CPAP Designer asks: What changes would you like to see made?

dsm · Post by **dsm** » Mon Sep 10, 2007 7:38 pm

My suggestions are going to be in the technical area & some will apply to specific manufacturers so may not apply to your company.

1) Providing access to nightly data through a larger panel (perhaps a 2.5" lcd screen). The data could be represented as numbers & optionally graphs.

2) Provide a version of the software for users. This is a big issue among us here. Any company that caves in to their DMEs etc: to not allow users to use monitoring data will attract a good deal of negative reaction.

3) Switch to allowing USB datasticks as the data capture devices - these are ubiquitous & cheap. If that is too difficult, swap to SD cards or T-Flash (but I would agree that perhaps T-Flash cards are so small, they are likely to be easily dropped & lost).

4) Consider adding SpO2 right into the xPAP unit - sell these as an upmarket feature. Perhaps a variation of the Nonin XPOD SpO2-in-a-cable may be viable as is already used with the Resmed Reslink. Even the Nonin iPOD all-in-one probe/SpO2 could be considered.

5) Consider adding bluetooth to allow the xPAP to communicate with intelligent attachments such as perhaps, a mask with an SpO2 probe built into the forehead rest - if not bluetooth, evan a special cable attachment to an SpO2 probe is acceptable.

6) Work on the motor whine evident in some models (M Series, VPAP III etc: )

7) If Resp - look into why Auto-Trak cannot handle low flow nasal breathing very well. Those of us with nasal congestion are likely to have Ipap to Epap timing problems due to Auto-Trak not getting its leak vs slow breathing right. The older pre Auto-Trak Bipap works very well in switching Ipap to Epap as do the Healthdyne (Resp) BiLevels, the Auto-Trak Bipaps all have difficulties in this area & thus far have not shown signs of improvement.

8 ) If Resmed, provide some adjustment for the user for the EPR risetime - it is just too slow & not as good as what standard BiLevels offer.

9) also consider adding heated hoses - perhaps even a sensor in the hose to detect level of humidity & adjust the temp.

Hope this input finds fertile ground & good luck.

DSM

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Slinky · Post by **Slinky** » Mon Sep 10, 2007 7:45 pm

Forgive me, DSM. But nah, I don't want any graphs on my LCD screen. I learned to read English and numbers in school but not graphs.

If I'm gonna grasp what a graph has to say I need it via the software where I have the TIME to figure it out!

I LOVE Respironics' EncorePro software's Daily Events Per Hour chart and wish Resmed's AutoScan or ResScan offered similar as easy to grasp and understand.

Roadie · Post by **Roadie** » Mon Sep 10, 2007 8:00 pm

I have a Respironics M series, so many of my comments relate to that form factor.

Get rid of the external power supply. I understand that UL testing requires the destruction of several machines, and power supplies that can be used with several machines can save design and manufacturing costs. To that end if you must make the power supply an extra piece, please make it clip in and attach to the main unit while still being "external", much like the main machine attaches to the humidifier. They are two separate pieces, and can be purchased separately, but when combined they really give the appearance of just being one piece.

The AEIOMed machines provide the integrated battery that will take over in the event of a power failure, this is a really good idea. It is unfortunate that the battery enclosures do not stack. This means that to provide long duration backup it is necessary to swap batteries. This seems like no big deal, but it has an impact on charging issues, and what happens when the first battery is drained in the middle of the night. Transportable battery backup with no fuss and several nights duration is a good feature. I would be willing to pay extra for it, it does not need to be inculded with every machine, however every machine should be capable of adding this option.

Provide end users with data access. I just want to be able to view the information in a more detailed way than is available on the small screen on my machine. I don't need to be able to change the pressure.

I use a 10 foot hose with a hose cover, it makes a huge difference in overall comfort. I can turn over and move away from the nightstand if I want to.

Make machine air filters large and easy to replace, the ones on my machine are certainly easy to replace, but frankly I think they are pretty small.

I really like the hose coming out of the back of the machine, I purchased the swivel for a few bucks, it is necessary for hose routing.

Lights don't bother me, but for those who are bothered by them, would it be that hard to put the buttons behind a door like the screen is. I usually auto start, and auto stop the machine so I don't usually touch the power button, and I don't use the ramp or change the comfort setting.

Speaking of comfort settings, include them. My pressure is only 7 and I find the A-Flex, and C-Flex to make a difference for me. This is the primary reason I got the Respironics machine rather than the AEIOMed one.

I have said that I don't use the ramp feature, but make it more flexible to adjust. I can set a start pressure, but am limited to 5 minute time increments, why not one minute increments or a curve of pressure over time rather than a linear progression.

Make the machines as small as possible. Sure I travel so size is a factor, but even at home I have limited space on my nightstand. smaller is always going to be better for the overall machine size. Make the display screen as large as possible. A touch screen like I have on my Treo would be a good size. If my machine had a high quality, backlit, color screen like my phone and gave me all sorts of data I would not need software for my personal computer, I could simply view all of the important info right on the machine. The screen and information on my machine is, well, poor; and I am being very polite. With a good touch screen you could get rid of several buttons, think iPhone.

