Validation of the mePAP: A low-cost, high-quality, open-source PAP device for research and increasing equity in respiratory care

Respiratory diseases affect 14% of New Zealand’s population, with over 100,000 individuals suffering from sleep apnoea, which causes breathing disruptions due to airway blockages. Positive airway pressure (PAP) devices are the gold standard treatment, typically operating in continuous (CPAP), bilevel (BiPAP), or automatic (APAP) modes. However, current PAP devices cost between NZ$800–$2500, creating a financial barrier for users, particularly those from lower socio-economic backgrounds. The mePAP was developed as a low-cost, open-source PAP device, constructed for NZ$250, capable of delivering CPAP, BiPAP, and APAP therapies with an airway pressure sensor for more precise control. Validation against a Fisher & Paykel CPAP was performed through benchtop testing, mechanical lung simulations, and a clinical trial with 40 healthy subjects. The mePAP was preferred by 42.5% of subjects, with 25% reporting no difference between the devices. A mean comfort rating of 6.36 for the mePAP compared to 5.92 for the Fisher & Paykel CPAP confirmed the two devices were comparable, with pressure fluctuations from the mePAP’s low-cost motor imperceptible to users. The airway sensor feedback loop enabled accurate pressure delivery, with BiPAP and APAP algorithms dynamically adjusting therapy pressure in response to breathing patterns. These results validate the mePAP as a low-cost alternative to commercial PAP devices, with comparable performance and comfort. Its affordability and open-source design have the potential to improve healthcare accessibility and reduce inequities, making respiratory therapy more accessible to underserved populations while enabling further research into respiratory treatments. • Low-cost PAP prototype built for NZ$250 with CPAP, BiPAP, and APAP modes. • Validated clinical trial shows comparable comfort and accuracy to gold-standard PAP. • BiPAP and APAP algorithms dynamically adjust pressure with breathing changes. • Adaptable device for personalised respiratory research applications. • Potential to improve healthcare accessibility and equity with affordable PAP therapy.