Mask System

Abstract

To provide alternative arrangements of mask systems to enhance the efficacy of therapy and compliance of patients with the therapy.SOLUTION: A shroud (1020) for a mask system includes a retaining portion structured to retain a frame (1040), a pair of upper headgear connectors (1024) each including an elongated arm (1026) and a slot (1027) at the free end of the arm adapted to receive a headgear strap, and a pair of lower headgear connectors (1025) each adapted to attach to a headgear strap. The retaining portion, the upper headgear connectors and the lower headgear connectors are integrally formed as a one-piece structure.SELECTED DRAWING: Figure 30

Description

[Technical field]

[0001] The present invention relates to a mask system for use in the treatment of, for example, sleep disordered breathing (SDB) using continuous positive airway pressure (CPAP) or non-invasive positive pressure ventilation (NIPPV).

[0002] This application claims the benefit of U.S. Provisional Patent Applications Nos. 61 / 064,406, filed March 4, 2008, 61 / 071,893, filed May 23, 2008, and 61 / 136,617, filed September 19, 2008, each of which is incorporated herein by reference in its entirety. [Background technology]

[0003] Patient interfaces, such as full face mask systems, nasal mask systems, and the like, used in conjunction with blowers and flow generators in the treatment of sleep disordered breathing (SDB), generally include a soft portion that contacts the face, such as a cushion, and a rigid or semi-rigid shell or frame. In use, the interface is held in a sealing position by headgear so that a supply of positive pressure (e.g., 2-30 cm H2O) can be delivered to the patient's airway.

[0004] One factor in the efficacy of and patient compliance with a treatment is the comfort and fit of the patient interface. [Prior art documents] [Patent documents]

[0005] [Patent Document 1] U.S. Provisional Patent Application No. 61 / 064,406 [Patent Document 2] U.S. Provisional Patent Application No. 61 / 071,893 [Patent Document 3] U.S. Provisional Patent Application No. 61 / 136,617 [Patent Document 4] US Patent Application Publication No. 2007 / 0144525 [Patent Document 5] US Patent Application Publication No. 2006 / 0283461 [Patent Document 6] PCT Application No. PCT / AU2006 / 000031 [Patent Document 7] U.S. Patent No. 6,561,190 [Patent Document 8] U.S. Patent No. 6,561,191 [Patent Document 9] U.S. Patent No. 7,207,335 [Patent Document 10] U.S. Patent Application Serial No. 12 / 230,120 Summary of the Invention [Problem to be solved by the invention]

[0006] The present invention provides an alternative configuration of a mask system that improves efficacy of and patient compliance with treatment. [Means for solving the problem]

[0007] One aspect of the present invention relates to a mask system without a forehead support adapted to engage the patient's forehead.

[0008] Another aspect of the invention relates to a mask system that includes a frame and a shroud removably connected to the frame, the shroud adapted to mount headgear.

[0009] Another aspect of the invention relates to a mask system including a frame defining a breathing chamber, a cushion provided on the frame, the cushion adapted to form a seal with a patient's face, and a shroud provided on the frame. The shroud and the frame are co-molded with one another. The frame is fabricated from a relatively soft elastomeric first material and the shroud is fabricated from a second material that is harder than the frame. At least a portion of the frame includes a bellows section having a plurality of pleats. Each pleat has a sidewall, the sidewalls of the pleats becoming progressively longer away from the patient's face.

[0010] Another aspect of the invention relates to a cushion module including a frame defining a breathing chamber and a cushion adapted to form a seal with a patient's face. The frame and cushion are co-molded with one another. The cushion is fabricated from a relatively soft elastomeric first material and the frame is fabricated from a second material that is harder than the cushion. At least a portion of the frame includes a bellows section.

[0011] Another aspect of the invention relates to a method of making a cushion module, the method including molding a first portion of the cushion module with a relatively soft elastomeric first material, co-molding a second portion of the cushion module to the first portion with a second material that is harder than the first material, and molding at least a portion of the second portion to include a bellows section.

[0012] Another aspect of the invention relates to a shroud for a mask system comprising a retaining portion constructed to retain a frame, elongated arms and a pair of upper headgear connectors at free ends of the arms, each including a slot adapted to receive a headgear strap, and a pair of lower headgear connectors, each adapted to attach to a headgear strap, wherein the retaining portion, the upper headgear connectors and the lower headgear connectors are integrally formed as a single piece structure.

[0013] Another aspect of the invention relates to a mask system including a frame defining a breathing chamber, a cushion provided on the frame, the cushion adapted to form a seal with a patient's face, a shroud provided on the frame, the shroud adapted to mount headgear, and an elbow provided on the frame, the elbow adapted to be connected to an air delivery tube that delivers breathable gas to the patient, the shroud including a retention mechanism constructed to establish a secure connection between the shroud and the frame.

[0014] Another aspect of the invention relates to a mask system including a frame defining a breathing chamber and a cushion provided on the frame. The cushion includes a body and a cushion, the cushion adapted to engage at least a portion of a patient's face. The cushion includes a base wall connected to an undercushion layer and a membrane, the membrane extending around a periphery of the cushion and in contact with the patient's face. The undercushion layer is disposed below the membrane and supports the membrane. The undercushion layer provides differential support to the membrane in predetermined areas of the face.

[0015] Another aspect of the invention relates to a medical mask assembly having upper and lower ends defined by their position relative to a patient's face and connected to a plurality of flexible straps adapted to engage the patient's head, the flexible straps engaging at least two elongated rigid arms integrally molded into a portion of the mask assembly, the elongated arms being molded into the mask assembly near the upper end of the mask assembly.

[0016] Another aspect of the invention relates to a medical mask assembly including a body connected to a cushion adapted to cover the nose and / or mouth and attached with a substantially normal force to the face, which force is approximately constant along the entire length of the mask assembly and balanced by portions of the cushion which engage the patient's cheeks.

[0017] Another aspect of the invention relates to a cushion for use with a medical mask, the cushion including an outer membrane layer adapted for sealable engagement with a face and an undercushion layer adapted to support the membrane layer, the membrane layer or the undercushion layer including a surface located between the two layers, the surface adapted to allow the layers to slide relative to their respective surfaces.

[0018] Another aspect of the invention relates to a mask system including a frame defining a breathing chamber, a cushion provided on the frame, the cushion adapted to form a seal with a patient's face, and a releasable shroud adapted to engage a portion of an exterior surface of the frame, the shroud being connected to straps for positioning the mask system.

[0019] Another aspect of the invention relates to a medical mask assembly having an upper end and a lower end, the upper end adapted to cover a patient's nose and the lower end adapted to cover the patient's mouth, the mask assembly does not include a forehead support and includes two rigid members attached to opposite sides of the upper end of the mask assembly, the rigid members including a generally curved shape and adapted to avoid obscuring the patient's field of vision.

[0020] Another aspect of the invention relates to a flexible cushion for attachment to a medical mask, the cushion including a membrane attached to the periphery of the cushion and adapted to seal against a patient's face, and at least one undercushion disposed below the membrane and adapted to support the membrane to prevent the membrane from collapsing during use. The membrane is softer than the undercushion. The height of the undercushion in the area of ​​the nose bridge or chin is between 0 mm and 30 mm, measured between the base and tip of the undercushion.

[0021] Another aspect of the invention relates to a medical mask assembly having an upper end and a lower end, the upper end adapted to cover a patient's nose and the lower end adapted to cover the patient's mouth, the mask assembly does not include a forehead support and includes two rigid members attached to opposite sides of the upper end of the mask assembly, the rigid members including a generally curved shape and adapted to avoid obscuring the patient's field of vision.

[0022] In alternative embodiments, the mask system may include headgear connectors or rigidizers constructed to attach to the frame via a snap fit, mechanical interlock, friction fit and / or (e.g., rubber) grommet arrangement.

[0023] In an alternative embodiment, the mask system may include head gear having a strap configuration made from silicone and / or Breath-O-Prene™ material.

[0024] Other aspects, features, and advantages of the present invention will become more apparent from the following detailed description when considered in conjunction with the accompanying drawings, which are a part of this disclosure and illustrate the principles of the invention.