Humidifiers should be easy to use, my only complaint is that some of them have a history of leaking, more intelligent design can combat this problem. The M Series chambers have a history of leaking, is it really that difficult to design a large chamber that does not need to open below the full level. My solution is simply to not fill the chamber above the seam, so at least direct fluid leakage is not an issue, but this limits the amount of water available every night.

Generally designs should be unobtrusive, and bland enough to fit almost any decor. Some manufacturers seem to want their machines to look like they just came out of a Star Trek episode, heck, just give it a flat top and let me set a book on it.

I have rambled on a bit, if you want more information from me feel free to send me a PM. I would be happy to get even more specific than I have already.

Roadie

dsm · Post by **dsm** » Mon Sep 10, 2007 8:49 pm

[quote="Slinky"]Forgive me, DSM. But nah, I don't want any graphs on my LCD screen. I learned to read English and numbers in school but not graphs.

If I'm gonna grasp what a graph has to say I need it via the software where I have the TIME to figure it out!

I LOVE Respironics' EncorePro software's Daily Events Per Hour chart and wish Resmed's AutoScan or ResScan offered similar as easy to grasp and understand.

Slinky · Post by **Slinky** » Mon Sep 10, 2007 8:56 pm

Now you ARE getting greedy, Doug!!!!! If wishes were horses ...

Let's face it, we all want an AutoPAP the size of a cell phone or iPOD with similar brains and capabilities to go w/it. In our lifetimes.

And masks that perfectly, but just barely cover our snozzes and mouth we can just whip out and stick on our face, no headgear, no straps, just stick them on our face to sleep and pull them off in the morning w/no sore or red skin.

Guest · Post by **Guest** » Mon Sep 10, 2007 9:25 pm

Have insurance companies provide and cover parts for masks when needed (or with a reasonable internval). It is not cost effective to get a new mask if you only need a part. I think that contributes to the high cost for insurance premiums, it s a waste.

Bookbear · Post by **Bookbear** » Mon Sep 10, 2007 9:47 pm

So many good ideas already. I'd just tike to echo a couple:

Mask PARTS available, to get around the need to buy a whole mask if only a part is broken/worn

Lights bother people it seems, but others want to be able to see buttons in the night. Provide a rheostat (thumbwheel or even a screw adjustment) to raise or lower light level on the controls

SOFTWARE!! legally and easily available for patients who want to monitor their treatment

Do not produce machines that are not fully data capable. Even your low-end, baseline machine should be fully data capable. There simply is no excuse to make a machine that cannot tell the doctor or patient how the patient is doing

My 57 cents worth.....

birdshell · Post by **birdshell** » Mon Sep 10, 2007 9:57 pm

Yes, there have been other threads in just the past year and a half that address this issue. I wrote a posting with many ideas for at least one, if not more. Below I have listed one from a developer, and others concerning mask and machine design.

Input on Designing a Sleep Lab

Have a Say in Innovation

Seal Leaking Masks

Don’t You Wish it was Cordless?

Why Hard Plastic Masks?

Secret Mask Look-A-Like

How long do you try out a new mask before you give up on it?

Chin Straps

Ruby Chin Strap

Noise Problems with Machines

A mask for a wild sleeper

My new used Liberty

Full Face Mask Users, Need Opinions

Here is a new suggestion:

xPAP equipment has been forumlated to be 100% latex free, and silicone has largely replaced the rubber. Couldn't there be versions of masks, or even some certain masks, made WITH latex/rubber? What should those who are sensitive to silicone do to continue therapy if ALL masks are silicone?

A partial answer might be SOME LABELING THAT SHOWS WHAT TYPE OF SILICONE AND PLASTICIZERS HAVE BEEN USED. I have been told by a couple of sources that plasticizers may be the most likely problem.

CPAP toxic off-gas

Silicone, Hybrid, Nasal Pillows, Pantyhose and Sweaty Chin!

Now, the challenge will be to design the BEST mask and BEST machine.

Then we can all just answer with those two whenever a newbie asks us...what is the BEST mask? Machine?

BTW, we keep helping out and then never hear anything about the results. If we have a personal connection to the latest and greatest mask/machine, wouldn't it make sense that we may be more likely to buy one...IF we know about that connection?

Besides, I think that hoses attached to one's head instill curiosity--or is it just that the sleep debt is being paid off so the curious thinking returns?

And, just one more suggestion:

Bookbear · Post by **Bookbear** » Mon Sep 10, 2007 10:10 pm

birdshell wrote:
BTW, we keep helping out and then never hear anything about the results. If we have a personal connection to the latest and greatest mask/machine, wouldn't it make sense that we may be more likely to buy one...IF we know about that connection?

AMEN!

Snoredog · Post by **Snoredog** » Tue Sep 11, 2007 12:41 am

1. Don't use the STUPID Blue LED's, make a way to disable them if wanted via software programming.

2. Take one of those LED's and put it under the LCD display so it is back-lit.

3. Bring the air output out the FRONT of the machine so you don't have to use a stupid swivel elbow to attach a hose that you no longer supply.

