As a point of clarification, this is _not_ for respirators, but for CPAP devices.
Incidentally, this has been awful for CPAP users: Pandemic supply chain issues resulted in short supply of CPAP devices, and combined with a huge spike in demand due to these faulty Philips units, many people were left with a choice to use CPAP devices which had the potential to expose them to carcinogenic foam, or to go without their CPAP, which obviously carries its own severe health risks.
This is true and just to clarify on your clarification patients have been unable to get a CPAP replacement for years. In some places they would be offered things like special pillows as a substitute.
Special pillows are in no way a substitute for positive airway pressure/airway splinting.
Or you could have a device that electrocutes your throat when it starts closing implanted into your neck.
A few years ago, there were a number of devices that came on the market that essentially blew ozone through the airflow pathways in PAP devices, and this was supposed to be a substitute for disassembly and scrubbing (which is a lot less convenient). While nobody has said these devices and the ozone methods actually damaged the foam, replacement PAP units all are not warranted if ozone cleaning devices are used. I don't know if this is the only "cleaning material" to which the article refers.
but I believe that more than anything else is the quality of this PE-PUR foam that is lacking.
[1] ozone sanitizing treatments have been found to damage a lot of materials (besides metal which oxidizes very quickly also rubbers) and actually ozone chambers are used to test rubber materials durability
The best thing is that third party manufacturers are making their own replacement parts for people to DIY repair their own machines and just have zero sound-deadening foam in them.
I'm in the recall, I refuse to use the reworked unit they sent me because it's a goddamn used CPAP first and foremost in the age of COVID -- I reworked my own machine instead. It wasn't a bad replacement project, I took my time - the sellers even provide in some of the kits all the tools you need, full color booklets, and video guides on Youtube on how to crack them open and swap it out.
I, random person on internet, highly recommend resmed airsense. Make sure it’s apap model. Their naming schemes are confusing. I’ve used Phillips and resmed and resmed is so much nicer in every way.
ResMed AirSense user here. Do take note that the water reservoir in the recent versions is prone to leakage after around a year of use, and replacing it is pretty expensive.
I sealed mine with food-grade silicone as fellow users in the internet suggested, and it's been good since.
The water tank for the AirSense 11 is something like $29 and it's a consumable item that's covered by your insurance. I just get a new one every six months.
I don't know - I guess because you could get build-ups of minerals and other things inside them and it's probably better not to rely on people cleaning them given that they're medical devices that blow air into your lungs?
Agreed, the specialist I saw recommended Airsense (I have the 10) with the water tank (and I also got the heated tube, highly recommended) above most everything else for the machine, but the mask is actually a Philips respironics which are the most comfortable. They are all intercompatible.
Been using for about 5 months now and it's been great
I have used CPAP for 12 years (1 Philips, 2 Resmed Airsense 10). Each one was provided under different health insurance, United Healthcare, Blu Cross Blue Shield and Cigna. I prefer paying a single lump sum for my co-pay, but some insist on 10 monthly payments if the supplier can verify you are using the unit.
But wait, there's more. Each insurer had a different schedule for how often you should change the tubing, mask, hose and filters. I have boxes of spare parts because I would not replace per the insurer's schedule. I always replaced the air filters, always used distilled water and cleaned, but never placed a tank. The mask and hose are sturdy, so I clean and reuse until they leak too much.
No its not, nobody died of it, no one got cancer from it, its just that the lawyers can make big bucks from this law suit, CPAP Lawsuit, so lets make it bigger than it is.
I'm mad I got one of the 'reconditioned' first-gen units as part of the recall on the DS1. I don't feel comfortable using a 'used' CPAP, even if it was "reconditioned". I'd love to know their logic as to why some people got brand new DS2s and others got used DS1s back.
I'm still waiting regardless -- I have a Dreamstation Go that's perpetually stuck because they haven't come up with any remediation efforts. The best part about the Dreamstation Go users is that we're getting 'general' recall emails that imply we need to provide further info but then smack in the middle of it just tell Dreamstation Go users to just continue waiting because we're still screwed over.
