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A more livable sleep apnea solution

By | May 20, 2010, 8:52 AM PDT

Many years ago I agreed to attend a trade show with a friend whom, while I did not know it at the time, suffered from sleep apnea.

When we arrived at our hotel room he unloaded his gear, which included a breathing system that ran throughout the night, filling the room with sound. He got a good night’s sleep. I didn’t. What must his wife’s life be like, I thought.

Ignoring the condition, I learned later, is not an option. Sleep is interrupted, you’re tired all day, it’s bad news.

My friend was taking the standard treatment, called Continuous Positive Airway Pressure, or CPAP. The device pushes pressurized air down the throat during sleep, so apnea won’t occur. But as I said, it’s noisy.

The device to the right, the ResMed S9, is the latest weapon in the fight against sleep apnea. It has a SIM card in it, which sends regular reports via SMS to a doctor or clinic about how the patient is sleeping. Continuous monitoring not only makes patients more compliant, it minimizes the intervention they need.

Getting a detailed diagnosis and treatment plan through a sleep center can be a real pain. You’re placed in a strange room and closely monitored all night. I can’t sleep that way.

With devices like the S9, this monitoring is extended into the home, it’s made continuous, and once you’re diagnosed you’re not only protected but evaluated. Knowing precisely how, when and why your sleep is interrupted by breathing troubles helps your family sleep better at night, too.

I hope my friend gets one of these soon.

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Dana Blankenhorn

About Dana Blankenhorn

Dana Blankenhorn was a contributing editor for SmartPlanet from 2009 to 2010.

Dana Blankenhorn

Dana Blankenhorn

Contributing Editor, Healthcare

Dana Blankenhorn has written for the Chicago Tribune, Advertising Age's "NetMarketing" supplement and founded the Interactive Age Daily for CMP Media. He holds degrees from Rice and Northwestern universities. He is based in Atlanta.

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Dana Blankenhorn

Dana Blankenhorn

Dana Blankenhorn has been a technology reporter since 1982, a business reporter since 1978, and a writer for as long as he can remember. His Schwab IRA has a few tech stocks in it, most notably some Intel and Applied Materials bought over 10 years ago. But the vast majority of his tiny fortune (emphasis on the word tiny) is invested in mutual funds. He presently writes for no one else but ZDNet, SmartPlanet and himself. But if you've got an opportunity let him know. If he takes the gig he"ll first add it to this disclosure page.

He writes for SmartPlanet and is not an employee of CBS.

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0 Votes
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RE: A more livable sleep apnea solution
I think the main result of using one of these is for the physician to
decide whether to prescribe you one of the breathing devices to
which you refer above, or a dental appliance, or surgery.

It's not a better solution, just a better way of diagnosing .. which of
course in and of itself is helpful.
Posted by JWife
20th May 2010
0 Votes
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Wrong again...
This is only a diagnosis device, not a treatment device. It doesn't replace a CPAP. Modern CPAPs are extremely quiet.
Posted by Narg
20th May 2010
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well.... kinda
I seldom find nits to pick with you, Dana... but this time I must.

You mentioned that your experience was "... many years ago...". A newer reference point might help; technology does move along.

My CPAP is a few years old. Simply running, there is some air noise from the face mask. Once the mask is in place, any air flow noise disappears. There is no noise whatsoever from the device itself.

On the other hand, I'm happy that it is not a necessity for you. Yet.
Posted by semi-adult
20th May 2010
0 Votes
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No sleep apnea, my wife just plain snores.
Unfortunately, she rumbles loud enough to vibrate the bed. And not the 50 cent motel version either. Were it continuous, I might be able to adjust; but it's intermittent, and non-regular interval.

Sleeping on the downstairs couch for now. I'll be glad when my boys go off to college in the fall and I can steal one of their beds for a decent night's sleep.
Posted by Dr_Zinj
20th May 2010
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RE: A more livable sleep apnea solution
Are you regurgitating someone's press release?

I have had a CPAP for several years now, and it is very quiet.

What the model that is the subject of this article does, is to collect usage information, and forward it to a treating physician via a cell phone.

BFD!!!

The model* that I have has a place for a SIM card that can be sent in with the collected data; or I could connect a cable between a port on it and a PC to send those reports electronically.

This is old news.

------
* Respironics BIPAP S/T
Posted by fatman65535
20th May 2010
0 Votes
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The continuing data is valuable
So is the ability to collect real-time data from someone who is
sleeping in their own bed. It's much better than what you get in a
clinic.
Posted by DanaBlankenhorn
20th May 2010
0 Votes
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RE: A more livable sleep apnea solution
The "news" here is the fact that it uses a SIM card and updates your sleep pattern/pressure requirements to the doctor in real time. Otherwise, my curent CPAP has fluid bearings and it is very quiet. It has a data card that I can take to/mail to a local office to have the data sent to my doctor in another city to see if I may need a pressure adjustment. Contrary to the comments made above, The CPAP referenced in the article is not simply a titration (diagnostic) tool but a constant use CPAP that has a more convenient method of updating data with your doctor.

