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CPAPs (continuous positive airway pressure devices) & Masks

 

Summary of Sleep Disordered Breathing

In the U.S. alone, there are approximately 40 million adults in the U.S. who suffer from sleep disordered breathing. The industry itself remains less than 10% penetrated on a global basis. Going back a couple of years ago, basically people thought you had to be a 60 or 70 year old obese male in order to have this disorder, when the reality is that most people being diagnosed today are in their 30's, 40's and 50's.     

More than 90% of the cases remain untreated. In fact, the United States is probably the most penetrated market in the world. It is assumed to be about 12% or so of the cases that have been identified. In most other countries in the world it's less than 5% and, in fact in most nations it's less than 1% of the affected population that has been identified.

The bottleneck within the industry has remained the diagnostic capability.  

CPAP Devices

CPAP stands for Continuous Positive Airway Pressure and is the most effective and widely used method of treating sleep apnea. The CPAP device does not breathe for you. You can breathe at a normal rate.

A CPAP device provides air pressure through a face mask to help keep the breathing passage open during sleep.

Types of Masks

Nasal Masks

This type of interface requires breathing through the nose and keeping the mouth closed. a chin strap can be worn with the nasal mask to help accomplish this, if needed.

A correctly fitting nasal mask extends from the bridge of the nose to the bottom of the upper lip without touching the sides of the nose or going above the top of the mouth.

Oral Masks

These are a good option for those who breathe through their mouths. Oral masks can be used with or without headgear, and have a flap that goes in front of the teeth and another flap that goes outside the mouth. The inner flap is enough to hold it in place during the day, but at night, an oral mask requires a strap.

A correctly fitting mask covers the entire mouth. To ensure a proper fit, it's important to find an inner flap that fits your mouth. The mask has an adjustment knob for changing the separation between the inner and outer flaps.

Full Face Masks

For those who breathe through both the nose and mouth, full face masks are the way to go. Their breathing flexibility makes them a favorite for nighttime use.

Some full masks reach from the bridge of the nose to the bottom of the mouth and others reach from the nose bridge to below the chin. Still, others cover the entire face, including the eyes. Full masks distribute the pressure over a wider area, which can mean less skin irritation.

While some feel more claustrophobic with a full mask, others prefer them to nasal masks with chin straps because they don't want their mouths held shut. Full masks also are better for people with mustaches, which can interfere with getting a tight seal.      

Mouthpieces

If breathing through the mouth is desired, an option would be a mouthpiece, which is similar to sucking on a straw. The mouthpiece hooks to a stand or arm that holds it near the mouth at a variety of angles. It can be worn at night with a strap that holds it is place.

People like mouthpieces because they're hardly noticeable. They can be washed with soap and warm water, put in the dishwasher or simply thrown away.   

Home Test Devices

On March 14, 2008, the CMS (Center for Medicare & Medicaid Services) came out with a ruling which dramatically changes the landscape of this industry. What they said is that no longer will you need to go to a hospital-based or a facility-based sleep lab in order to be diagnosed, but rather you will be able to be diagnosed at home using a home device. CMS said that this decision would affect up to 4 million people covered by Medicare who suffer from some form of sleep apnea.

A home take-home test is about 35% cheaper to administer and also allows the patient the comfort of sleeping in his/her own bed. However, with portable tests, proper interpretation of the data is still needed. It is very important that qualified personnel (sleep technicians) analyze the data. Also, the data is more likely to be accurate with people who have moderate to severe sleep apnea and no other medical conditions. Otherwise, false positives are possible. Consequently, home testing is not likely to cut out the sleep lab entirely, nor should it.

The feeling is that over the long haul this is going to dramatically expand the size of this industry. Don't expect to see the results of this for another 18 to 24 months because there will be adoption curves that will occur within the diagnostic industry.

Some statistics - over 70% of Type II diabetics have sleep disorder breathing at a level that CMS would pay for treatment. 50% of congestive heart failure patients have sleep disorder breathing. Over 40% of hypertensive and 80% of drug resistant hypertensions have sleep disordered breathing.

This is a market where the two largest players control about 80% of the market. ResMed is a medical device company that focuses particularly on the disorder of sleep disorder breathing. There is the pending acquisition of Respironics by Royal Philips.

More Information

Respiratory Equipment Device Manufacturers

Cardinal health (owner of Pulmonetic)  800-582-7458  www.cardinalhealth.com

Contour Products  800-950-0230   www.contourliving.com

Covidien (mfr. of Puriten Bennett products)   800-635-5267   www.puritanbennett.com

 

Fisher & Paykel healthcare  800-446-3908   www.fphcare.com

 

Hans Rudolph   800-456-6695   www.rudolphkc.com

 

Hudson Industries   800-343-8112   www.cpasupplyusa.com

 

Innomed Technologies   800-200-9842   www.innomedinc.com

 

Invacare   800-333-6900   www.invacare.com

 

Pulmonetic   866-752-1438   www.pulmonetic.com

 

ResMed   800-424-0737   www.resmed.com

 

RespCare (sister co. of InnoMed Technologies)  888-280-6607

 

Respironics   800-638-8208   www.respironics.com

 

Sunrise Medical   800-333-4000   www.sunrisemedical.com

 

Talk About Sleep   866-657-5337   www.papillow.com

 

Ventlab Corp.   800-593-4654   www.ventlab.com

 

 

Source: Marketdata Enterprises, Inc. research

*page last updated  04/28/2008

 

 



 

 

 

 

 

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