[0025] [Additional note 1] A frame defining a breathing chamber; a cushion provided on the frame, the cushion adapted to form a seal with a patient's face; a shroud provided on the frame; Equipped with the shroud and the frame are co-molded together, the frame being made from a relatively soft elastomeric first material and the shroud being made from a second material that is harder than the frame; At least a portion of the frame includes a bellows section having a plurality of pleats, each pleat having a sidewall, the sidewalls of the pleats gradually increasing in length away from the patient's face. Mask system. [Additional note 2] 2. The mask system of claim 1, wherein the frame is made of silicone. [Additional note 3] 3. The mask system according to claim 1, wherein the shroud is made of polycarbonate. [Additional note 4] 4. The mask system of any one of claims 1 to 3, wherein the bellows section is formed in a nasal bridge region of the frame. [Additional note 5] 5. The mask system of claim 1, wherein the cushion is a full face cushion. [Additional note 6] 6. The mask system of any one of claims 1 to 5, wherein the flexibility of the bellows section is variable. [Additional note 7] 7. The mask system of claim 6, wherein the flexibility of the bellows section can be varied by changing at least one of the number of pleats, the wall thickness of each pleat, and the depth of each pleat. [Additional note 8] A frame defining a breathing chamber; a cushion adapted to form a seal with the patient's face; Equipped with The frame and the cushion are co-molded together, the cushion is made from a relatively soft elastomeric first material, the frame is made from a second material that is harder than the cushion, and at least a portion of the frame includes a bellows section. Cushion module. [Additional note 9] 9. The cushion module of claim 8, wherein the bellows section includes a bellows structure having one or more pleats. [Additional Note 10] 10. The cushion module of claim 9, wherein the flexibility of the bellows section is variable. [Additional Note 11] The cushion module of claim 10, wherein the flexibility of the bellows section can be changed by changing at least one of the number of pleats, the wall thickness of each pleat, and the depth of each pleat. [Additional Note 12] 12. The cushion module of any one of claims 8 to 11, wherein the bellows section is formed in a nasal bridge region of the frame. [Additional Note 13] 13. The cushion module of any one of claims 8 to 12, wherein the cushion is a full face cushion. [Additional Note 14] The shroud, A cushion module according to any one of claims 8 to 13 provided on the shroud; A mask system comprising: [Additional Note 15] 15. The mask system of claim 14, wherein the shroud includes a headgear connector adapted to removably attach to a respective headgear strap of a headgear. [Additional Note 16] 16. The mask system of claim 15, wherein the shroud includes upper and lower headgear connectors on either side of the shroud. [Additional Note 17] 17. The mask system of claim 16, wherein each upper headgear connector includes an elongated arm and a slot at a free end of the arm adapted to receive a respective headgear strap in use. [Additional Note 18] 18. A mask system according to any one of claims 16 to 17, wherein each lower headgear connector includes a clip receptacle adapted to releasably interlock with a headgear clip coupled to a respective headgear strap. [Additional Note 19] 19. The mask system of any one of claims 14 to 18, wherein the shroud includes an aperture structure providing an annular retention portion constructed to retain the frame. [Additional Note 20] 20. The mask system of any one of claims 14 to 19, further comprising an elbow adapted to be connected to an air delivery tube that delivers breathable gas to a patient. [Additional Note 21] 21. The mask system of claim 20, wherein the elbow is provided on the frame. [Additional note 22] 22. A mask system according to any one of claims 20 to 21, wherein the elbow includes a vent arrangement for gas washout, the vent arrangement having the form of a vent insert adapted to be removably attached to the elbow. [Additional Note 23] 23. A mask system according to any one of claims 20 to 22, wherein the elbow includes an anti-asphyxiation valve, the anti-asphyxiation valve having the form of an insert adapted to be removably attachable to the elbow. [Additional note 24] 24. The mask system of claim 23, wherein the anti-asphyxiation valve includes a flap portion adapted to selectively close a port formed in the elbow, and a clip portion adapted to removably attach to the elbow. [Additional note 25] 25. The mask system of claim 24, wherein the flap portion and the clip portion are co-molded with each other. [Additional note 26] 26. The mask system of any one of claims 20 to 25, wherein the elbow comprises at least a first and a second elbow, and at least one aspect of the at least first and second elbows differs from each other. [Additional note 27] The mask system according to any one of claims 14 to 26, wherein the frame includes at least a first and a second frame adapted to be provided to the shroud, and at least one aspect of the at least first and second frames differs from each other. 1. A method of making a cushion module, comprising: molding a first portion of the cushion module using a relatively soft elastomeric first material; co-molding a second portion of the cushion module to the first portion using a second material harder than the first material; molding at least a portion of the second portion to include a bellows section; The method includes: [Additional note 29] 1. A shroud for a mask system, comprising: a retaining portion constructed to retain the frame; a pair of upper headgear connectors each including an elongated arm and a slot at a free end of the arm adapted to receive a headgear strap; a pair of lower headgear connectors, each adapted to attach to a headgear strap; Equipped with The retaining portion, the upper headgear connector, and the lower headgear connector are integrally formed as a single piece structure. Shroud. [Additional note 30] 30. The shroud of claim 29, wherein each lower headgear connector includes a short arm and a slot at a free end of the arm adapted to receive the headgear strap. [Additional note 31] 30. The shroud of claim 29, wherein each lower headgear connector includes a clip receptacle adapted to releasably interlock with a headgear clip coupled to the headgear strap. [Additional note 32] 30. The shroud of claim 29, wherein the elongate arms are contoured to extend over and past the patient's ears in use and to hold the headgear straps in a position above and spaced from the patient's ears. [Additional note 33] 30. The shroud of claim 29, wherein the elongated arms can be secured to headgear straps by gluing or sewing. [Additional note 34] A shroud as described in claim 33, wherein each elongated arm can be secured to an upper headgear strap, each slot of the elongated arm is adapted to receive a rear headgear strap, and each lower headgear connector is adapted to attach to a lower headgear strap. [Additional note 35] 35. The shroud of claim 34, wherein the lower strap and rear strap join at an angle and are adapted to pass behind the patient's head in use. [Additional note 36] A frame defining a breathing chamber; a cushion provided on the frame, the cushion adapted to form a seal with a patient's face; a shroud provided on the frame, the shroud adapted to mount a headgear; an elbow provided on the frame, the elbow adapted to be connected to an air delivery tube that delivers breathable gas to a patient; Equipped with The shroud includes a retention mechanism constructed to establish a positive connection between the shroud and the frame. Mask system. [Additional note 37] 37. The mask system of claim 36, wherein the frame includes a collar surrounding an opening adapted to communicate with the elbow. [Additional note 38] 38. The mask system of claim 37, wherein the retention mechanism includes one or more tabs arranged to be sandwiched between the elbow and the frame. [Additional note 39] 39. The mask system of claim 38, wherein the elbow includes an annular protrusion, the annular protrusion constructed to sandwich the one or more tabs between the collar and the annular protrusion. [Additional note 40] 40. The mask system of claim 39, wherein the collar includes one or more recesses adapted to receive respective tabs formed on the shroud. [Additional note 41] 41. The mask system of any one of clauses 37 to 40, wherein the retention mechanism further comprises one or more snap fingers configured to engage the collar with a snap fit. [Additional note 42] 42. The mask system of claim 41, wherein the collar includes one or more protrusions adapted to engage with respective snap fingers formed on the shroud. [Additional note 43] 43. The mask system of any one of claims 37 to 42, wherein the elbow includes a distal shoulder adapted to extend below an edge of the opening and retain the elbow to the frame. [Additional