CPAP compressed air path design, foam, filtration & maintenance

[MaNoise]

The importance of good design of CPAP machines is critical to user health. Relying on manufacturers to lead design doesn’t seem to be working, they all have some kind of foam in the air pathway, filtration is not ideal with any..

Has there been any organized pushes by users / patients to influence healthier design of these devices? Either directly with manufacturers or thru government regulators around the globe?

Machine design seems too profit oriented.

I think it’s a good idea to reduce plastic that is heated and reduce the potential off gassing exposure for a home machine. I don’t travel often, I want a tank for a home machine that will last and is healthy. If I need a frequent air travel machine I would prefer to buy one for that (even tho expensive).

This is my list of preferred design changes for a home machine, would you add or remove from the list?


1. Provide air intake filter adapter for either 3M or Honeywell North respirator N95 or P100 filters.
2. Seal the air pathway from inlet filter to blower intake (basically HEPA quality).
3. Make it easier to clean air pathway once a year.
4. Remove all foam from therapy air pathway.
5. Make humidifier water chamber out of stainless steel with easy access design lid.


User conveniences:
6. Make remote capabilities optional external addition to main machine.
7. Require ability for offline home software to review sleep data, let patient manage encryption of data if they want.

Thoughts, comments?

[srlevine1]

Most major manufacturers do not listen or respond to patients as they consider prescribers and DMEs their primary customers. While they may accept feature or design suggestions, it is usually a one-way communication as they fear lawsuits from individuals who may claim their ideas have been stolen.

As for group input, it takes time and money to lobby government entities such as the FDA to affect rules and regulations.

Since it takes a considerable amount of effort and compliance testing by a manufacturer to get FDA approval, most changes are incremental and cosmetic.

As for your design changes, consider the amount of money generated by consumables and replacement parts such as water chambers. Also, filters affect air impedance values and might require algorithmic changes to maintain effective therapy levels.

Data is mostly encrypted to maintain a proprietary platform more than security. Why would a user want to deal with encryption?
Offline software already exists -- see OSCAR.

[Frankiboy]

I don't want any larger or different filters, the devices are getting bigger and that wouldn't be good. The existing ones are sufficient and should only be replaced regularly, that's quite enough. I don't breathe filtered during the day either.

Of your suggestions, I could only agree with the foam, because there really is another way.

[MaNoise]

Fair points, the patient is the one handing over the cash. The more people that insist on change the better odds of change happening.

I think email campaigns and petitions can and do have impact on politicians to support change. Setting up a website to host a mailto email campaign is reasonably easy & cost effective to do.

Most likely DME’s won’t be supportive of changes that reduces purchasing of consumables.

Europe seems most engaged with consumer protections with right to repair & the usb standard. Unlikely Canada would adopt these kinds of laws. I think it is possible to influence standards for CPAP manufacturers tho in Canada with organized customer support.
Cheers

[MaNoise]

Hi Frankiboy,
I get it, a lot of people are going to be happy with the filtration that exists today. Some are not happy. With the increase of forest fire smoke globally and more people with allergies / lung issues, people might want the option to use a non-CPAP manufacturer filter with better filtration capabilities.

CPAP manufacturers could easily add a threaded & o-ring sealed connection where the air intake is for people who want to choose after market filters. In my opinion, an industry standardized option is needed vs a manufacturer by manufacturer option.

Better inlet filtration keeps the insides cleaner & they can last longer.

[MaNoise]

Re. Encryption, I thought one of the new models coming out encrypts the sleep data and users cannot download it for Oscar. If manufacturers start encrypting the data for wireless transmission it would make sense, but if it locks out the patient from the data on the card that is bad. Maybe I came across incorrect information.

Patient managed encryption puts the patient in control, gives patients agency of their data if they want it. How the encryption keys are managed to allow DME’s and manufacture access would matter.

[Sleeprider]

MaNoise, when the Dreamstation 2 was released, we found the data was encrypted. This appears to have been done to require users to consult with doctors and suppliers equipped with "official" Philips software. The encryption specifically made the devices incompatible with Oscar. It was clear to us this was part of a larger business plan, and Apnea Board issues an Action Alert https://www.apneaboard.com/forums/Thread...encryption Read that and draw your own conclusions, but in the end the encryption was broken and data is available to users. Philips' problems with product quality, recalls and discontinuation of sales in the U.S. was a huge dose of Karma.

[MaNoise]

Appreciate the detailed info Sleeprider! Good the encryption was resolved. Patients should have some agency of their health data.
For sure the Karma for Philips is warranted. A lot of people still using the machines thru warranty replacement. Interesting Philips left the USA, but still selling in other countries.

DME’s pushing Philips thru the incentive program didn’t help matters.

Would be great if better CPAP design standards were created after this recall.

[srlevine1]

Standardization of design specifications is the road to commoditization and the road to reduced innovation. Should you want a cheaper option, you need only explore Chinese knock-offs. The secret sauce would be the response algorithm and clinical evidence of effectiveness and efficacy.

As for email campaigns directed to politicians, they are not that effective unless the target is well-defined, and there is existing actionable legislation with respected sponsors and co-sponsors. If you want to experiment, make a case and post a petition on change.org. It’s free and a test of “resonance.” Then post the link in the forum where most people have a subject-matter interest. Can’t hurt.

I used to use inline filters with my ResMed S8 and they were somewhat problematical in a pollen-rich environment or if they were exposed to moisture. Most of the non-hypoallergenic filters are crap and seem to be getting worse.

[BoxcarPete]

Adding a feature on the air inlet for "an aftermarket filter" is a neat idea, but it's a seriously non-trivial task for a manufacturer. What kind of filter interface would they target? What's the carrot for the filter manufacturers? CPAPs are getting more common, but as Frankiboy pointed out there is far from a universal desire among users to engage in strict filtration protocols for their machine.

Then, as srlevine pointed out, it's not a great idea to influence the airstream if it can be avoided. If you're hanging a filter off the outside of the machine, it has a pressure drop across it. I'm not sure where various manufacturers are putting their pressure transducers, but if they're one apiece on opposing sides of the blower motor, the flow rate will directly affect the inlet pressure in an unintended way, and this will directly cause a loss of mask pressure. They might account for this by avoiding the inlet as atmospheric pressure reading, but if a change like that is needed, again it requires non-trivial design alteration, as now that particular portion of the outer body of the machine is more susceptible to harm and needs to be protected.

It's a neat idea, but in my opinion it's a bit of an uphill battle towards a dead end. Better off sourcing a nice in-room air purifier and placing your CPAP near the outlet of your HEPA unit.