' set up is that my computer screen is larger than anything that would likely appear on a cpap machine. This makes comparing different data easy.

So if I can try to unmix my messages, I'll say that I would appreciate a well designed screen built into a cpap unit that displayed the same info that I now get from my Encore download. But since I'm paying out of pocket, and these machines are expensive to begin with, I have to admit that I wouldn't pay much more for this feature.

zoocrewphoto wrote: c - not sure what you mean by sleep pattern. Are you talking about sleep cycles? Seems like that would be a separate piece of equipment. My LCD screen already tells my ahi, sleep time, and leak. What more are you suggesting? Rather than vaguely ask us what we want, why not suggest what is possible and see if we want it.

Just wanting to clarify something for lindalq, the OP: zoocrewphoto uses a Resmed S9 AutoSet.

The data available on the Resmed S9 AutoSet's LCD runs rings around the data available on the PR RemStar System One Auto CPAP. That difference in "data available on the LCD" is a small, but potentially important selling point that is currently strongly in Resmed's favor. If it's within the rules allowed for your design project, it would be well worth it for you and your team to look at just how rich the data available on the Resmed S9 AutoSet's LCD is and just how lousy the data on the PR System One's LCD is.

A redesign of the PR System One Auto CPAP's LCD to make more user friendly and more useful with much more useful data available at the user's finger tips would be a worthwhile design project---or so says this current PR System One BiPAP Auto user who once upon a time used an S9 AutoSet. I still wish I could just click through the LCD each morning for a quick, but thorough "Sleep Quality" report rather than taking the time to download all the data into Sleepy Head each and every morning just because my System One has really lousy LCD data that does NOT give me a decent snapshot of what the night really was like in term of events or leaks.

I believe that manufacturers producing cpap like machines could offer plug in modules to provide a rich data extraction from inexpensive machines. The current difference in price between a S9 Escape (no data) and S9 Elite (full data) is very small ($50). If the module could be user purchased that would convert an insurance provided machine into a full data machine that would be wonderful. The price target for the module should be no higher than the difference in the two machine costs in the above example.

I believe that manufacturers producing cpap like machines could offer plug in modules to provide a rich data extraction from inexpensive machines. The current difference in price between a S9 Escape (no data) and S9 Elite (full data) is very small ($50). If the module could be user purchased that would convert an insurance provided machine into a full data machine that would be wonderful. The price target for the module should be no higher than the difference in the two machine costs in the above example.

Devilbiss has already taken this approach. In addition to the very simple AHI score on the screen of their IntelliPap units, they provide codes that can be typed into their website to get compliance type data reports. They also sell the plug-in SmartLink module for about $100 without software. This module provides more comprehensive data collection that is written to an SD card. The port also provides an oximetry port and a port for uploading firmware updates.

The problem with addressing cost here is you are in Canada, the majority of posters here seem to be from the US, but with several other continents also represented. Therefore you not only have the differences between insurance policies and government sponsored systems but those who must pay out of pocket. Some rich some not so. It is impossible to get a consensus here about price to be paid for a feature, since there is great disparity regarding who actually pays. Even those with a 20% copayment, would only pay $20 for a $100 feature upgrade.
Most of us here insist on data accessible to us, but many RTs and DMEs rue the patient who fiddles with his own machine. They seem to view it as sacrilegious. The manufacturers regard the DMEs as their customer not the end users. If you could change that one perception it might be the most significant thing you could accomplish.
If you wanted to provide a data viewer that was useful you might incorporate a proctor that would put a large 60"+ image on the wall or ceiling. then we might be able to see meaningful data without going to the computer. Wifi or blue tooth along with an IOS or Android app to view the detail data would be an interesting approach, but contrary to the attitude mentioned above.

