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

I agree with many of the comments here - especially make the software available - many of us know more about it than the techs.

One area not addressed in this thread is the storage case

(1) Provide a flexible case for a mask, something that can be placed safely in a waist pack or briefcase

(2) Please allow enough room in the cases for the hose, cord, smartcard adapter and a mask. Remember that even as carry ons cases get bumped, dropped, or someone places another object on top. It would be great if there were adequate space and protection (especially for the mask).

(3) Battery cables and batteries - there shouldn't be such a mystery about what can be used with each device and the power cables shouldn't look like clamps left over from someone trying to jump start a car battery.

First of all they are a pain to transport and second they can not be used in flight due to the potential for sparks. How about a nice cable and connector
to use with a battery?

(4) Noise. The ResMed Assist SV is relatively quiet, especially when compared to some of the other machines. Quiet is good.

(5) Mask / hose interfaces should have a 90 degree swivel. Not all masks have that.

(6) Some full face masks desperately need a strap from the center top to go over the head. Supports on some masks appear useless in controlling leaks. More adjustment because one size doesn't fit all.

(7) Add the Pulse Ox to the design without charging hundreds of dollars.
If someone can't make one inexpensively in China by now -- we are doing something wrong.

(8) Here Here to the comments about integrating aussie style heated hoses to the machine. F&P does this - everyone should do this. Waking up with a mask full of water is not helpful, not part of the treatment, and easy to fix -- so designers should do that.

(9) Major manufacturers need end user patient advisory panels, not attitudes that say patients are stupid and need a DME or MD to convey information. We are the ones dealing with this treatment night after night -
not someone who may have never worn a mask with a machine attached.
Not all of us are newbies -- but we all started that way

Lubman

Just like campers, we need battery operation, DC operation, etc. We also need machines and humidifiers that can take the rolling and pitching, and heeling of a sailboat. After all, if I can cook on a gimbaled stove in a rolling seaway with pressurized alcohol, without liquid fuel spilling out of my fuel tank and hose (and causingh a fire!), wy can't xpap humidifiers have the water totally isolated from the xpap macine and surface it rests on?! (I've heard of more than one xpap mishap from spilled humidifier chamber in a bedroom on dry land!) And if I can cook on a gimballed stove that maintains its level in a seaway, and keep my simmering soup from spilling with steel pot holders, and view my electronics mounted on gimballed mounts, wy can't xpap macines have someting available to mount them for my needs? And for all the rest of the SDB boaters in the world?

girlsaylor

PLASTIC ! Look at all the plastic the machines and masks are made of! It is so easy breakable, for example, humidifier of Resmed Escape - drop it, it will brake. Compare with Respironics' humidifier, made of polyethelene, which is much better shock and scratch resistant. Also, look at the masks - well, I have only owned Mirage Quattro, but its plastic is so fragile and cheap, I am sorry, why they make it from such a crappy plastic?

How about being able to TRAIN for mask leaks or the ability to input mask specks??

And have this info show up on printouts!!

BERT

We have different faces, noses, chins, etc. The material mask is made from should be something that would encompass any size/shape of named above. Today, gel is used, but designers should continue with researching for better material and design

The hans rudolph full face mask (new version just came out, but not available here at cpap.com) is made completely of silicone. This mask seems to be designed to try to fit as many face types as possible. It has gotten bad reviews at cpap.com due to its sizing issues. It runs rather larger than most ff masks. It also can be put in the dishwasher to clean.

Despite my inabiltiy to get a seal with all the other ff masks on the market, this one I can get a seal and tolerate for a few hours.

I think designers should be really interested in the design and function of this mask. And users should give it a more fair chance when sizing issues are taken into consideration.