With my old (very noisy) CPAP, I would have to borrow a titration CPAP that could record data to check my settings periodically.
Posted by brucelparsons@...
20th May 2010
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RE: A more livable sleep apnea solution
My wife and I both use CPAP machines and unless you check to see if there is airflow, you would not know they are running. They are so quiet.


JJF
Posted by furjar@...
20th May 2010
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RE: A more livable sleep apnea solution
I followed the link to the S9 and read the info on it.
It is a full CPAP machine along with the communication and monitoring features.
It has an optional humidifier and "slimline" tube and everything you need for CPAP.
Posted by seamorob
21st May 2010
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RE: A more livable sleep apnea solution
My wife made me do a sleep study, they found I had sleep apnea giving me a CPAP. I found it unlivable, uncomfortable and noisy. I went to a Doctor and found out I had a deviated septum. Once that was corrected through outpatient surgery I stopped using the CPAP and sleep much better. CPAP may work for some but not me. Sleep Apnea is not fun but there are options other than CPAP.
Posted by geoff@...
21st May 2010
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RE: A more livable sleep apnea solution
My wife uses a CPAP machine and the machine is very quiet, at least to my no longer great hearing. What is very noisy is the mask. If, for whatever reason, the mask begins to leak, the machine goes into a frenzy. I assume that it is designed and set up to maintain a minimum back pressure and when and if the mask is slightly dislodged it pumps more and more air in order to accomplish that. The consequence is very loud whistling and shrieking noises and at times enough of a "wind" that it tousles what remains of my hair. My wife sleeps through it all. This does not happen every night but it does happen often enough that my sleep is seriously disturbed. When it lasts long enough I get up and sleep elsewhere. Complaints to the provider are met by shrugs. It does not awaken the "patient" so what is your problem? I beegin to wonder how many times CPAP machines have been named coresponents in divorce cases.
Posted by canuck31
21st May 2010
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ResMed Falls Short
ResMed is offering a great machine in their SP model. Where they are falling short is the failure to make the software for this model available to patients. Other CPAP manufactucturers do have optional patient software.

I will stay away from ResMed machines and continue to use one of the other brands and the optional software. Every morning I can download the card and get reports including minute-by-minute graphs of how I breathed throughout the night. The graphs show on a time line every apnea, hypopnea, and snore and any mask leaks and any changes in pressure.

It is very difficult for a sleep lab to get optimal pressure and other settings in a one-night stay. The patient is sleeping in a strange environment, hooked up to many devices and often using CPAP for the first time. The patient is often under stress from this and it is rare that a patient will sleep like he does at home. The patient has yet to learn how to sleep with the mask and how to prevent mask leaks.

With the software, the motivated patient can monitor his therapy daily and know every morning if something went wrong and with a little self-education he can make adjustments to improve the therapy. The doctors do not understand the machines well (unless they are also CPAP patients) and do not have the time to adjust all the patients machines and give each patient the attention needed to get an optimal therapy. And the doctors certainly do not understand the masks, how to sleep with them and how to prevent them from leaking.

I never want my data sent to my doctor. When I have a followup appointment with my doctor, I bring hard copies of some reports and graphs and expalin to her how my therapy is and what changes I have made to optimize my therapy. She is always interested, likes to keep the copies in my file and says, "Keep doing the good work and call me if something comes up that you can't handle."

ResMed needs to look at the diabetes model. How ridiculous would it be if a doctor said here is a glucose meter that you should use every day and transmit the results to me and I will tell you how to adjust your diet and insulin or other medication? That would be ridiculous of course.

A CPAP patient should go home with starting settings prescribed from the doctor. Then with just a little bit of education and patient software for the CPAP machine, the patient can monitor his data over several nights or even weeks and adjust settings until he achieves an optimal pressure. This is what I did and proved to my doctor that the settings they prescribed from two nights in certified sleep labs were far from optimal - in fact the machine hardly reduced my deadly apnea condition. Nothing against the labs - they just have their limitations because of the problems mentioned in the preceeding paragraph.

There is a basic rule of process improvement that says, "If you want to improve something, then measure it." CPAP is a process. To improve it the person operating the process (= the patient) needs to see the data to see what went wrong and to know if the changes he makes is improving the process.

Manufacturing plants typically have charts of quality and productivity posted around the plant. Management likes to see them but their great value lies in the workers reading them - it tells them what went wrong and what went right and they then know what to work on. It is no different with CPAP patients - they need the data to optimize their therapy.

Shame on ResMed for not offering the software to patients and shame on the doctors who are afraid of letting control of patient health be the responsibility of the patient.

BTW Dana, the first inexpensive basic machine I used five years ago was as quiet as the S9, which means very quiet.

Sincerely,

R.
Posted by Banyon
21st May 2010
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