note 44] 44. The mask system of any one of claims 36 to 43, wherein the frame includes a vent arrangement for gas washout. [Additional note 45] 45. The mask system of any one of clauses 36 to 44, wherein the cushion is a full face cushion. [Additional note 46] 46. ​​A mask system according to any one of claims 36 to 45, wherein the shroud includes a pair of upper headgear connectors adapted to attach upper headgear straps and a pair of lower headgear connectors adapted to attach lower headgear straps. [Additional note 47] 47. The mask system of claim 46, wherein each upper headgear connector includes an elongated arm and a slot at a free end of the arm adapted to receive a respective upper headgear strap. [Additional note 48] A mask system according to any one of claims 46 to 47, wherein each lower headgear connector includes a clip receptacle adapted to releasably interlock with a headgear clip coupled to a respective lower headgear strap. [Additional note 49] A mask system according to any one of claims 46 to 48, wherein each upper headgear connector is formed in a form, shape or contour suitable to follow the contours of the patient's face in use and avoid the patient's line of sight. [Additional Note 50] 50. The mask system of any one of claims 36 to 49, wherein the upper end of the frame includes one or more slots adapted to receive respective tang projections disposed on the underside of the shroud. [Additional note 51] 51. The mask system of any one of claims 36 to 50, wherein the elbow includes an anti-asphyxiation valve. [Additional note 52] 1. A mask system comprising: a frame defining a breathing chamber; and a cushion provided on the frame, the cushion including a body and a cushion, the cushion adapted to engage at least a portion of a patient's face, the cushion including a base wall connected to an undercushion layer and a membrane, the membrane extending around a periphery of the cushion and in contact with the patient's face, the undercushion layer disposed beneath the membrane and supporting the membrane, the undercushion layer providing differential support to the membrane in predetermined areas of the face. [Additional note 53] 53. The mask system of claim 52, wherein the undercushion layers vary in thickness or stiffness to provide differential support. [Additional note 54] 53. The mask system of claim 52, wherein the undercushion layer is absent in certain areas under the membrane to provide differential support. [Additional note 55] 55. The mask system of any one of clauses 52 to 54, wherein the predetermined area of ​​the face includes the bridge of the nose and / or the chin. [Additional note 56] 56. The mask system of claim 55, wherein the frame module is attached to headgear adapted to engage with a patient's head. [Additional note 57] 56. The mask system of claim 55, wherein the frame module is made of nylon. [Additional note 58] 56. The mask system of claim 55, wherein the main body is made of polycarbonate. [Additional note 59] 56. The mask system of claim 55, wherein the cushion is made of matte silicone. [Additional note 60] 1. A medical mask assembly having upper and lower ends defined by their positions relative to a patient's face, connected to a plurality of flexible straps adapted to engage the patient's head, said flexible straps engaging at least two elongated rigid arms integrally molded into a portion of the mask assembly, said elongated arms being molded into the mask assembly near the upper end of the mask assembly. [Additional note 61] 61. The mask assembly of claim 60, wherein the arms are generally arcuate. [Additional note 62] 62. The mask assembly of claim 61, wherein the arms are adapted to extend from the mask assembly in a direction parallel to the patient's cheeks and below the patient's field of view. [Additional note 63] 61. A mask assembly as described in claim 60, covering the patient's nose and mouth. [Additional note 64] 1. A medical mask assembly comprising a body connected to a cushion adapted to cover the nose and / or mouth, and attached with a force substantially perpendicular to the face, said force being approximately constant along the entire length of the mask assembly and balanced by portions of the cushion which engage the patient's cheeks. [Additional note 65] 65. The mask assembly of claim 64, wherein the portion of the cushion is relatively firmer than other areas of the cushion. [Additional note 66] 66. The mask assembly of claim 65, wherein the portion of the cushion is defined by a side of the cushion. [Additional note 67] 67. The mask assembly of claim 66, wherein sides of the cushion engage the patient's cheeks in use to stabilize the mask assembly. [Additional note 68] 68. The mask assembly of claim 67, wherein the area of ​​the cushion adapted to engage the bridge of the nose or the chin is relatively soft when compared to the sides of the cushion. [Additional note 69] 70. The mask assembly of claim 68, wherein the force is provided by a strap engaged with the mask assembly by being attached to at least two elongate arms extending away from the mask assembly in a direction along the patient's cheeks. [Additional note 70] 70. The mask assembly of claim 69, wherein the arms are shaped to avoid limiting the patient's field of vision by avoiding the patient's eye area. [Additional note 71] 71. The mask assembly of claim 70, wherein a padded sleeve covers at least a portion of the arm. [Additional note 72] 72. The mask assembly of claim 71, wherein the sleeve is a relatively resilient, flexible tube. [Additional note 73] A cushion for use with a medical mask, comprising: an outer membrane layer adapted for sealable engagement with the face; an undercushion layer adapted to support the membrane layer; Equipped with The membrane or undercushion layer includes a surface located between the two layers, the surface adapted to allow the layers to slide relative to each other. cushion. [Additional note 74] 74. The cushion of claim 73, wherein the membrane layer is softer than the undercushion layer. [Additional note 75] 75. The cushion of claim 74, wherein the membrane layer is made of a matte polymer or silicone. [Additional note 76] 76. The cushion of claim 75, wherein the undercushion layer is made of a matte polymer or silicone. [Additional note 77] 1. A mask system comprising: A frame defining a breathing chamber; a cushion provided on the frame, the cushion adapted to form a seal with a patient's face; a releasable shroud adapted to engage a portion of an exterior surface of the frame; Equipped with The shroud is connected to a strap to deploy the mask system. Mask system. [Additional note 78] 78. The mask system of claim 77, wherein the shroud engages with the frame through the use of a connector. [Additional note 79] 80. The mask system of claim 78, wherein the shroud includes at least two integrally formed elongated arms. [Additional note 80] 1. A medical mask assembly comprising: a mask having an upper end and a lower end, the upper end adapted to cover the patient's nose and the lower end adapted to cover the patient's mouth; the mask assembly does not include a forehead support and includes two rigid members attached to opposite sides of the upper end of the mask assembly, the rigid members including a generally curved shape and adapted to avoid obscuring the patient's field of vision. Mask assembly. [Additional note 81] 81. The mask assembly of claim 80, wherein the rigid member is curved at an angle of 10° to 20° from a horizontal axis. [Additional note 82] 81. The mask assembly of claim 80, wherein the rigid member is curved at an angle of about 17° from a horizontal axis. [Additional note 83] 1. A flexible cushion for attachment to a medical mask, comprising: a membrane attached to a periphery of the cushion, the membrane adapted to seal against a patient's face; and at least one undercushion positioned below the membrane, adapted to support the membrane to prevent the membrane from collapsing during use, wherein the membrane is softer than the undercushion, and the height of the undercushion in the area of ​​the bridge of the nose or chin is between 0mm and 30mm, measured between the base and tip of the undercushion. [Additional note 84] 84. The cushion of claim 83, wherein the height of the undercushion is less than the height of the membrane. [Additional note 85] 85. The cushion of claim 84, wherein the height of the membrane, measured between the base and tip of the membrane, is between 1 mm and 40 mm. [Additional note 86] 86. The cushion of claim 85, bifurcated into two to form the undercushion and the membrane. [Additional note 87] 1. A medical mask assembly comprising: a mask having an upper end and a lower end, the upper end adapted to cover the patient's nose and the lower end adapted to cover the patient's mouth; A mask assembly, the mask assembly not including a forehead support, but including two rigid members attached to opposite sides of the upper end of the mask assembly, the rigid members including a generally curved shape and adapted to prevent obscuring a patient's field of vision.