At this point I just want the $1300 or so I've spent on this damn thing back in cash so I can go buy a Transcend Micro and move on.
I put both of these recalls in the day they went live in June 2021.
For example, the old one had the hose attach at a top pivoting point, the new one is a fixed side point. Therefore, it is far easier to move the machine at night via tossing/turning (and maybe pull it off the table/damage it).
The old one pushed the water holder out for quick DAILY replacements/cleaning. The whole mechanism was very overbuilt, and it didn't feel like it was going to fail in the machine's lifetime. The new water tank is bulkier to remove, and everything feels cheap (particularly the top-latch) and like it will fail soon.
The screen is on top, which you cannot see while laying in bed. The touch screen is unresponsive and small (it is going to be rough for older people with arthritis and rough finger skim).
As to travel/camping mobility: The 2 is superior if you want to take the humidifier tank (smaller overall), but with the old one if you left the humidifier at home it was tiny.
PS - Both the old and new are annoying with light pollution at night.
What I'm hearing is that there are a lot of mostly functional CPAP devices on the used market now. Maybe I should look into getting one. And by getting one I mean sneaking one into my country illegally.
> What I'm hearing is that there are a lot of mostly functional CPAP devices on the used market now.
Phillips is doing a replacement and you are supposed to send in your old device for disposal. Not sure what happens if you don't send it in, but they included a box and pre-paid label. No real reason to keep the old cpap since it's being recalled and the risk of being sent a bill from phillips for not returning the old one doesn't make trying to make some money on the side worth it. These things are hundreds of dollars.
Philips had to recall millions of sleep apnea devices and ventilators due to potential health risks posed to users. If the sound-dampening foam in the devices made contact with certain cleaning materials, the foam could crumble, and users could breathe it in. “This quarter, Philips Respironics recorded a EUR 575 million provision in connection with the anticipated resolution of the economic loss class action, an important step in addressing the litigation related to the recall,” the company said.
After such a long and storied history in electronics, Philips should be embarrassed to let itself turn into just a healthcare company -- and one with these kind of quality problems.
Philips doesn't make foam (or much of anything anymore). What do you bet this was caused by outsourcing cheap materials (foam + adhesives + whatever plastics are in there) that decompose when placed together. And, as just designer and brander of the device (you know they don't manufacture these, either), they didn't do much testing or chemical compatibility work?
Tangentially- Why, in America, do we need a doctor's prescription to purchase a CPAP machine? Of course, I know plenty of bad reasons why, but I'm wondering if there are any legitimately good reasons at all? This reminds me of the situation with hearing aids, where the FDA recently reduced the barriers to purchasing them and this appears to have been a good move.
> All the prescription does is set some baseline parameters. Most CPAPs you can buy are APAPs anyway and modify the parameters on the fly.
And training on how to use it property is also provided. I would not be shocked if the number of people using tap water would sky rocket if there was zero barrier to having one.
Training is not actually required to be provided by anyone, manufacturer, government or otherwise. There’s plenty of online shops selling you the prescription which come with at best a short user guide that you can probably find online. They come with no aftercare, and you’re just given a device (usually unlocked) and the pressure recommendation preset. That’s it.
The current state of CPAP prescriptions is total bullshit.
> There’s plenty of online shops selling you the prescription which come with at best a short user guide that you can probably find online. They come with no aftercare, and you’re just given a device (usually unlocked) and the pressure recommendation preset. That’s it.
Don't these problems get worse without prescriptions?
The bar is already so low, it's not going to get noticeably worse. If the standard already is minimal training, then having more places provide just as minimal training is not going to noticeably change anything.
Lower prices and a streamlined process would certainly mean more people are going to be getting CPAPs but that seems like a net positive if anything. Sleep apnea affects millions of people and is generally extremely tough to get treatment for. And that's not due to the "safety risks" (there are very few if any in day to day use) but rather an entrenched set of companies and providers that obviously benefit from this.
Recently got an rx. The RX itself was worthless (4-20, not dialed in for me). Insurance refused to pay for a titration study as not medically necessary, so I had to join special CPAP forums and learn how to titrate myself.
