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Respironics, ResMed and Fisher & Paykel

Here at SleepGuide, ResMed and Respironics have always loomed large as the big boys of the Sleep Apnea industry. Bad news for us, the patients, because that kind of duopoly can't be good for competition and innovation, the two forces we see as critical to moving these devices forward in terms of ease of use and comfort for patients. So we were delighted to see that Fisher & Paykel, a longtime participant in the Sleep Apnea device market, but, in our view, something of an ugly stepchild to Respironics and ResMed, has quietly and without much fanfare brought to market a device that might very well embody the most innovative steps forward yet. The Fisher & Paykel Sleepstyle 200 Auto Series HC254 was cleared by the FDA to go to market in September 2008 (clearance attached below). The machine has many nice bells and whistles, with two standing out as particularly innovative:

SensAwake Technology
Just like Santa, this machine knows when you are sleeping, and knows when you're awake. The result: no need to be good for goodness sake and just "take" the high pressure other machines will dish out during your wakeful states. Pressure is not needed when you're awake, and can prevent some people from getting to sleep. This machine's algorithm detects the kind of breathing you do when you're awake and reduces the delivered pressure to its lowest, most comfortable level at this time. Similarly, the machine's algorithm detects the kind of breathing you do when you're asleep, and increases the pressure accordingly. Other machines try to solve for the discomfort of delivering high pressure while awake by providing a "ramp" feature that requires the user to push a button to have the pressure gradually ramp up. But that is a more crude solution than Fisher & Paykel's SensAwake technology which does the work for you, and keeps the pressure where it needs to be until it "knows" you're asleep. The last thing we need is something else to worry about and fumble with while we're trying to get some shut eye.

SmartStick Technology
Like many ResMed and Respironics machines, the HC254 is data-capable and records therapy effectiveness, including duration of use, AHI, leak and pressure. Unlike most ResMed and Respironics machines, however, the HC254 records this data onto a "SmartStick" at the rear of the device that can be removed and plugged into any other computer through that computer's USB port. Most ResMed and Respironics machines record data onto a smart card of some sort that requires the purchase not only of additional software, but also of a card reader compatible with the particular brand of smart card ResMed and Respironics have developed. The result is that users have to go through unnatural acts to actually access their detailed usage data (i.e., data not available through the display screens on the devices themselves). Unfortunately, even though in theory USB technology makes access to the data easier, as of the date of this publication, Fisher & Paykel seems to restrict the sale of the PerformanceMaximizer software for the HC254 to clinicians, which means patients will get the shaft, as usual, in terms of being able to access their detailed compliance data. We at SleepGuide may be mistaken on this one, and welcome any of our users, or F&P themselves, providing a link to a vendor of this software that will sell us the software.

Conclusion
We will continue to keep an eye on Fisher & Paykel as it brings to market devices for treatment of Sleep Apnea that give us patients innovative alternatives to the products being put out by the big boys, ResMed and Respironics.

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Comment by Dianne on September 18, 2010 at 11:50am
Yes , SensAwake is awesome. You don't need pressure relief on every exhalation, just when you are awakening so there is no discomfort. The patient can see their AHI, Leak, from the previous night on the display screen if they like as well as compliance.
The software is for every nights detailed data as the others.
Comment by Judy on August 9, 2009 at 9:35pm
Let's not forget DeVilBiss. They've been around awhile and they recently introduced the DeVilBiss IntelliPAP AutoAdjust. cpap.com in conjunction w/DeVilBiss recently held a "product challenge" wherein 30 Respironics M Series Auto w/A-Flex users were provided w/a DeVilBiss IntelliPAP AutoAdjust for a month long review and comparison. Participants were required to fill out a detailed survey about both products. The IntelliPAP AutoAdjust received 4.9 out of 5 stars and was noted to be the quietest. The Respironics M Series Auto w/A-Flex received 4.8 out of 5 stars and was noted for its easy breathing A-Flex.

I recently visited the Mayo Clinic (Rochester) CPAP Shop and they are currently favoring the Resmed over the Respironics devices.

The Puritan Bennett GoodKnight 420E has long had its admirers, the Sandman PSG software is one of the more popular PSG softwares and Covidien/Puritan Bennettrecently released the Sandman Auto that looks to be every bit as popular w/its users as the 420E has been.
Comment by Banyon on August 9, 2009 at 6:03pm
Bump.
Comment by Judy on March 21, 2009 at 5:04pm
Great article, Mike. It is too bad that the FDA prevents or makes very difficult, patient access to their xPAP therapy data.Kudos to the manufacturers for developing fully data capable devices, thumbs down to the FDA and the American medical community for keeping that data from us or making it difficult for us to access it. Unfortunately, North America and especially the USA is the LARGEST xPAP market and thus force the manufacturers to kowtow to the FDA w/stumbling blocks for patients to access their data, stumbling blocks that do NOT exist in countries outside of North America.
Comment by Mike on December 28, 2008 at 1:13pm
Good point.
Comment by Rock Conner RRT on December 28, 2008 at 10:36am
Puritan Bennett has also been a substantial presence in the CPAP market for many years.
Comment by Mike on December 27, 2008 at 4:52pm
Here's the FDA market clearance.HC254.pdf

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