[0026] The accompanying drawings facilitate an understanding of various embodiments of the present invention. [Brief description of the drawings]

[0027] [Figure 1] FIG. 1 is a front perspective view of a mask system according to one embodiment of the present invention. [Figure 1B] FIG. 2 is a perspective view showing the mask system of FIG. 1 and headgear placed on a patient's head. [Figure 1C] FIG. 2 is a cross-sectional view of the mask system of FIG. 1. [Figure 1D] FIG. 2 is another cross-sectional view of the mask system of FIG. 1. [Figure 1E] FIG. 2 is a side view of the mask system of FIG. 1. [Diagram 2] FIG. 2 is a front perspective view showing the frame and cushion of the mask system of FIG. 1. [Diagram 3] FIG. 2 is an exploded perspective view of the mask system of FIG. 1 showing the frame, cushion, shroud and elbow. [Figure 4] FIG. 2 is another exploded perspective view of the mask system of FIG. 1 showing the frame, cushion and shroud. [Diagram 5] FIG. 2 is an exploded perspective view of the mask system of FIG. 1 showing the shroud and assembled frame / cushion. [Figure 6] FIG. 2 is a front perspective view of a shroud of the mask system of FIG. 1. [Figure 7] FIG. 2 is a front perspective view of the cushion of the mask system of FIG. 1. [Figure 8] FIG. 8 is a cross-sectional view showing a portion of the cushion of FIG. 7. [Figure 8B] 8 is a cross-sectional view of the nasal bridge and chin areas of the cushion of FIG. 7. [Figure 9] FIG. 2 is a top view of headgear laid flat in accordance with one embodiment of the present invention. [Figure 10] FIG. 2 is a front perspective view of a mask system according to another embodiment of the present invention. [Figure 11] FIG. 11 is a front perspective view of the frame of the mask system of FIG. 10. [Figure 12] FIG. 11 is a front view showing the frame of the mask system of FIG. 10. [Figure 13]FIG. 11 is a side view of the frame of the mask system of FIG. 10. [Figure 14] FIG. 11 is a front perspective view of the shroud of the mask system of FIG. [Figure 15] FIG. 11 is a front view of the shroud of the mask system of FIG. 10. [Figure 16] FIG. 11 is a side view of the shroud of the mask system of FIG. 10. [Figure 17] FIG. 11 is a rear perspective view of the shroud of the mask system of FIG. [Figure 18-1] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 18-2] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 19-1] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 19-2] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 19-3] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 19-4] 11A to 11C are cross-sectional views showing the attachment of the shroud and frame of the mask system of FIG. 10 in sequence. [Figure 20] FIG. 13 is a perspective view showing an alternative arrangement for attaching the shroud to the frame. [Figure 21] FIG. 11 is a rear perspective view of the shroud of the mask system of FIG. [Figure 22] FIG. 11 is a cross-sectional view showing the attachment of the shroud and frame of the mask system of FIG. 10. [Diagram 23] FIG. 11 is a cross-sectional view showing the attachment of the shroud, frame and elbow of the mask system of FIG. [Figure 24] 11A-11C are cross-sectional views showing alternative configurations for mounting the shroud to the frame. [Diagram 25] FIG. 2 is a front perspective view of a mask system according to another embodiment of the present invention. [Figure 26] FIG. 26 is a rear perspective view of the mask system of FIG. 25. [Figure 27] FIG. 2 is a front perspective view of a mask system according to another embodiment of the present invention. [Figure 28] FIG. 28 is an exploded view of the mask system shown in FIG. 27. [Figure 29] FIG. 28 is an enlarged front perspective view of the mask system shown in FIG. 27. [Diagram 30] FIG. 28 is a side view of the mask system shown in FIG. 27. [Figure 31-1] FIG. 2 is a rear view of a cushion according to one embodiment of the present invention. [Figure 31-2] FIG. 31-2 is a front view / partial cutaway view of the cushion shown in FIG. 31-1. [Figure 31-3] This is a cross-sectional view taken along line 31-3-31-3 in Figure 31-1. [Figure 31-4] This is a cross-sectional view taken along line 31-4-31-4 in Figure 31-1. [Figure 31-5] This is a cross-sectional view taken along line 31-5-31-5 in Figure 31-1. [Figure 32-1] FIG. 2 is a top view of a bellows section in accordance with one embodiment of the present invention. [Figure 32-2] FIG. 32-2 is a front view of the bellows section of FIG. 32-1. [Figure 32-3] FIG. 32-2 is a side view of the bellows section of FIG. 32-1. [Diagram 33] FIG. 13 is a side view of a mask system according to an alternative embodiment of the present invention. [Diagram 34] 1 illustrates a cushion including a bellows section according to one embodiment of the present invention. [Figure 35-1] FIG. 13 is a front view of a mask system according to another embodiment of the present invention. [Figure 35-2] FIG. 35-2 is a side view of the mask system of FIG. 35-1. [Figure 35-3] FIG. 35-2 is a rear view of the mask system of FIG. 35-1. [Diagram 36] 2 is a perspective view of a shroud of a mask system according to one embodiment of the present invention. [Figure 37-1] FIG. 2 is a perspective view of a mask system according to another embodiment of the present invention. [Figure 37-2] FIG. 37-2 is a front view of the mask system of FIG. 37-1. [Figure 37-3] FIG. 37-2 is a side view of the mask system of FIG. 37-1. [Figure 38-1] FIG. 37-3 is a perspective view of a shroud of the mask system shown in FIGS. 37-1 to 37-3. [Figure 38-2] FIG. 38-2 is a front view of the shroud of FIG. 38-1. [Figure 38-3] FIG. 38-2 is a top view of the shroud of FIG. 38-1. [Figure 38-4] FIG. 38-2 is a side view of the shroud of FIG. 38-1. [Figure 38-5] FIG. 38-2 is a bottom view of the shroud of FIG. 38-1. [Figure 39-1] FIG. 2 is a perspective view of a mask system according to another embodiment of the present invention. [Figure 39-2] FIG. 39-2 is another perspective view of the mask system of FIG. 39-1. [Figure 39-3] FIG. 39-3 is a front view of the mask system of FIG. [Figure 39-4] FIG. 39-3 is a side view of the mask system of FIG. [Figure 39-5] FIG. 39-3 is a bottom view of the mask system of FIG. [Figure 39-6] FIG. 39-3 is a top view of the mask system of FIG. [Figure 40-1] FIG. 2 is a perspective view of a mask system according to another embodiment of the present invention. [Figure 40-2] FIG. 40-2 is a side view of the mask system of FIG. 40-1. [Figure 40-3] FIG. 40-3 is a perspective view of a frame of the mask system shown in FIGS. 40-1 and 40-2. [Figure 40-4] FIG. 40-4 is a diagram showing a holding member of the frame shown in FIG. [Figure 40-5] FIG. 40-4 is a diagram showing a holding member of the frame shown in FIG. [Figure 40-6]FIG. 40-3 shows the clip-on headgear connector of the mask system shown in FIGS. 40-1 and 40-2. [Figure 40-7] FIG. 40-3 shows the clip-on headgear connector of the mask system shown in FIGS. 40-1 and 40-2. [Figure 41-1] FIG. 13 is a rear perspective view of a mask system according to another embodiment of the present invention. [Figure 41-2] FIG. 41-2 is a front perspective view of the mask system of FIG. 41-1. [Figure 41-3] FIG. 41-1 and 41-2 are exploded views of the mask system shown in FIGS. [Figure 41-4] FIG. 41-1 and 41-2 are exploded views of the mask system shown in FIGS. [Figure 41-5] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-6] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-7] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-8] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-9] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-10] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-11] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 41-12] FIG. 41 shows the clip-on headgear connector of the mask system shown in FIGS. 41-1 and 41-2. [Figure 42-1] FIG. 13 is a rear perspective view of a mask system according to another embodiment of the present invention. [Figure 42-2] FIG. 42-1 is an exploded view of the mask system shown in FIG. [Figure 42-3] FIG. 42-3 shows the clip-on headgear connector of the mask system shown in FIG. 42-1. [Figure 42-4] FIG. 42-3 shows the clip-on headgear connector of the mask system shown in FIG. 42-1. [Figure 42-5] FIG. 42-3 shows the clip-on headgear connector of the mask system shown in FIG. 42-1. [Figure 42-6] FIG. 42-3 shows the clip-on headgear connector of the mask system shown in FIG. 42-1. [Figure 42-7] FIG. 42-3 shows the clip-on headgear connector of the mask system shown in FIG. 42-1. [Figure 43-1] FIG. 2 is a perspective view of a mask system according to another embodiment of the present invention. [Figure 43-2] FIG. 43-2 is a side view of the mask system of FIG. 43-1. [Figure 43-3] FIG. 43-2 is a front view of the mask system of FIG. 43-1. [Figure 43-4] FIG. 43-2 is a rear view of the mask system of FIG. 43-1. [Diagram 44] FIG. 1 illustrates a mask system according to another embodiment of the present invention. [Diagram 45] FIG. 1 illustrates a mask system according to another embodiment of the present invention. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0028] The following description is directed to several embodiments or examples that may have common characteristics and features. It should be understood that one or more features of any one embodiment or example may be combined with one or more features of another embodiment or example. Furthermore, any single feature or combination of features of any of these embodiments or examples may constitute an additional embodiment or example.

[0029] In this specification, the word "comprising" is to be understood in its "open" sense, i.e., "including", and therefore this word is not limited to its "closed" sense, i.e., "consisting only of". When the related words "comprise", "comprised" and "comprises" are used, these words also have the corresponding meanings.

[0030] The term "air" should be understood to include breathable gases, for example air with added oxygen.

[0031] The term "shroud" should be understood to include a component that partially or completely covers a second component in the illustrated embodiment. In one embodiment, the shroud may include a component that partially covers or is mounted on a frame component of the illustrated embodiment.

[0032] The term "positive connection" should be understood to include connections between components of the illustrated embodiments in which connectors mounted on the respective components are adapted to mate with each other.

[0033] 1. Mask System An embodiment of the present invention is directed to a mask system that does not have a forehead support adapted to engage the patient's forehead. Such a configuration provides a mask system with a less obtrusive configuration that does not significantly affect the patient's field of vision. The system is designed so that a forehead support is not required, although such a forehead support can be added if desired.

[0034] As will be described in more detail below, the mask system includes a frame, a cushion provided on the frame and adapted to form a seal with a patient's face, a shroud provided on the frame and adapted to receive headgear, and an elbow provided on the frame and adapted to be connected to an air delivery tube that delivers breathable gas to the patient. The headgear can be removably attached to the shroud to maintain the mask system in a desired adjusted position on the patient's face. The mask system is intended for use in positive pressure therapy for users with obstructive sleep apnea (OSA) or other breathing disorders.

[0035] Although each of the following embodiments is described as including a full-face interface type or an oral / nose interface type, each embodiment can be adapted for use with other suitable interface types, i.e., the interface types are merely examples, and each embodiment can be adapted to include other interface types, such as a nasal interface, a nasal mask, nasal prongs, etc.

[0036] 2. Stabilization mechanism The stabilization features of the mask system (e.g., frame, shroud, headgear with associated headgear vectors) according to embodiments of the present invention are constructed to accommodate the elimination of the forehead support from the full face interface, e.g., the forehead support typically eliminates rotation of the mask system in the sagittal and frontal planes, and thus the mask system and headgear according to embodiments of the present invention are constructed to inherit these features since they do not have this forehead support.

[0037] The headgear connects to the top and bottom of the frame either directly or through a shroud, which provides headgear attachment points for the headgear positioned and arranged to maintain the mask system stably in place on the patient's face.

[0038] 2.1 Frames As shown in Figures 1, 1B-1E and 2-5, the frame 1040 of the mask system 1010 is constructed to maintain the cushion 1060, shroud 1020 and elbow 1070 in a functional position relative to the patient's face. The frame 1040 is fabricated (e.g., injection molded) from a harder material (e.g., polyurethane) than the cushion 1060 (e.g., silicone), although other materials (e.g., polycarbonate) would likely work. In one embodiment, the overall wall thickness of the frame is about 1-2 mm, e.g., 1.5 mm.

[0039] The frame 1040 defines a breathing chamber or cavity adapted to receive the patient's nose and mouth and provide air communication with the patient. A portion, i.e., the lower portion, of the frame 1040 includes an opening 1046 adapted to receive or otherwise communicate with an elbow 1070 (e.g., a swivel elbow), and another portion, i.e., the upper portion, of the frame 1040 includes a vent arrangement 1076 for gas washout. Additionally, the upper portion of the frame 1040 includes an interface structure 1048 that interfaces with or otherwise removably connects to the shroud 1020.

[0040] 27-30 show a mask system 10 including a frame 40 with a cushion 44 providing a sealing portion or ring adapted to form a seal with the patient's nose and / or mouth. The frame 40 further includes an opening 46 adapted to communicate with an elbow 70.

[0041] 2.2 Shroud As shown in Figures 1 and 3-6, the shroud 1020 is connected to a frame 1040 and is constructed to mount the headgear to the mask system. In one embodiment, the shroud 1020 is fabricated (e.g., injection molded) from a resilient material including, but not limited to, plastic or nylon (e.g., Nylon 12). However, the shroud may be fabricated from other suitable materials, such as polycarbonate, polypropylene, thermoplastic elastomers (TPE), Pocan®, etc. In one embodiment, the shroud has an overall wall thickness of about 1-2 mm, e.g., 1.3 mm.

[0042] The upper end of the shroud 1020 is adapted to be positioned near the patient's nasal bridge area or nose, and the lower end is adapted to be positioned near the patient's mouth or chin. The upper end of the shroud includes an opening or vent receiving hole 1021 that receives a vent arrangement 1076 protruding from the frame 1040, and the lower end includes an opening or elbow hole 1032 that receives the elbow 1070 and the elbow opening of the frame 1040 (e.g., the shroud does not contact the elbow when assembled).