But yah, no training was given at all. No reason I couldn't have picked it up at Walmart and used on my own.
I have a Resmed Airsense 10 with nose pillow, and if the meshed vent gets wet it does not work so well anymore. I experience this as a shortness of breath and wake up from it. I can imagine that this is dangerous for people who don't wake up from this. I have a replacement so I can swap in the middle of the night if neccessary. I regularly clean the mesh with warm soapy water and an electric toothbrush and I replace the mesh every 6 months.
Can you clarify what you mean by mesh vent, and what it is exactly you replace? I could not find any info. My father uses this machine so you have me worried.
You can use a Resmed AirSense with a nose pillow or a face mask. I only use the nose pillow. It covers the nostrils. You breathe through the nose. The mouth stays uncovered. If you manage to keep the mouth closed while sleeping, this is enough. Between the tube and the nose pillow there's a piece with two mesh vents. When the CPAP increases the pressure, some air is vented through the meshes. When you breathe out, most of the breathed air leaves by the vents. I feel the air: when breathing in only a little and when breathing out a lot. It is a fine mesh creating some resistance but it works because when you breathe out, you temporarily increase the pressure and the mesh lets your stale air out. However when the mesh gets wet by condensation, not enough stale air is vented and you get the feeling of not having enough air. It feels like the head being under the blanket. The first time this happened I was confused. Now I know to recognize and to avoid this situation. If the room air is very cold, this can happen because the air you breathe out can condensate. If you use an air moisturizer, you need to find a balance between temperature and too much moisture. You need to position the tube such that moisture can't flow downwards to the nose pillow.
This all sounds a bit complicated and dangerous, but in reality this works surprisingly well. It really works and it is helpful. I know CPAP devices are a nuisance and need a lot of time and dedication to get used to, but they are able to fix sleep apnea. They give me a good sleep. I needed about three months to find the sweet and deep sleep we humans all need thanks to this bloody contraption. It is a hate-love relationship.
It sounds like you're using the Resmed P10 nasal pillow. I've tried that before and agree the mesh vents get clogged easily (not just because of condensation, but also because it gets dirty easily).
There are other similar pillow masks out there that don't have that problem. I found the Philips Nuance, Philips Dreamwear, and F&P Brevida to not have any venting issues. The Brevida has a cloth mesh that still works when wet, and probably is the best if you want that "resistance" feeling on exhale.
I thought they typically had safeguards to prevent this, but maybe not all models do. Not trying to be obtuse here- but how is this different from the fact that I could go to a hardware store and buy a propane space heater with zero restrictions, then ignore the instructions and use it in an unsafe way? Why don't we require some kind of professional to "prescribe" us a space heater then?
Like, obviously rebreathing CO2 is deadly, but that's more of a "plastic bags and children" kind-of issue. Luckily your body doesn't like the feeling of breathing in CO2 so it is uncomfortable if you leave the mask on without running the machine, but even then, it vents a decent percent when you exhale.
I'm not sure what a doctors prescription does for this. I imagine the doctor is just a middle man in most CPAP journeys. As-in, the doctor is not the one who provides or trains you to use the CPAP. A third-party medical device provider does (Also, the training is a two minute, "put-the-mask-on and use distilled water, now sign here" kind-of-thing)
Edit: BTW I think the deadly thing is how long it takes to get a CPAP, from scheduling with a doctor to finally seeing them and getting a device it takes like 6mo to 1+ year. EVEN IF THEY THINK YOUR CASE IS VERY BAD. (I went to a sleep doctor in a hospital and they said I had one of the worst apnea cases he had seen, it still took another 3+mo from that point to get a device...)
You have 1. a device manufacturer, 2. a third party device seller, and 3. a sleep doctor. It takes time to get seen by a sleep doctor who then orders a sleep study device that needs to be provided by party 2 who gets it from party 1. Party 2 then provides results to party 3 who then prescribes a device, party 2 then needs to give you one of there devices if they have them in stock, if not they need to order them from party 1.
IMO there are two middle men here, the doctor and the device shop.