4. Design the humidifier so it sits UNDER the machine and has a smaller footprint

5. Add a real-time CLOCK chip so you can set the date/time on the machine.

6. Get RID of that STUPID SmartCard, use a STANDARD USB "B" connector so you can connect it to a PC or plug in a Pen drive or use a STANDARD SD card and dump the data in html/XML/text format so NO special software is needed to dump data or use of a specialized card reader. Even a cheap HP Inkjet comes with a SD card slot.

7. Make the thing display separate AI, HI, pressure, and leak data, try and make it reliable and accurate, if you can't do that, farm it out to someone who can.

SleeplessinCLE · Post by **SleeplessinCLE** » Tue Sep 11, 2007 5:37 am

Why not design a machine that uses the little oxygen cannulas? Then there's no fitting of masks, no bruising, no headgear, and we'd be able to read, talk, watch t.v., and roll over.

Regulate the sleep labs. I did not even see the sleep doc! Everyone's experience with the labs has been so vastly different. That shouldn't be.

Make the machine smaller. We have the technology, why not use it?

Give advice as to which machine is best for each patient's individual care and let the patient decide which one to take home to try. The machines and masks should be loanable, like a library book, until you find one that works.

Have techs on hand to answer questions. At my sleep lab, I was only able to talk to a tech AFTER 11 p.m. That's not so good.

Allow people to have more control over the programming etc. We're all big people, we should be able to change the settings easily.

mindy · Post by **mindy** » Tue Sep 11, 2007 5:43 am

CPAPDesigner wrote:I am affiliated with a manufacturer of CPAP machines and equipment.

I'm not sure what you mean by "affiliated" - could be lots of things! In hopes that you're not putting us on....

My biggest item on the wish list is some truly innovative mask designs, new materials?, etc. Most of the problems I've seen have to do with the masks - comfort, leaks, awkward, etc.

Second biggest: consistent software providing us with enough info to manage our own sleep apnea in conjunction with our sleep docs. I don't want to mess around with settings when I don't really know what I'm doing but I do think we can be partners in this.

It seems like the machines themselves are generally good.

Mindy

GreenIce · Post by **GreenIce** » Tue Sep 11, 2007 6:05 am

1) Bundle software with xPAP, most user will need it any way. OS friendly too, supports for Windows, OS X and Linux.

2) Use standard memory card or USB thumb drive.

3) Less noise from the xPAP.

4) Make LCD slanted, the user can look from the bedside. LCD with lights that will dims (sleeps) or off after 10 minutes or so.

5) Alarm clock would be nice.

6) xPAP should be small and light for traveling.

Bert_Mathews · Post by **Bert_Mathews** » Tue Sep 11, 2007 6:13 am

Snoredog wrote:1. Don't use the STUPID Blue LED's, make a way to disable them if wanted via software programming.

2. Take one of those LED's and put it under the LCD display so it is back-lit.

3. Bring the air output out the FRONT of the machine so you don't have to use a stupid swivel elbow to attach a hose that you no longer supply.

4. Design the humidifier so it sits UNDER the machine and has a smaller footprint

5. Add a real-time CLOCK chip so you can set the date/time on the machine.

6. Get RID of that STUPID SmartCard, use a STANDARD USB "B" connector so you can connect it to a PC or plug in a Pen drive or use a STANDARD SD card and dump the data in html/XML/text format so NO special software is needed to dump data or use of a specialized card reader. Even a cheap HP Inkjet comes with a SD card slot.

7. Make the thing display separate AI, HI, pressure, and leak data, try and make it reliable and accurate, if you can't do that, farm it out to someone who can.

I agree with almost ALL the post so far -but- Snoredog #4 "Humidifier" is a BIG one I know everybody has seen the lamps that produce FOG This could be incorporated into the system being low voltage -- with a water level switch for auto shutoff and a easy external fill point to prevent possible internal electronic damage!
----------- USB --- Memory is cheep KEEP ALL data so comparison to older data or different mask can be compared???? It's a pain making printouts and checking different changes in equipment or settings.... this should be easy and built in to the equipment or software --- As a builder YOU don't need to be making big bucks on software so make the "OUTPUT" in dBase or Importable in most spreadsheet software,,,,,,,,,,,,,,, THANKX
Bert

greyhound · Post by **greyhound** » Tue Sep 11, 2007 10:48 am

I'll second the need for reasonably priced software available directly to users. The best machine is of only limited use if users can't see their detailed results. And don't tell me that a "well trained" DME is a required intermediary.

With respect to features, I'd like to see more manufacturers incorporate exhalation relief (in Auto mode, not just CPAP mode) into their machines.

Humidifier

Additional Comments: CozyHoze Boss™ -- Regenesis™ Pillow -- CPAP Desensitization aromatics..SleepyHead Software

Machine	Mask

Additional Comments: Avg. AHI .4

Machine	Mask

Additional Comments: Avg. AHI .4

CPAP Designer asks: What changes would you like to see made?

Re: CPAP Designer asks: What changes would you like to see m