[0043] Extending from either side of the upper end are upper headgear connectors 1024 and extending from either side of the lower end are lower headgear connectors 1025. The headgear connectors 1024, 1025 may be integrally molded with the shroud or may be otherwise attached to the shroud.

[0044] 2.2.1 Upper Headgear Connector Each of the upper headgear connectors 1024 includes an elongated arm 1026 and a slot or receiving hole 1027 at a free end of the arm 1026 adapted to receive a respective headgear strap. In use, the arms 1026 wrap around the patient's face and extend below the patient's eyes at a generally concave angle to avoid the patient's line of sight, i.e., to guide the headgear away from the patient's eyes. For example, as shown in FIG. 1E, each of the arms 1026 can extend at an angle α of about 10-25° (e.g., 17°) relative to the horizontal. That is, each of the arms 1026 is formed in a form, shape or contour suitable to follow the contours of the patient's face in use and avoid the line of sight. In one embodiment, the shape of the arms can be generally arcuate and extend in a direction across the patient's cheeks, adapted to avoid the eyes, i.e., to avoid limiting the field of view. In one embodiment, the arms can be integrally molded into the shroud of the mask system. One possible advantage of molding the arms onto the shroud is that manufacturability is greatly increased, and furthermore, in the event of accidental breakage of the arms, the shroud can be easily replaced rather than replacing the entire mask system. Furthermore, molding the arms onto the shroud can greatly increase the strength of the connection, reducing or limiting the actual likelihood of the arms breaking.

[0045] In one embodiment, the arm 1026 is at least semi-rigid (e.g., relatively stiff) to prevent the arm from moving up and down or bending relative to the patient's face. The arm 1026 can therefore effectively function as a stable configuration and act as a rigidizer that creates a mechanical advantage where pressure or force applied to the top of the mask system is rebalanced against a fulcrum that is near the center of equilibrium between the top and bottom of the mask system. To further stabilize this configuration, in one embodiment, the arm is attached at the highest point possible relative to the mask system. In one embodiment, a pivot fulcrum or moment is located between the top and bottom connection points of the straps, and the design, angle, length and / or shape of the arm 1026 can effectively adjust this fulcrum. In the illustrated embodiment, this fulcrum is shown to be between the vent configuration and the elbow of the mask system. Additionally, when placed on the face, the mask system can have a fulcrum around or near the area between the bottom of the patient's nose and the lip area. This feature effectively stabilizes the mask system on the surface of the patient's face without the traditionally required forehead support.

[0046] The net result of the arm 1026 being attached at a position that extends from the top of the mask system around the patient's face is that the mask system is more stable during use, reducing the net twisting force experienced about the x-axis 1001 (see FIG. 1) of the mask system. It should be noted that the arm 1026 could be rigidly connected to another suitable position on the mask system to produce a similar result.

[0047] In one embodiment, the arm 1026 can be used to stabilize the mask system by contacting the patient's cheek. Cheek pads can be placed on the inner surface of the arm to support the arm against the patient's cheek during use. The arm 1026 can also be covered with a soft fabric sleeve that provides additional padding against the patient's cheek. The soft fabric sleeve can have the form of a resilient tube that covers a portion of the arm 1026.

[0048] 2.2.2 Lower Headgear Connector Each lower headgear connector 1025 includes a short arm and a clip receptacle 1031 at a free end of the arm adapted to releasably interlock with a headgear clip coupled to a respective headgear strap. The clip allows for easier placement or donning / removal of the mask system. In one embodiment, the short arm and clip are also relatively stiff to prevent the arm from moving laterally along the y-axis 1002 relative to the mask system during use.

[0049] Figures 27-30 show exemplary headgear clips 33 adapted to releasably interlock with clip receptacles 31. As best shown in Figure 28, each clip 33 includes two spring arms 35 adapted to interlock with a respective clip receptacle 31 by a snap fit, and a slot 37 adapted to receive a respective headgear strap in use.

[0050] 2.2.3 Alternative Headgear Connectors 27-30, the arm 26 can be removably coupled to the shroud, for example, the arm 26 includes a clip structure adapted to removably interlock with a clip receptacle disposed on the shroud. This configuration allows for various styles of upper and lower headgear connectors to be used with the shroud, for example, arms for both upper and lower headgear connectors, clips for both upper and lower headgear connectors, arms of different lengths for the upper and lower headgear connectors, etc.

[0051] However, the shroud may provide another suitable configuration for attaching the headgear straps of the headgear. Additionally, the shroud may include one or more additional components, such as a forehead support.

[0052] 2.2.4 Headgear Connector Location 1-6, the upper and lower headgear connectors 1024, 1025 provide headgear connection points as far away from each other (i.e., the top and bottom of the frame) as possible to allow for greater adjustability (e.g., allowing adjustment at the top and bottom of the mask system) and stability (e.g., anchor points are distributed throughout the mask system and therefore more stable on the patient's face). Additionally, the upper headgear connector is positioned as close to the top of the mask system as possible without blocking the patient's eyes during use.

[0053] 2.2.5 Separate Shroud In the embodiment of Figures 1-6, the shroud 1020 is formed (e.g., molded) separately and attached to the frame 1040. Such a configuration facilitates molding of the shroud, allows for different materials to be used for the frame and shroud (e.g., the frame can be semi-rigid or rigid for stability and the shroud with the headgear rigidizer can be flexible for adjustment), allows the shroud to hide elbow retention features around the elbow / frame opening that holds the elbow to the frame (e.g., providing a visually appealing shroud for aesthetic appeal), allows for frames without lower clip receptacles, allows the shroud to be used with frames of various sizes, and allows the shroud to be designed and modeled to make the mask system as unobtrusive as possible. This separate shroud further allows for independent replacement and cleaning of the headgear, frame, cushion and / or elbow.

[0054] 2.2.6 Sleeves In one embodiment, the upper and / or lower headgear connectors may be fitted with a soft woven sleeve. For example, the sleeve may be elastic and may be adapted to slide over the arms of the headgear connector to form an interference fit. In one embodiment, the sleeve forms a resilient tube. The sleeve may be padded to increase the comfort of the mask system during use. The sleeve may be particularly useful, for example, to protect the patient's skin from irritation when the arms of the headgear connector come into contact with the patient's skin.

[0055] 2.2.7 Arms that extend over the patient's ears Figures 35-1 to 35-3 and 36 show a shroud 220 for a mask system 210 according to another embodiment of the invention. The shroud 220 includes an annular retaining portion 222 constructed to retain a frame 240, and upper and lower headgear connectors 224, 225 on either side of the retaining portion 222. In the embodiment shown, the shroud 220 is integrally formed as a single piece (see, e.g., Figure 36).

[0056] In the embodiment shown, the upper headgear connectors 224 each include an elongated arm 226 and a slot 227 at a free end of the arm 226 adapted to receive a respective rear strap 298 in use. As shown, the arms 226 extend along the cheek and past the above of the patient's ear just in front of the patient's temple, and are suitably contoured to hold each rear strap 298 in a position above and spaced from the patient's ear, e.g., to prevent the straps from rubbing or irritating the patient's ear during use.

[0057] Additionally, each of the arms 226 is constructed to extend along and engage with an upper strap 292 of the headgear during use. Each of the arms 226 is secured to the upper strap 292 as shown to add stiffness to the strap and stabilize the mask system on the patient's face during use. Additionally, the strap 292 provides padding for the arms 226 on the patient's face during use. In one embodiment, the upper strap 292 can be secured to the arms 226 by, for example, gluing or stitching. Alternatively, the arms 226 can be encased by or inserted into the respective strap 292 such that the arms 226 are substantially invisible.

[0058] Each lower headgear connector 225 includes a short arm 228 having at its free end a slot 229 adapted to receive a respective lower strap 294 in use. As shown, the arms 228 are appropriately oriented to hold each lower strap 294 below and spaced from the patient's ear, for example to prevent the straps from rubbing or irritating the patient's ear during use.

[0059] In one embodiment, the arms can each be attached to the top of the mask system, with each arm curving below the patient's field of view or eyes and curving upwards at an angle of about 10 to 20 degrees from the horizontal axis.

[0060] In an alternative embodiment, as shown in Fig. 36, each lower headgear connector 225 may include a clip receptacle 231 adapted to releasably interlock with a headgear clip (not shown) coupled to a respective lower strap 294. In one embodiment, the headgear clip receptacles and clips may be similar to those of ResMed's Mirage Liberty™ mask. Exemplary clip configurations are disclosed in U.S. Patent Application Publication Nos. 2007 / 0144525 and 2006 / 0283461, each of which is incorporated herein by reference in its entirety.

[0061] 2.2.8 Shroud without upper headgear connector 37-1 to 37-3 show a mask system 310 according to another embodiment of the present invention. As shown, the mask system 310 includes a shroud 320, a frame 340, a cushion 344 and an elbow 370.

[0062] As best shown in Figures 38-1 through 38-5, the shroud 320 includes an opening 322 constructed to receive the elbow 370 and headgear connectors 325 on either side thereof. In the embodiment shown, the headgear connectors 325 each include a clip receptacle 331 adapted to releasably interlock with a headgear clip (not shown) coupled to a respective lower headgear strap.

[0063] Frame 340 is removably attached to shroud 320 , for example, with fingers and tabs 345 extending from openings 322 adapted to engage with a collar of frame 340 .