If you get a prescription you can get devices directly online (from sites who are just a more market-competitive version of party 2 above), but sometimes ResMed and Philips only sell there newer devices to people in the middleman scenario described above. E.g. for the first year or two of the ResMed AirSense 11, online shops (still requiring prescriptions) were not able to sell them.
xPAP use actually increases CO2 elimination, which is why it can lead to Treatment-Emergent Central Sleep Apnea.
You'd have to fall asleep with the device off to get meaningful CO2 rebreathing, which is neither an easy feat nor particularly different whether you've been prescribed or not.
Actually given the number points my "contrarian" comments tend to get, I've come to believe my opinions are actually pretty in-line with those of the average HN user. For better or worse.
52 comments
[ 3.4 ms ] story [ 99.3 ms ] threadIncidentally, this has been awful for CPAP users: Pandemic supply chain issues resulted in short supply of CPAP devices, and combined with a huge spike in demand due to these faulty Philips units, many people were left with a choice to use CPAP devices which had the potential to expose them to carcinogenic foam, or to go without their CPAP, which obviously carries its own severe health risks.
Special pillows are in no way a substitute for positive airway pressure/airway splinting.
Or you could have a device that electrocutes your throat when it starts closing implanted into your neck.
I wonder if "cleaning materials" means a chemical, like a spray, or something different.
https://www.fda.gov/medical-devices/safety-communications/ce...
https://www.fda.gov/medical-devices/safety-communications/up...
but I believe that more than anything else is the quality of this PE-PUR foam that is lacking.
[1] ozone sanitizing treatments have been found to damage a lot of materials (besides metal which oxidizes very quickly also rubbers) and actually ozone chambers are used to test rubber materials durability
The best thing is that third party manufacturers are making their own replacement parts for people to DIY repair their own machines and just have zero sound-deadening foam in them.
I'm in the recall, I refuse to use the reworked unit they sent me because it's a goddamn used CPAP first and foremost in the age of COVID -- I reworked my own machine instead. It wasn't a bad replacement project, I took my time - the sellers even provide in some of the kits all the tools you need, full color booklets, and video guides on Youtube on how to crack them open and swap it out.
I sealed mine with food-grade silicone as fellow users in the internet suggested, and it's been good since.
The water tank for the AirSense 11 is something like $29 and it's a consumable item that's covered by your insurance. I just get a new one every six months.
Been using for about 5 months now and it's been great
But wait, there's more. Each insurer had a different schedule for how often you should change the tubing, mask, hose and filters. I have boxes of spare parts because I would not replace per the insurer's schedule. I always replaced the air filters, always used distilled water and cleaned, but never placed a tank. The mask and hose are sturdy, so I clean and reuse until they leak too much.
Thoughts on the replacement unit they sent? I don't like the new one. The pressure dynamics don't feel the same especially on exhale.
I'm still waiting regardless -- I have a Dreamstation Go that's perpetually stuck because they haven't come up with any remediation efforts. The best part about the Dreamstation Go users is that we're getting 'general' recall emails that imply we need to provide further info but then smack in the middle of it just tell Dreamstation Go users to just continue waiting because we're still screwed over.
At this point I just want the $1300 or so I've spent on this damn thing back in cash so I can go buy a Transcend Micro and move on.
I put both of these recalls in the day they went live in June 2021.
For example, the old one had the hose attach at a top pivoting point, the new one is a fixed side point. Therefore, it is far easier to move the machine at night via tossing/turning (and maybe pull it off the table/damage it).
The old one pushed the water holder out for quick DAILY replacements/cleaning. The whole mechanism was very overbuilt, and it didn't feel like it was going to fail in the machine's lifetime. The new water tank is bulkier to remove, and everything feels cheap (particularly the top-latch) and like it will fail soon.
The screen is on top, which you cannot see while laying in bed. The touch screen is unresponsive and small (it is going to be rough for older people with arthritis and rough finger skim).
As to travel/camping mobility: The 2 is superior if you want to take the humidifier tank (smaller overall), but with the old one if you left the humidifier at home it was tiny.
