Welcome to Malibu

A rare product review by Tracy R. Nasca

August 9, 2007

Having been a BiLevel user for nearly 18 years, I consider myself a veteran OSA patient. Because of my long term experience, the equipment manufacturers frequently ask me to trial cpap devices and masks and opine. I am picky, not easily impressed with machines and masks. We all have our favorites, just the right mask to fit our face but not always found easily. Trial and error are a part of the OSA patients life and I am no exception. Traditionally, I prefer machines with fewer bells and whistles. Ramp, for instance, is not important to me. Just give me air and all that I am entitled to at first inhalation breath! Masks are so specific to a patient face, it's not always easy for me to trial and opine on a mask, but adjustment features and fit nuances are important issues. There is no such thing as "one size fits all".

My first BiLevel device was big, heavy and loud. It was like carrying around a bowling ball. It was not easy to travel with but it was all that was available in 1990. Who knew that one day machines would be so small, lightweight and virtually fit in our purse or briefcase!

As a founder and vice president of support for Talk About Sleep I have the privilege of speaking to patients every single day. Phone calls and email exchanges are some of the favorite parts of my job. To be able to assist fellow OSA patients in a responsible and accurate way, I am compelled to try all new products that come to market. I may not like them all, they may not be the right mask for my face, but I have worn most of them for at least one night. I can speak from experience and answer the basic questions that patients want to know. It's the least I can do for my fellow patient and for my advocacy work.

It's rare that I find myself giving a product testimonial but I was given the opportunity to try a new BiLevel device recently and it was so awesome that I am compelled to share my experience. ResMed launched an auto-bilevel device earlier this year. At a recent medical conference, I was invited to try out the machine for a few nights. I left my trusty unit at home, glad not to have to drag along another piece of luggage to the hotel. Drew Terry, Director, Product Management - Americas met with me, the new machine was set to my prescribed pressure and I took it up to my hotel room. When bed time arrived, I pressed the "start" button and nothing seemed to happen. I couldn't believe ResMed had given me a faulty machine. I felt air coming out but the machine was silent and there was not the usual audible and mechanical inhalation whoosh - exhalation whoosh noise I have been used to for the past many years. I have used several different brands of bilevel machines and at my high pressure level, they are audibly noisy. They've gotten remarkably quieter over the years but still somewhat akin to a ventilator noise you might hear at a hospital WHOOSH - SILENCE - WHOOSH...inhalation, silence, exhalation. Not having my own machine as a back up, I was forced to use the machine that first night. I dreaded the thought of losing a nights sleep. At a busy medical conference, I had a big day ahead of me and needed to wake up alert and ready to put in a hard 15 hour work day. I also dreaded the embarrassment I would face in the morning of having to inform my friends at ResMed that they had given me a defective machine.

When morning came, I was surprised to feel rested and alert. Nevertheless, I packed up the auto-bilevel and headed down to the exhibit hall to return it. I was sure it was broken. I just hoped they had another machine to lend me as I had not brought my own. When I told Drew Terry my story, he immediately plugged in the machine and checked it out. It had recorded data and showed a compliant nights sleep. But "it was not working", I said...."it couldn't have been, it was too quiet. I heard no whoosh inhalation, woosh exhalation". "How'd ya sleep", he inquired. "I feel great", I said, puzzled. He smiled and said, "welcome to Malibu ".

I had the pleasure of using that same VPAP Malibu auto bilevel for the remainder of the conference. I've been on a pressure setting of 20-11 for nearly 15 years. I was shocked to see that Malibu delivered an average of 13 for inhalation. The transition between inhalation and exhalation was unbelievably smooth. I did not realize that my sleep could become better than it already was. I felt like a selfish little kid, not wanting to give back this machine that was so quiet and smooth.  This will be an out of pocket expense for me but one I can justify.  A good nights sleep is priceless and I can't wait to take my nightly vacation to “Malibu”. Sweet dreams.

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