Bluetooth sync along with sync from a smart phone/tablet app that syncs with something like health vault.

lindalq wrote:

zoocrewphoto wrote: I think you have a partially incorrect premise. A lot of us get our machine via insurance, and the insurance pays the same for a machine with NO date and a machine WITH data. That meas that if we used insurance to get our machine, we didn't have to pay a higher amount for features. We can simply demand the better machine and get it, or find a differnt place to sell us the machine.

a - already have the data I want. I can't imagine what other data it could possibly collect. So, this question makes no sense to me.
b - nothing. As mentioned above, the insurance pays the standard rate for a cpap machine. I want the best machine in that category. Personally, I believe ALL machines should have data. Bricks should be discontinued.
c - not sure what you mean by sleep pattern. Are you talking about sleep cycles? Seems like that would be a separate piece of equipment. My LCD screen already tells my ahi, sleep time, and leak. What more are you suggesting? Rather than vaguely ask us what we want, why not suggest what is possible and see if we want it.
d - again, insurance pays the same for all machines in the category. If this system is changed, then only rich people would get good machines. It would be better to simply eliminate bricks and make sure that everybody gets a machine with useful data.
e - wireless would be great. Is it worth paying extra to save me from the act of putting the card in the computer. Not unless it is really cheap. Maybe a one time $20 gadget to add to my machine. But honestly, I usually don't pay for things I can do easily myself. I usually only download my data once a month or so. It only takes a few minutes.

Hi,

Thank you for your feedback and for clarifying our misconception.

From our research, we thought that insurance only pay partially the cost, whereas the patients would pay the rest. I guess that's not the case.

From other general surveys, it seems like users want data. But we honestly had no idea what data information patients would want. Others also mentioned how only their physicians have access to those data and they want to be able to view the data themselves. It seems like this is different from your case?

I guess a better topic for us to target would be wireless transfer of data. As opposed to presenting more data or a bigger LCD to present the data.

Regarding wireless transfer of data, it would definitely be a one time cost. We thought this would prevent the monthly procedure of extraction data, as well as prevent accidents such as forgetting the SD in the computer. Please let us know what you think.

Most people who use insurance pay a portion but that portion is usually a percentage. Since the insurance pays the same amount for any cpap machine, then my percentage is also the same for any cpap machine.


Also many machines already have awesome data. It is not promoted to the users but we can get the software for free and download our own data I've been doing this for a year and a half already. I can see graphs with my events (what kind, when, and how long). I can see what my pressure did all night. I can see my breathing, my mask leaks, etc. perhaps you need to see what is already available with Encore, resScan, and sleepyhead.

Some thoughts from a U of T Eng Sci grad who has very recently started using a CPAP because of OSA (my AHI is > 40 without CPAP, less than 1 with)

a) What kind of useful data would you like to see? Response: The data I obtain from my PR system 1 and viewed with Sleepyhead already provides most of the data that I like to use. One item that I would like explored further is the leak rate data. The masks are designed to leak by a certain amount (per cm of H2O back pressure) therefore the sleepyhead software assumes flow rate in excess of the as-designed mask leak are unintentional leaks. What the software doesn't figure out is if the unintentional leak is an unintentional mask leak or mouth breathing. I would like someone to figure out if there is something in the data that can be used to determine which of these types of unintentional leak is taking place, as the fix for each type is different.

b) How much more are you willing to pay for a machine with showing these data? Response: As I'm in Ontario, the government picks up ~$700 and my company benefits pick up the rest. If I were picking up the tab myself, however, I would suggest a sales model where a system with "enhanced data processing" could be up to $200 more. A few enhanced data features would have to be thrown in to make the extra cost worthwhile.

c) What do you think of incorporating a LCD screen that allow you to quickly view your sleep pattern the next morning? Data will still be stored on a SD card that would allow you to analyze long term sleep pattern. Response: CPAPs already have an LCD screen, but they're very small. If you're considering a slightly larger screen, I would suggest adding the AHI "pie chart" that sleepyhead provides, as well as a simplified figure of the nightly breathing trace which shows periods of periodic breathing, apnea events, etc. as "markers" during the night. For APAP machines, a trace of the nightly pressure history would be helpful.

d) How much more are you willing to pay for a machine with feature mentioned in c? Response: I'd include this feature with the aforementioned "enhanced data processing" and increase the machine price by $200.

e) Current CPAP machines store data on a SD card. Would you be interested in having a wireless transfer of data? If so, how much more are you willing to pay for this? Response: I currently have no less than 17 wireless devices on my home network right now (four laptops, one PC, an iMac, three iPhones, two iPods, an iPad, a blackberry, a playstation, a wii, a printer, a canon camera) as well as a two separate bridges and two routers. What's another wireless device? Sure, I'd go for the wireless connection as I currently "sneakernet" the CPAP SD card over to my laptop for processing once a week or so. A wireless CPAP will need to keep the SD card capability, however, to bring historical data to one's respiration therapist for analysis (unless they also go to a fully internet-based data reporting method.) As for how much I'd pay, again I'd toss that in with the $200 enhanced data capability feature.