PS - Both the old and new are annoying with light pollution at night.
Phillips is doing a replacement and you are supposed to send in your old device for disposal. Not sure what happens if you don't send it in, but they included a box and pre-paid label. No real reason to keep the old cpap since it's being recalled and the risk of being sent a bill from phillips for not returning the old one doesn't make trying to make some money on the side worth it. These things are hundreds of dollars.
Isn't it typical business practice to need to account for potential pending liabilities.
Philips had to recall millions of sleep apnea devices and ventilators due to potential health risks posed to users. If the sound-dampening foam in the devices made contact with certain cleaning materials, the foam could crumble, and users could breathe it in. “This quarter, Philips Respironics recorded a EUR 575 million provision in connection with the anticipated resolution of the economic loss class action, an important step in addressing the litigation related to the recall,” the company said.
Philips doesn't make foam (or much of anything anymore). What do you bet this was caused by outsourcing cheap materials (foam + adhesives + whatever plastics are in there) that decompose when placed together. And, as just designer and brander of the device (you know they don't manufacture these, either), they didn't do much testing or chemical compatibility work?
And this is a medical device.
All the prescription does is set some baseline parameters. Most CPAPs you can buy are APAPs anyway and modify the parameters on the fly.
And training on how to use it property is also provided. I would not be shocked if the number of people using tap water would sky rocket if there was zero barrier to having one.
The current state of CPAP prescriptions is total bullshit.
Don't these problems get worse without prescriptions?
Lower prices and a streamlined process would certainly mean more people are going to be getting CPAPs but that seems like a net positive if anything. Sleep apnea affects millions of people and is generally extremely tough to get treatment for. And that's not due to the "safety risks" (there are very few if any in day to day use) but rather an entrenched set of companies and providers that obviously benefit from this.
But yah, no training was given at all. No reason I couldn't have picked it up at Walmart and used on my own.
All CPAP masks have vents in them to prevent CO2 buildup, and those vents work regardless of the pressure settings.
This all sounds a bit complicated and dangerous, but in reality this works surprisingly well. It really works and it is helpful. I know CPAP devices are a nuisance and need a lot of time and dedication to get used to, but they are able to fix sleep apnea. They give me a good sleep. I needed about three months to find the sweet and deep sleep we humans all need thanks to this bloody contraption. It is a hate-love relationship.
There are other similar pillow masks out there that don't have that problem. I found the Philips Nuance, Philips Dreamwear, and F&P Brevida to not have any venting issues. The Brevida has a cloth mesh that still works when wet, and probably is the best if you want that "resistance" feeling on exhale.
I'm not sure what a doctors prescription does for this. I imagine the doctor is just a middle man in most CPAP journeys. As-in, the doctor is not the one who provides or trains you to use the CPAP. A third-party medical device provider does (Also, the training is a two minute, "put-the-mask-on and use distilled water, now sign here" kind-of-thing)
Edit: BTW I think the deadly thing is how long it takes to get a CPAP, from scheduling with a doctor to finally seeing them and getting a device it takes like 6mo to 1+ year. EVEN IF THEY THINK YOUR CASE IS VERY BAD. (I went to a sleep doctor in a hospital and they said I had one of the worst apnea cases he had seen, it still took another 3+mo from that point to get a device...)
You have 1. a device manufacturer, 2. a third party device seller, and 3. a sleep doctor. It takes time to get seen by a sleep doctor who then orders a sleep study device that needs to be provided by party 2 who gets it from party 1. Party 2 then provides results to party 3 who then prescribes a device, party 2 then needs to give you one of there devices if they have them in stock, if not they need to order them from party 1.
IMO there are two middle men here, the doctor and the device shop.
If you get a prescription you can get devices directly online (from sites who are just a more market-competitive version of party 2 above), but sometimes ResMed and Philips only sell there newer devices to people in the middleman scenario described above. E.g. for the first year or two of the ResMed AirSense 11, online shops (still requiring prescriptions) were not able to sell them.
Have CPAP, not really any way to "mess up" outside of putting a bag over your head.