[0064] The frame 340 includes upper headgear connectors 324 on either side of its upper portion. The headgear connectors 324 each include a clip retainer 333 adapted to releasably interlock with a headgear clip (not shown) coupled to a respective upper headgear strap.

[0065] Figures 39-1 through 39-6 show alternative forms of the mask system 310, indicated by like reference numerals. As shown, the frame 340 does not have an upper headgear connector, and the clip receptacles 331 each include an alternative configuration (e.g., holes for snap-fit ​​tabs on the clips). Additionally, the shroud 320 of Figures 39-1 through 39-6 includes a support bar 329 constructed to wrap around each auxiliary port 343, while the shroud 320 of Figures 37-1 through 38-5 includes a support bar 329 that extends in front of each auxiliary port 343.

[0066] 2.3 Headgear To maintain the mask system 1010 in a desired position on the patient's face, headgear can be removably attached to headgear connectors 1024, 1025 of the shroud 1020. See, for example, Figure 1B.

[0067] As shown in FIG. 9, the headgear 1090 includes a pair of upper and lower straps 1092, 1094, with the upper strap 1092 removably attached to a respective upper headgear connector 1024 and the lower strap 1094 removably attached to a respective lower headgear connector 1025. The free end of each strap may include a Velcro® tab configured to engage with the remainder of the strap to secure the strap in place. Such Velcro® attachment further allows the length of the strap to be adjusted. However, the upper and lower headgear straps may be secured to the shroud in other suitable manners, such as an adjustable ladder-lock arrangement.

[0068] The upper strap 1092 splits at the crown of the patient's head into a top strap 1096 (e.g., connected to one another by a buckle) that is adapted to pass over the patient's head in use, and a rear strap 1098 that is adapted to pass behind the patient's head in use. In one embodiment, the headgear 1090 is constructed to be free standing.

[0069] In Figure 9, the top straps 1096 are adapted to be connected together by a buckle. In an alternative embodiment, as shown in Figures 27-30, the headgear 90 can include upper and lower straps 92, 94, a top strap 96 and a rear strap 98, with the top strap 96 being integral with one another.

[0070] The upper strap 1092 is designed to adjust the position of the mask in a similar manner as an adjustable forehead support changes the position of the mask system, i.e., moves the top of the mask system closer to or further away from the bridge of the patient's nose.

[0071] Since there is no forehead support, this headgear is connected to the top and bottom of the mask frame 1040 via shrouds 1020, and the arms 1026 of the upper headgear connector extend at an angle to avoid the eyes and ears. This aligns the headgear vectors V1 and V2 (see Figures 1 and 1B) such that the mask system has a tendency to ride up on the patient's face (i.e., the upper headgear connector directs the upper headgear vector upwards from the horizontal, and the lower headgear connector directs the lower headgear vector generally horizontal). By splitting the upper headgear straps 1092 at the crown of the patient's head (i.e., the top and back straps 1096, 1098), the upper headgear vector is realigned to prevent the mask system from riding up on the patient's face.

[0072] 2.3.1 Headgear adjustment 35-1 through 35-3 show headgear 290 attached to headgear connectors 224, 225 of shroud 220 to maintain the mask system in a desired position on the patient's face.

[0073] In the illustrated embodiment, the headgear 290 includes a pair of upper or top straps 292, a pair of lower or bottom straps 294, and a pair of rear straps 298. In use, the upper straps 292 are secured to respective upper connectors or arms 226, the lower straps 294 are removably attached to respective lower connectors via slots 229 / clip arrangements 231, and the rear straps 298 are removably attached to respective upper connectors via slots 227. The upper straps 292 may include upper strap portions adapted to pass over the patient's head and couple to one another, for example, via a headgear buckle or adjustable ladder lock arrangement 299. In the illustrated embodiment, the lower straps 294 and rear straps 298 are formed as a single piece.

[0074] This headgear configuration allows for adjustment in three positions: top strap 292 adjustment at headgear buckle 299, bottom strap 294 adjustment at slot 229 / clip 231 connection, and rear strap 298 adjustment at slot 227 connection.

[0075] As shown, the free end of each strap may include a hook-and-loop tab 295 (e.g., Velcro®) constructed to engage the remainder of the strap to releasably secure the strap in place. Such hook-and-loop attachment further facilitates adjustment of the length of the strap.

[0076] In the embodiment shown, bottom strap 294 and rear strap 298 join and are adapted to pass behind the patient's head during use (see, e.g., FIG. 35-3). As shown, bottom strap 294 joins at an angle α (e.g., an angle similar to the bottom strap of ResMed's Mirage Liberty mask) to prevent the strap from irritating the patient's neck and / or from shifting due to movement of the patient's neck during use.

[0077] In one embodiment, the headgear can be similar to that of ResMed's Mirage Liberty mask, but with a modified top strap and the addition of a rigidizer system. The top strap can be similar to ResMed's Swift style headgear with rigidizers running along the sides.

[0078] 2.3.2 Alternative Headgear Materials 43-1 through 43-4 show a mask system 610 including a mask 615 and headgear 690 according to another embodiment of the present invention. In the embodiment shown, the headgear 690 includes a strap arrangement in which some straps are made from silicone and some straps are made from Breath-O-Prene™ material. However, the headgear can also be made such that the straps are made entirely from silicone or entirely from Breath-O-Prene™.

[0079] As shown, a lower strap portion 692 of the headgear is made from Breath-O-Prene™ and extends along the cheeks and around the back of the patient's head. An upper strap portion 694 of the headgear is made from silicone and includes side straps 694(1) that extend along the upper cheeks and pass above the patient's ears, a top strap 694(2) that extends across the top of the patient's head, a rear strap 694(3) that extends across the back of the patient's head and connects to the lower strap portion 692 (see FIG. 43-4 ), and a connecting portion 694(4) that extends from each side strap 694(1) in front of the patient's ears and connects to the lower strap portion 692.

[0080] The headgear straps may be connected to the mask in any suitable manner, for example, in the embodiment shown, a lower strap portion 692 is connected to the mask by a headgear clip arrangement and an upper strap portion 694 is connected to the mask using an elongated buckle 695 having a buckle portion on each end.

[0081] In one embodiment, the headgear straps are configured such that the force vectors applied by the headgear to the mask are substantially perpendicular to the mask and substantially parallel to each other (e.g., as shown by the arrows in FIG. 43-2.) This configuration enhances the seal of the mask because the headgear presses the mask directly against the patient's face.

[0082] 3. Stickers The seal (ie, cushion) of the mask system is constructed to accommodate the elimination of forehead support from the full-face interface.

[0083] 3.1 Cushioning As shown in Figures 1-5 and 7-8, the cushion 1060 is constructed to interface with the frame 1040 and form a seal with the patient's nose and mouth in use. In the embodiment shown, the cushion is a full face cushion adapted to engage the patient's face generally along the bridge of the nose, cheeks and lower lip / chin area of ​​the patient's face. However, other cushion interfaces are possible, such as nasal interfaces.

[0084] The cushion 1060 is constructed to be more pliable or flexible (eg, particularly in the nasal bridge area) to absorb more of the movement caused by some of the loss of stability due to the lack of forehead support.

[0085] The cushion 1060 is fabricated from a soft, pliable biocompatible material, such as silicone, for example. In the embodiment shown, the cushion 1060 includes a dual wall configuration with an undercushion or support wall 1062 below a membrane 1064, as shown in FIG.

[0086] The membrane 1064 is generally softer and less stiff than the undercushion 1062 and provides a seal against the patient's face in use. The membrane can be relatively thin to allow for a wider range of contact and better conformance to the patient's face, allowing for less mask stability due to the lack of forehead support. The undercushion is constructed to provide general support for the membrane and prevent it from collapsing when the mask system is attached and tightened using headgear.

[0087] The membrane 1064 is generally concave and curves inwardly towards the breathing chamber. The undercushion 1062 also curves inwardly, but is generally shorter, thicker and stiffer than the membrane.

[0088] In one embodiment, the undercushion 1062 is lower or absent in the patient's nasal bridge and / or chin areas, and the height of the undercushion 1062 from tip to base may be approximately 0 to 30 mm. The membrane is generally longer than the undercushion 1062 in a given cross section, and may be approximately 1 to 40 mm. For example, Figure 8B shows a cross section taken through a line through the nasal bridge and chin areas of the cushion to show the membrane 1064 without the undercushion in these areas.

[0089] In one embodiment, the undercushion 1062 may be provided only in selected areas of the mask system, for example in areas that push the mask system away from the patient's face. It is preferable to avoid applying pressure by tightening the headgear in certain areas of the patient's face. In the embodiment shown, the patient's nose bridge and chin areas do not include the undercushion 1062. In these areas, to more evenly distribute the force vectors applied by the mask system during use, the undercushion is provided only along the sides of the cushion that press against the patient's cheeks (see, for example, FIG. 7). In one embodiment, the stiffness of the undercushion along the cheek areas may be relatively high, since these contact points act as anchor points, i.e., they hold the mask system in the proper position to provide an effective seal.

[0090] This configuration, which avoids the patient's nose bridge and chin, can increase the patient's perceived comfort of the mask system by reducing pressure or force on sensitive areas of the patient's face or on protruding areas that experience relatively high contact pressures. Additionally, this configuration prevents the cushion from pinching the patient's nose bridge when adjusting the mask system. Additionally, the absence of an undercushion allows the cushion in this embodiment to be significantly softer in the nose bridge and chin areas.