Jen

Dear CPAP Designer,

You have already heard all the best suggestions about the "dream" machine. I'd like to address some other considerations:

• Forgive my skepticism, but it seems like it would be very easy for someone as a designer to come in, make 'promises' for a better machine and then leave without saying "boo." If you're going to engage us, I would like to see some reciprocity. Engage us. We've obviously got the time. We're also very friendly.
• I would like to know what company you are representing or designing for. (I'll understand if you are legally bound not to say, but you can give us a hint.) Update: In fact, it would be great if some of those members who actually work for the companies could reveal themselves and act as envoys for the company as well as patient advocates for the concerns of forum members.
• I would at least like to know this other information:
  1. When do you plan to graduate, and what will be your degree?
  2. What will be the title of your thesis?
  3. In return for our cooperation, I and others who have participated would probably like to see your finished paper, including all design schematics in pdf format. Perhaps even in cad format.
  4. Prior to your thesis completion, I would like to see image mockups of your devices so that we can further comment on them. You want feedback. I think we should take this all the way. It could be at a private website or on a second private forum on cpaptalk.com where we could make revisory comments on your designs.
• In order to design the machine correctly, you are going to have to actually use it, at least for a couple weeks. If you aren't suffering from OSA, buy one or get one from your sponsor and use it. It's the only way you're going to get a feel of what we go through. Try a number of masks over night, and not just the ones made by your sponsor. You might be inspired.
• Items that have been touched on before that I'd like to develop further:
  1. Right now, it's sort of the 'wild west' era of sleep problem medicine. Everyone here has had such a vastly different experience, that there is no way to compare them. There needs to be a more formal method for trundling the walking dead through the system because sometimes we're too damned tired when we start to know what the heck we're doing.
     1. First contact: the GP - distribute brochures that will help them recognize that some people don't 'fit the profile.' Follow up at educational conferences with factual evidence that not all sleep problem patients 'fit the profile.'
     2. Second contact: The sleep doctor - Noone should go through this without actually getting face-time with their sleep doctor. The sleep doctor should give the patient a brochure with information about the procedures, options and expected outcomes, as well as the path most patients take and what to expect along the way. It should include caveats and pitfalls.
     3. Third contact: The sleep study techs on the night(s) of study - They should further explain the steps, options and outcomes as they hook up the patient. The patient should be allowed to test a number of masks, including nasal, full face and hybrid. The mask trial part of the process should not be excluded. Hypo-allergenic water-based contact gel or paste should be used to attach contacts. A shower area should be provided in the morning so patients can wash off the gunk.
     4. Fourth contact: Sleep specialist from the sleep lab. This person calls the patient back with the results of their study and mails it to them after they call. They answer any lingering questions, including what local DME's are available and what to expect from the DME. The patient should be advised to call this specialist if they have any problems with the DME.
     5. Fifth contact: The DME - There seem to be so many problems at this juncture. There needs to be some sort of feed back system either through sleep centers or a reporting agency, like a 'Tell me how I'm driving' number for truckers. It should not be sponsored by the DME companies, but rather by an overarching DME association. All DME's should be required to participate. DME's should be comfortable explaining more than just cleaning the device and masks. DME's should be required to buy the software and be able to explain it to patients who have an interest.
     6. The above letters 'a' through 'e' are only one example path. It's gotten to the point now that much of the preliminary testing can be done using data-gathering equipment at home. There may be better paths for some patients. Regardless, there needs to be a clear explanation from the beginning what to expect.
     7. There needs to be a open and valid path for those without insurance or resources so they may easily acquire a data-capable APAP machine and associated paraphernalia along with guidance on how to use it.
  2. Hardware issues.
     1. Outgassing - All equipment should be guaranteed outgas-free. All cleaning fluids used at sleep centers and DME's should be natural products that do not encourage worse outgassing. You can't sleep if the smell of the equipment itself stinks.
     2. Color - I want color. I want color flow machines, humidifiers, tubes, masks. I want muted colors and flamboyant colors, dark colors and light colors. I want it so that kids can get cartoon characters on theirs - and not just sticky labels. They don't have to be trademarked cartoons - just something lively and smiling that doesn't look something at the side of a sick bed.
     3. Heated Hose - From what I understand, it took a while for insurance to cover humidifiers. Well now that we know they are so important, they shouldn't have gone half way. I want a ten foot heated hose covered by insurance included with my humidifier. I'm tired of getting water dripping out of my mask onto my face or into my nose. Worse, if the water has sat for a while in the folds of the silicone of the mask, the outgassing into the rainout stings your sinuses worse than if it were just plain water. This machine is supposed to help you sleep, but 'water torture' defeats the purpose. I want one cheap, durable enough to last a year and washable, with a thermostatic control.
