Boosted by launches from Philips and ResMed, the market for small positive airway pressure devices has never been bigger.
Patients with obstructive sleep apnea (OSA) who are prescribed a CPAP machine are instructed to use it every night. But that means lugging the device and its accouterments on every overnight trip—no small consideration given the shrinking space for airplane carry-on luggage. Enter the travel-friendly CPAP. While some, like Human Design Medical’s Z1, have been on the market for years, new options from Philips and ResMed have recently expanded the portables market.
“According to the U.S. Bureau of Transportation, in May 2016—just one month—there were 63 million domestic travelers going through US airports,” says Laura Jennings, product manager of ResMed’s AirMini. “Since we know that roughly one-quarter of US adults have sleep apnea, that’s about 16 million people each month who can benefit from a CPAP that’s easy to pack and use while traveling.”
Jennings says that about two-thirds of CPAP users surveyed by the company cited size as the reason for leaving their machine at home. The AirMini can be held easily in one hand.
There is some debate over the consequences of a few nights away from CPAP therapy. In one study, patients who had heart attacks at night were six times more likely to also have obstructive sleep apnea than those whose heart attacks happened during the day.1 Anecdotally, skipping CPAP therapy has been linked to the sudden deaths of Supreme Court justice Antonin Scalia and football player Reggie White.
Mark D’Angelo, sleep therapy business leader at Philips, says the company’s DreamStation Go offers “the exact same clinically proven therapy as the patient’s device at home.” D’Angelo says Philips chose to enter the travel CPAP market after extensive market research for optimal design.
“Anyone with proper backing can encase a miniature blower in plastic and deliver CPAP. The challenge becomes acceptance of the therapy being delivered,” he says. “You can make a tiny CPAP, but if users (or their bed partners) can’t tolerate the noise or feel of the therapy, all you’ve done is disappoint your end consumer. The art is finding the right balance of size, performance, and convenience.”
While Philips’ and ResMed’s additions could be seen as competition for the portable CPAPs already on the market, company spokespeople assure Sleep Review that a rising tide lifts all boats.
“We welcome the marketing help in educating the market to the options of travel devices,” says Wendy Frazer of Human Design Medical (HDM). “Most patients have no idea there is an option. Because of our size, unlimited mask options, programmability, and price point, we believe we will do very, very well.” Sales of HDM’s Z1 Auto have been on an upswing since the other products launched earlier this year, Frazer adds.
Shrinking a CPAP provides a technical challenge. The internal blower must be smaller than that in a conventional machine, but just as powerful. That means the blower spins faster and produces a different, and sometimes louder, sound.
“When you reduce the size of the CPAP, you reduce your volume of dead space available to muffle the noise generated by a CPAP motor,” says Allison Bordewick, marketing manager at Somnetics International Inc, maker of the Transcend portable CPAP and a player in the travel CPAP market for years.
Another compromise is jettisoning the conventional humidifier. To save space, several manufacturers use moisture exchangers instead, where vapor from a patient’s breathing is recirculated. The Luna CPAP from 3B, which is not marketed specifically as a travel machine but is only slightly larger in size than the DreamStation Go, has an option for a humidifier attachment. Adding the attachment roughly doubles the size and weight of the device.
Angela Giudice, director of clinical sales and education at 3B, says the Luna has a “good sturdy square base” that makes it a good bedside machine. “A small sleek CPAP can be unobtrusive in a home setting,” she says.
Drive DeVilbiss also opted for a device that can shuttle between travel and home use. At about two pounds, the IntelliPAP 2 is among the heavier of the machines in this category, but director of product marketing Brian Palmer says that actually works better for many patients.
“It is large enough to be used on the nightstand for everyday use and small enough when the humidifier is removed for the patient to take it with them,” he says. “Having a single device is also important for some patients that are required to track compliance.”
Transcend and the AirMini also left out an on-device screen to save space, so the machines are programmed with a smartphone app. Some can be powered by an external battery, which is a good solution for camping trips but increases a device’s size and weight.
The line of devices does not just increase options for patients, but for durable medical equipment (DME) providers as well. Patients buying a CPAP for travel are less likely to be reimbursed by their insurance for the second device, so the products are an added source of cash revenue for these companies. On cpap.com, travel CPAPs are listed between about $300 and $900.
Rose Rimler is associate editor of Sleep Review.
1. Kuniyoshi FH, Garcia-Touchard A, Gami AS, et al. Day-night variation of acute myocardial infarction in obstructive sleep apnea. J Am Coll Cardiol. 2008;52(5):343-6.
TOP PHOTO: DreamStation Go is about half the size of Philips’ previous generation devices.