[0091] In one embodiment, the undercushion may include variable height, stiffness and / or thickness to create variable softness in certain areas of the face that require lighter support as discussed above.

[0092] In the embodiment shown, the cushion can be constructed to seal lower on the bridge of the patient's nose and eye sockets so that the cushion is less obtrusive.

[0093] In one embodiment, the cushion can be matte-finished throughout, except for the patient-facing surface, which is matte-finished. In one embodiment, the matte-finish of the cushion can reduce the restriction between the face and the membrane and / or between the membrane and the undercushion. The matte-finish allows the membrane and undercushion surfaces to slide against each other without causing the same restriction as non-matte silicone. This feature can further prevent or limit sticking between the membrane and undercushion components, and generally improve the overall comfort and sealing properties of the cushion. Additionally, the matte-finish of the cushion can facilitate manufacturing, leading to reduced manufacturing costs. The cushion can be fabricated from matte silicone or other suitable materials.

[0094] 3.2 Lower cushion on the bridge of the nose 31-1 through 31-5 show various views of a cushion 44 (e.g., made of silicone) according to one embodiment of the present invention. As shown, the cushion 44 includes a base wall 44(1) provided on a frame, an undercushion layer (UCL) 44(2) extending away from the base wall 44(1), and a membrane 44(3) provided to substantially cover the UCL 44(2) and provide a sealing structure. In the embodiment shown, the cushion 44 is constructed to sit lower on the bridge of the nose to make the mask less obtrusive when in use and to improve "line of sight."

[0095] Additionally, as best shown in Figures 31-3 and 31-5, the design of the UCL 44(2) in the nasal bridge region is constructed to provide improved stability across the bridge of the nose when in use. As shown in Figures 31-1 and 31-3, no UCL is provided in the lower lip / chin region. However, other placements of the UCL are possible, such as a circumferential placement of the UCL.

[0096] In one embodiment of the cushion shown in Figures 31-1 to 31-5, D1 is about 15 to 20 mm, for example 18.2 mm, D2 is about 53 to 59 mm, for example 55.8 mm, D3 is about 88 to 93 mm, for example 90 mm, D4 is about 78 to 83 mm, for example 81.1 mm, D5 is about 58 to 63 mm, for example 60 mm, D6 is about 95 to 100 mm, for example 98.1 mm, D7 is about 57 to 62 mm, for example 59.7 mm, and D8 is about 77 to 81 mm, for example 82. D9 may be about 88-93 mm, e.g., 90.7 mm, D10 may be about 30-35 mm, e.g., 33.1 mm, D11 may be about 14-19 mm, e.g., 16.4 mm, D12 may be about 8-13 mm, e.g., 9.6 mm, D13 may be about 0.3-0.5 mm, e.g., 0.35 mm, D14 may be about 0.4-0.6 mm, e.g., 0.5 mm, and D15 may be about 0.3-0.5 mm, e.g., 0.4 mm. Although specific dimensions and ranges are given, it should be understood that these dimensions and ranges are merely examples and other dimensions and ranges are possible depending on the application. For example, depending on the application, these exemplary dimensions may be varied by 10-20% or more or less.

[0097] 3.3 Higher cushion on the nose bridge 35-1 and 35-2 show a full face cushion 244 adapted to engage the patient's face generally along the bridge of the nose, cheeks and lower lip / chin area of ​​the patient's face. In this embodiment, the cushion 244 is constructed such that the cushion is positioned higher on the bridge of the nose (e.g., as compared to cushion 44 described above) for better seal and comfort. The cushion 244 may also be more suitable in terms of anthropometrics, i.e., it will fit a larger number of people.

[0098] In one embodiment, the cushion 244 may include a concertina section (eg, in the nasal bridge area), as described below, to increase the flexibility of the cushion during use.

[0099] 3.4 Bellows Section As best shown in Figures 30 and 33, a bellows section 50 can be formed in the nasal bridge area of ​​the cushion and / or frame. As shown, bellows section 50 includes a bellows structure having one or more pleats 52 that provide a higher degree of flexibility or increased movement. That is, bellows section 50 provides a higher level of conformance or flexibility to the nasal bridge area of ​​the cushion / frame during use, which is a more sensitive area of ​​the patient's face. Additionally, bellows section 50 provides increased movement without adversely affecting the seal.

[0100] 32-1 through 32-3 show various views of a bellows section 50 (separated from the remainder of the cushion / frame) according to one embodiment of the present invention having one or more pleats 52. As best shown in FIG. 32-3, the pleats can have various lengths, depths and / or contours relative to one another to optimize the bellows effect, e.g., to provide a sufficient degree of movement without adversely affecting the seal. For example, as shown in FIG. 32-3, each of the pleats 52 includes a first side wall 52(1) and a second side wall 52(2) interconnected with the adjacent side wall 52(1).

[0101] In the illustrated embodiment, the first sidewall 52(1) and / or the second sidewall 52(2) can be progressively longer as they move away from the patient's face. For example, the first sidewall 52(1) and / or the second sidewall 52(2), or a combination of sidewalls 52(1) and 52(2) adjacent the patient's face, can have a length that is longer than the adjacent sidewall 52(1) and / or 52(2), and in some cases significantly longer than the adjacent sidewall 52(1) and / or 52(2) (e.g., one sidewall can be at least 25% larger than the other sidewall, and can be up to five times, e.g., one, two, three or four times, the other sidewall).

[0102] The pleats can be constructed and configured to move or collapse in a predetermined order, for example, the pleats can be constructed to collapse in a sequential or stepwise manner, with one pleat collapsing before an adjacent pleat. For example, when a force is applied, pleats closer to the patient's face will fold or collapse before pleats further from the patient's face. Additionally, the pleats can be constructed and configured to fold or collapse to different degrees, for example, some pleats can fold or collapse more than others.

[0103] In one embodiment of the bellows section shown in Figures 32-1 through 32-3, D1 may be about 50-60 mm, e.g., 55.7 mm, D2 may be about 5-15 mm, e.g., 9.7 mm, and D3 may be about 0.3-0.5 mm, e.g., 0.4 mm. Although specific dimensions and ranges are shown, it should be understood that these dimensions and ranges are merely examples and other dimensions and ranges are possible depending on the application. For example, these exemplary dimensions may be varied by 10-20% or more or less depending on the application.

[0104] It should be appreciated that bellows section 50 may be positioned in other areas of the cushion and / or frame, e.g., according to patient comfort. For example, bellows section 50 may be positioned around the entire periphery of the cushion and / or frame, or bellows section 50 may be positioned in selected areas of the cushion and / or frame.

[0105] Additionally, the flexibility of the bellows section 50 can be varied, and the flexibility of the bellows section 50 in different regions of the cushion and / or frame can be varied, for example, according to patient comfort. For example, the cushion and / or frame can include a bellows section having a relatively high flexibility in the nose bridge region and a bellows section having a relatively low flexibility in the lower lip / chin region. The flexibility of the bellows section 50 can be varied by changing the number of pleats 52 (e.g., 1-5), the length and thickness of the walls of the pleats 52, the depth of the pleats 52, etc.

[0106] As previously mentioned, the cushion and frame can be co-molded from two parts having different materials / stiffness or can be integrally formed from the same material. In both embodiments, the bellows section can be located in the frame and / or the cushion.

[0107] In Figures 27-30, the cushion 44 and the frame 40 are co-molded from two parts, with the bellows section 50 disposed in the frame 40. The frame 40 and the cushion 44 include different stiffnesses to optimize the function of each part. For example, one part (i.e., the cushion 44) can be made from a relatively soft and pliable material to optimize the sealing effect, while the other part (i.e., the frame 40) can be made from a stiffer material to provide sufficient support for the cushion while allowing a sufficient degree of movement to optimize the bellows effect. The frame can be made from a flexible material that is stiffer than the cushion, but allows for the bellows effect.

[0108] In Figure 33, frame 40 and cushion 44 are integrally formed as a single piece, with bellows section 50 disposed on frame 40. Material properties and / or dimensions can be selectively altered to optimize sealing and bellows effects.

[0109] With respect to the embodiments of both Figures 27-30 and Figure 33, it should be understood that the bellows section can alternatively be located on the cushion 44 or on both the frame 40 and the cushion 44. For example, Figure 34 shows the bellows section 50 in the nose bridge region integrally formed with the cushion 44.

[0110] 4. Elbow 3, elbow 1070 (fabricated from a relatively rigid material, such as polycarbonate, polypropylene, etc.) includes a first end 1074(1) and a second end 1074(2). First end 1074(1) provides an interface structure constructed to interface with or otherwise connect to frame 1040. Second end 1074(2) is adapted to connect to an air delivery tube.

[0111] 4.1 Elbow and frame connection The frame 1040 is constructed to maintain the elbow 1070 in a functional position relative to the patient's face, i.e., the frame serves as a bearing and supporting surface for the elbow. The frame and elbow may be connected by a friction fit, a snap fit, a mechanical interlock, or other suitable attachment mechanism, however, other suitable configurations for attaching the elbow to the frame are possible.

[0112] In the embodiment shown, the elbow 1070 includes a series of tangs 1075 adapted to releasably engage, e.g., by a snap fit, with the opening 1032 in the frame 1040. The tangs 1075 hold the elbow in place (preferably, e.g., in a relatively airtight connection) and allow the elbow to rotate or pivot relative to the frame.