Some other ideas. I worked out in a spreadsheet the rate of humidifier water consumption based on room temperature, room humidity, humidifier setting, and CPAP flow rate. The latter is greatly impacted by unintentional leaks. As an idea, the CPAP could provide the user with a prediction of the nightly humidifier consumption based on the above and an internal psychrometric chart to avoid waking up in the middle of the night with a dry humidifier and an even drier nose. The system could provide the user with advanced warning that they may run out of humidifier water based on a best guess of the upcoming night's CPAP flow rate based on past leak rate data (the system could provide a "best case" scenario assuming no unintentional leaks and a "worst case" scenario assuming leaks of the size recorded in the past few days.) This would require including a simple thermometer and relative humidity sensor. In dry climates and high mask leak rates, one can easily go through an entire humidifier full of water in 6 hours.

If you want to get in to the mechanical engineering of the CPAP, figure out how to make the machine as silent as possible. If you can get the thing to less than 20 dB, you'll want to patent that, and I'll ask a small percentage of your royalty cheques. Similarly, if you can figure out how to make the built-in mask leaks more diffuse (rather than a jet of air) yet retain the required leak vs. pressure characteristics, you'll make a few CPAP users' spouses' happier. I can't sleep on my right side or I'll blast my wife with a 30 km/h stream of air.

Good luck.

Rustsmith, Thank you for the idea about sleep vs awake. We'll definitely look into this.

Thank you hegel,

So if I can try to unmix my messages, I'll say that I would appreciate a well designed screen built into a cpap unit that displayed the same info that I now get from my Encore download. But since I'm paying out of pocket, and these machines are expensive to begin with, I have to admit that I wouldn't pay much more for this feature.

We'll look into Encore, and figure out if incorporating similar data into the CPAP LCD would be feasible.


robysue, thank you for clarifying the drastic difference in data between Resmed S9 and PR System One.

I still wish I could just click through the LCD each morning for a quick, but thorough "Sleep Quality" report rather than taking the time to download all the data into Sleepy Head each and every morning just because my System One has really lousy LCD data that does NOT give me a decent snapshot of what the night really was like in term of events or leaks.

This did come up in our brainstorming session, but we weren't sure how feasible this was. Glad to see some user support for this. We might just target this one as one of our design changes.


STL Mark, Thank you for providing a benchmark price for us. We will definitely keep the values in mind if we decide to implement full data.


bwexler, Thank you for clarifying the insurance questions, and their discrepancies between different countries.

Most of us here insist on data accessible to us, but many RTs and DMEs rue the patient who fiddles with his own machine. They seem to view it as sacrilegious. The manufacturers regard the DMEs as their customer not the end users. If you could change that one perception it might be the most significant thing you could accomplish.

I guess this might be why some of the people we surveyed emphasized they want data to themselves, not DME's (a few other people also mentioned this on our survey). Thank you for clarifying that. The projector provides an interesting idea as well as your agreement on the wifi/blue tooth to an app.


thank you jbloodwo for your feedback regarding bluetooth sync! We have more people supporting wireless transfer of data now, and we might just target this design change


Thank you zoocrewphoto for following up =D. We'll look into the current softwares you suggested and see what other data can be provided or other features that can be improved on relating to data.


Ontario CPAP, Thank you for your input. We're also in EngSci and this is one of our fourth year design projects.
Thank you for presenting some other ideas for us! Predicting humidifier water usage and advanced warning system regarding the potential of running out of water seems interesting. We didn't know this was a problem. Thank you for bringing it up.
We've thought about using white noise to cover up the noise, but we got mixed response regarding noise since some users identified the noise problem from the machine whereas others identified noise from the mask. Do you have any comment regarding this?
We'll look into slower speed of the mask leaks and see if this would be feasible. thank you for your ideas!

lindalq wrote:Hi everyone,

Just want to get some of your opinion on this. Our fourth year biomedical engineering design project at University of Toronto involves improving on CPAP machines and this is one of the idea we brainstormed. We would definitely love some user feedback on this.

