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.