     4. Jskinner started an excellent thread with a link to the reasons why blue led's are just poor design. The best would be red LED's with a variable knob so you can manually lower them or turn them off at your discretion. The next xPAP designer to create one with blue LED's will likely go to his own special little hell - lit entirely by blue LED's.
     5. I might sleep better with pressure at slightly different settings at different points in the sleep session. While beginning 'ramp' is an attempt at that, I want better time- or event-based control of the pressure settings. For instance, if my pressure should be higher or lower when I'm in REM sleep, I want the machine to ramp slowly into that pressure setting when it detects that I am in REM sleep, and then slowly back out to the normal setting.
     6. I want the option for my xPAP machine to discover when I am in REM sleep and give me an extra user-specified boost of pressure when I've gone over a user-specified number of seconds into an apnea.
     7. Device pressure settings should be easily avialable to the patient, as per other people's suggestions, from the device itself.
     8. For people who want the audio alarms on, they should have a volume control to accomodate both those who are hard-of-hearing, and those who want to just barely hear it.
     9. For those who are hearing-impaired and want an alarm, it might be good to have an under-pillow vibration unit like those found in cell-phones - also with 'volume' control. This could be bluetooth-enabled or wired.
     10. I want temperature-, relative-humidity- and timed control of the humidier and hose heat available at my discretion. For instance, it might be nice to start out with one humidifier setting, then ramp it down or up depending on the current indoor 'weather.'
     11. FOSQ - can anybody reasonably expect people to press those little buttons on that tiny display for thirty questions? I could just see my Dad trying to peer at that little display and fill out those numbers, bleary eyed in the morning. The interface for filling out the questions is not even remotely intuitive. Does anyone really have that kind of time? Hey, I may be obsessive, but this -- this is just ridiculous. It's an ugly way to get data into a card. FOSQ was never even pointed out to me by the DME - probably because they see it as a waste of time too, or maybe they just don't know about it. I had to look it up in the help section of the Encore Pro software. I filled in one directly from the software to see what the questions were. I didn't see anywhere an explanation of how to fill out the questionnaire on the machine, but that's what's expected. No pdf of the questions was included with the software. There's not even a copy in the manual. So I played around with the questionnaire on the machine one morning. Now, every morning when I download my data, I get a copy of the same FOSQ report as a new interaction in my patient homepage. Every day. I've got seven 'interactions' in a row for my 'trial' October 10 FOSQ. (That's a software issue, sure. I'll delete them later.) If you're going to include something like that, add a bigger more legible panel, and actually include the questions on the panel and show the date your inputting the data for. Allow people to review old questionnaires, delete, remove and reset FOSQ tests. Or heck - just leave it off the machine altogether. They're worthless compared to actually viewing the nightly data.
     12. Update: Include an ethernet connection on machine. Include a web-accessible interface for the machine that will allow making changes to the settings. You could take do the FOSQ questions quickly, and edit, delete or reset them easily. Allow us to assign a static IP or use DHCP for the web interface. That way, we could just connect to the webpage from our home intranet using a password of our choice. It could email us our results as a PDF from our own SMTP every morning or once a week, or once a month. It would also allow the machine maker to give users updated, improved and debugged firmware for a machine that otherwise would be old in a couple years. So when someone like Rested Gal comes up with a good idea - like making daily stats easily available from the lcd screen - we can get the fix without worrying about circumventing fda approval - firmware updates are already part of the box.
  3. Data enablement issues.
     1. As others have said - don't even think of creating a low-end machine at isn't data-enabled. Include the software with the machine.
     2. Smart cards are overly proprietary. USB and SD are obviously superior. For discussion below, I'll refer to USB and SD archive devices as 'cards'.
     3. I know I've ranted about this before, but it needs to be said here. There needs to be an industry standard for recording the data. I want a universal industry standard for recording medical data written in XML format that is common among all mobile xPAP, spO2, EKG and EEG devices. The XML should be free of encryption or code-obfuscation of any kind. I want the data in a format that anyone can easily adapt to their own software. It should be independent of physical archive architecture (USB or SD). I want all the data. Cards are now high enough capacity to hold multiple years worth of excrutiatingly detailed data, so the chance of actually writing over old data could be made a thing of the past. Limit the data storage to the capacity of the card, not to a specific set file size. Saving backup data from the card should be as easy as dragging and dropping a file on the desktop of your computer. Restoring the data to a new card if your old card is broken should be similarly easy.
     4. Do not build the archive into a bottom line data-enabled xPAP architecture without a card, expecting people to hook up their xPAP with a usb cable directly from their computer. Who the heck want's to take their machine to their computer every morning or vice versa? Ugh. Please don't do anybody this 'favor.'
     5. The reader software should be free and open source and should work with any device using the industry standard xml format. It should work on any operating system. I'm sure there are more than enough people interested in developing open source software with which to view their data.
     6. It would also be nice to have device settings available from card viewer software as well.