From previous feedbacks on our posts, it seems that data is a high priority for many users. What do you think?
a) What kind of useful data would you like to see?
b) How much more are you willing to pay for a machine with showing these data? (This is used to rank the priority of this idea)
c) What do you think of incorporating a LCD screen that allow you to quickly view your sleep pattern the next morning? Data will still be stored on a SD card that would allow you to analyze long term sleep pattern.
d) How much more are you willing to pay for a machine with feature mentioned in c? (This is used to rank the priority of this idea)
e) Current CPAP machines store data on a SD card. Would you be interested in having a wireless transfer of data? If so, how much more are you willing to pay for this? (This is used to rank the priority of this idea)

Thank you so much for your help!! Much appreciated!!

The sad sad sad usability numbers for CPAP cry out how busted the current SYSTEM is. You are thinking about an air pump - I am thinking about a SYSTEM to meet the needs of the patients who need a cure not a splint.

I need to get to the gym and it is getting late so lets just take some ideas for the first one.

Yes we need the flow data with analysis viewable in drill down detail. Lets add sound (why not, cheap and easy, you could mask the machine noise and get some real detail - some claim able to do some structural analysis from such data). Why not the ability to sense and analyze the carbon dioxide content of the exhaled air?

But since I really believe that the full PSG belongs in the home not the lab (you break basic science by using the lab as it is not the native habitat and the stress of the cost alone along with the one night structure does greatly affect the person being measured and so the results are actually invalid) well lets start with some EKG data. EKG can sense sub clinical events through heart rate variability. You may actually be able to extrapolate that from the SpO2 data which I would also like to see. Frankly rig so the CPAP can be used as part of an in home system to measure full PSG for several days at a time. This would meet the real need. Again, think part of a whole new system. If you make something that actually works the entire world will beat a path to your door.

lindalq wrote:(Any feedback would be awesome since we've been getting mixed feedback regarding this and we would really like to key down a design to help improve CPAP therapy. )

Honestly? In the end we are all responsible for our own treatment.

Take for example a diabetic who records in great detail everything he eats, all his glucose readings, insulin doses etc. He hands that logbook to his physician who then replies "You didn't make that logbook for me, I can't use it. You made it for yourself as your livelihood depends upon it!" Hopefully most doctors would be interested in at least looking at it, but the point is still very clear. We are in charge of our own destiny.

Many of us on this forum seek medical advice regularly, but generally feel responsible for our own treatment. This is the age of the Internet. We have Google, YouTube, Wikki, etc. Many here are tech savvy and understand how to validate the various sources of web-based information we come across. We read, research, ask questions, and learn as much as we can about our issues. We look at our nightly data and make sure our treatment is on track. When we feel changes may be in order, we make them ourselves.

I'm certainly not saying everyone should be dial-winging. Many here have invested quite a bit of time and research and have gained the appropriate knowledge to take charge of their therapy.

And even for those who know nothing about their machine other than how to turn it on or off, a machine that doesn't record performance data greatly hinders their treatment. A doctor can't read what isn't there...

We have a much more vested interest in our health than any doctor could!

Now wireless syncing would be nice, but not earth shattering.

Sleep vs awake, sleep stages, rem cycles, etc would be *VERY VERY* helpful.

Web-based data storage with desktop & mobile apps may be interesting. No need to sync, data always available, doctors could look up data whenever necessary. If so, a one-stop solution would be nice. Incorporate a wrist-oximeter (non-corded such as a CMS-50F) to the xPAP and sync everything up to the cloud...

Better data flagging routines. Process the nightly data and automatically alert the doctor if anything scary or noteworthy shows up such as nasty clusters, periods of CSR, unstable breathing patterns, heart rate spikes, major O2 desats etc..

An optional camera accessory to look back and see what you were doing during the night...?