So to sum, the above suggestions and preferences are an attempt to build on what others already excellent suggestions.

Looking forward to hearing more from you CPAP Designer!

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, hose, rainout, Encore Pro, CPAP, DME, Ramp, APAP

TXKajun wrote:Hmmm, this thread seems like deja vu....all over again.

We've already had several requests over the last couple of years for changes/improvements/suggestions for CPAPs, so you might want to do a search of topics to see what we've already covered.

Good luck.

Kajun

Yep ... I think this semester project comes up once a year around this time. I guess the course is only offered every other semester.

DreamDiver wrote:Dear CPAP Designer,

You have already heard all the best suggestions about the "dream" machine. I'd like to address some other considerations:

• Forgive my skepticism, but it seems like it would be very easy for someone as a designer to come in, make 'promises' for a better machine and then leave without saying "boo." If you're going to engage us, I would like to see some reciprocity. Engage us. We've obviously got the time. We're also very friendly.
• I would like to know what company you are representing or designing for. (I'll understand if you are legally bound not to say, but you can give us a hint.) Update: In fact, it would be great if some of those members who actually work for the companies could reveal themselves and act as envoys for the company as well as patient advocates for the concerns of forum members.
• I would at least like to know this other information:
  1. When do you plan to graduate, and what will be your degree?
  2. What will be the title of your thesis?
  3. In return for our cooperation, I and others who have participated would probably like to see your finished paper, including all design schematics in pdf format. Perhaps even in cad format.
  4. Prior to your thesis completion, I would like to see image mockups of your devices so that we can further comment on them. You want feedback. I think we should take this all the way. It could be at a private website or on a second private forum on cpaptalk.com where we could make revisory comments on your designs.

It didn't happen before and I doubt it will this time. He's just a kid and there is no company.

How about including a clock and alarm clock so that I can get rid of mine. I don't have alot of room on my nightstand.

odawa wrote:How about including a clock and alarm clock so that I can get rid of mine. I don't have alot of room on my nightstand.

I like that idea, then I thought mine would be blinking [blink]12:00[/blink] so maybe that wouldn't be so good. I have noticed the time is slightly off on my reports. I wonder if this mod would hurt or help?