[0113] That is, the elbow is rotatably mounted to the frame such that the elbow can be rotated, for example, 360° relative to the frame during use. This configuration allows the elbow to be oriented in different directions during use, for example, depending on the patient's preference. For example, the elbow can be oriented in a first direction such that the elbow extends generally downward from the mask to guide the air delivery tube under the patient's head during use. Alternatively, the elbow can be rotated and oriented in a second direction such that the elbow extends upward from the mask to guide the air delivery tube over the patient's head during use. In one embodiment, the frame and elbow can be made of different materials to prevent or at least reduce creaking between the frame and elbow during use.

[0114] The second end of the elbow can be provided with a swivel fitting adapted to be connected to the air delivery tube. For example, Figures 27-30 show a swivel fitting 80 provided on the second end 74(2) of the elbow 70. In the embodiment shown, the swivel fitting 80 is provided on a short tube 82 (e.g., a retractable tube) that interconnects the elbow and the air delivery tube. In one embodiment, the swivel fitting 80 and the short tube 82 can be integrally formed as a single piece.

[0115] 4.2 AAV Elbow 1070 includes a slot 1081 for receiving an anti-asphyxiation valve (AAV), a port 1079 that is selectively closed by a flap portion of the AAV (depending on the presence or absence of pressurized gas), and structure for attaching the AAV, for example by a snap fit.

[0116] 27-30 illustrate an exemplary AAV 85 that includes a flap portion 86 that selectively closes the port 79 in the elbow 70. In this embodiment, the flap portion 86 is provided with a clip portion 88 for attaching the AAV 85 to the elbow 70. In the embodiment shown, the flap portion 86 and the clip portion 88 are co-molded together to form a single piece, integral component. However, the flap portion 86 and the clip portion 88 can be secured together in any other suitable manner, such as with a mechanical interlock.

[0117] In one embodiment, the flap portion 86 may be made from a relatively soft elastomeric material (eg, silicone) and the clip portion 88 may be made from a harder material (eg, hard plastic) for interfacing with the elbow 70.

[0118] The clip portion 88 of the AAV 85 includes structure for releasably interlocking with the elbow 70, for example, by a snap fit. For example, the clip portion 88 may include tabs constructed to interlock with respective recesses / protrusions formed in the elbow.

[0119] Figures 35-1 and 35-2 show elbow 270 including a port 279 that is selectively closed (depending on the presence or absence of pressurized gas) by a flap portion 286 of an AAV 285. Figures 37-1 through 37-3 also show elbow 370 including a port 379 and a slot 381 that retains an AAV.

[0120] Alternative embodiments of AAVs are disclosed in PCT Application No. PCT / AU2006 / 000031, which is incorporated herein by reference in its entirety.

[0121] 4.3 Large diameter end 27-30, the first end 74(1) of the elbow 70 may have a relatively large diameter that provides the potential for cleaner / smoother lines, thereby contributing to an overall improved appearance of the mask and making the mask less obtrusive. Additionally, this relatively large elbow diameter provides the potential for the patient's nose to protrude into the elbow cavity, thereby allowing the mask to be closer to the patient's face (i.e., less obtrusive), less moment due to the mask's center of gravity being closer to the patient's face, and / or improved line of sight.

[0122] 5. Modular design The mask system provides a modular design that allows for various styles and / or sizes of frames (also referred to as frame modules), shrouds (also referred to as shroud modules), cushions (also referred to as cushion modules) and / or elbows (also referred to as elbow modules) to be interchanged or mixed and matched with one another to provide a more customized mask system for the patient. Moreover, such a design allows for easy replacement of selected modules, for example, in the event of changing treatment requirements, wear or damage, etc.

[0123] In one embodiment, the mask system can include several different cushions, each having a different style and / or size of cushion (e.g., depending on patient preference and / or fit). For example, the non-face-contacting side of each cushion can include a common or generic configuration that interfaces with the frame, and the face-contacting side of the cushion can include a different style and / or size. This provides a modular configuration that allows the frame to be selectively (e.g., removably) coupled to one of the multiple cushions. The different cushions can include, for example, cushions of different sizes (e.g., small, medium, and large) and can include different cushion configurations.

[0124] In one embodiment, the mask system may include different shrouds, e.g., shrouds having different types and / or sizes (e.g., shrouds with different headgear connector configurations / types, shrouds with forehead supports, shrouds with different headgear vectors, etc.).

[0125] In one embodiment, a mask system may include different frames, for example frames having different styles and / or sizes (eg, frames with different vent configurations, small, medium and large size frames, etc.).

[0126] In one embodiment, a mask system can include several different elbows, e.g., each having a vent configuration, an AAV (in the case of an oral-nasal mask), and / or different styles and / or sizes. In the embodiment shown in Figures 27-30, a vent configuration 76 and an AAV 85 are constructed such that they can be removably attached to the elbow 70. This provides a modular configuration that allows the elbow to be selectively and removably coupled to one of multiple vent configurations and / or AAVs. This further allows the vent configurations and AAVs to be easily replaced, e.g., if they are damaged.

[0127] 5.1 Shroud and frame connection The shroud is attached to the exterior surface of the frame, preferably by a matching interference fit onto the frame.

[0128] 5.1.1 Upper holding mechanism In the embodiment shown in Figures 1-5, shroud 1020 is connected to frame 1040 by an upper retention mechanism or interface structure 1048 located at the upper end of the frame.

[0129] 2-5, the upper retention mechanism 1048 has the form of two taper locks that are constructed to secure the shroud 1020 on the frame 1040 and prevent unintentional disassembly due to headgear forces, among other things. In this embodiment, each side of the frame includes a female slot 1055 that is adapted to receive a respective tang projection (which is tapered along its length) on the underside of the shroud 1020. The tapered projections engage with the respective female slots, for example, by a friction fit.

[0130] Figures 10 to 19-4 show another embodiment of a mask system 1110, more clearly illustrating one embodiment of a taper lock. Figures 10 to 17 show various views of the frame 1140, shroud 1120 and elbow 1170 of the mask system 1110.

[0131] As best shown in FIGS. 11-13, each side of the upper end of the frame 1140 includes a platform 1154 that provides a first female slot 1155(1). Additionally, the space between the platform 1154 and the outer surface of the frame 1140 defines a second female slot 1155(2). As best shown in FIG. 17, each side of the upper end of the shroud 1120 includes a tang projection 1156 on the underside of the shroud 1120. The tang projection 1156 includes a first tang 1156(1) and a second tang 1156(2) that extends generally perpendicular to the first tang 1156(1). As shown in FIGS. 18-1 and 18-2, each tang is tapered along its length, i.e., thinner toward its free end.

[0132] FIGS. 18-1 and 18-2 and 19-1 through 19-4 sequentially illustrate the installation of the shroud 1120 to the frame 1140. As shown, the tangs 1156(1), 1156(2) of each tang projection 1156 are constructed to engage, for example, by a friction fit, with the respective slots 1155(1), 1155(2). As best shown in FIGS. 19-1 through 19-4, each slot 1155(2) includes a lead-in or guide 1157 that is curved (i.e., extends vertically and horizontally) along its length to guide the tang 1156(2) into the slot 1155(2) and aid in assembly. FIGS. 18-2 and 19-4 show the tangs 1156(1), 1156(2) when fully inserted into their respective slots 1155(1), 1155(2).

[0133] In an alternative embodiment, the upper retention mechanism may include a clip-type configuration, as shown in FIG. 20. As shown, each side of the upper end of the frame 1240 provides a shoulder 1255(1) and a tapered protrusion 1255(2). Each side of the upper end of the shroud 1220 includes a first tang 1256(1) and a second tang 1256(2) on an underside of the shroud 1220. In use, each of the first tangs 1256(1) engages with a respective shoulder 1255(1) and the second tang 1256(2) engages or clips with the tapered protrusion 1255(2), for example, by a snap fit.

[0134] 5.1.2 Lower holding mechanism In one embodiment, the shroud may also be connected to the frame by a lower retention mechanism located at the lower ends of the frame and the shroud. For example, an opening in the shroud may be provided with a retention mechanism that is constructed to interlock or otherwise engage with an opening in the frame.

[0135] For example, as shown in Figures 14, 15, 17 and 21, the opening 1132 of the shroud 1120 can include structure adapted to engage via a snap fit with a collar 1149 that surrounds the opening 1146 in the frame. As shown, the shroud 1120 includes snap fingers 1145(1) (e.g., three snap fingers) and sandwich tabs 1145(2) (e.g., three sandwich tabs) extending from the opening 1132. The snap fingers and sandwich tabs are alternately spaced apart around the periphery of the opening.

[0136] In use, the snap fingers 1145(1) resiliently deflect (e.g., 0.5 mm) and engage respective partial annular projections 1149(1) formed on the collar 1149 (see, e.g., FIGS. 22 and 23) to provide an initial retention (e.g., at allowable stress) of the shroud 1120 to the frame 1140, e.g., facilitating assembly and disassembly. Furthermore, as the snap fingers 1145(1) engage with their respective projections 1149(1), the sandwich tabs 1145(2) are received in respective recesses 1149(2) formed in the ends of the collar 1149 (see, e.g., FIGS. 22 and 23). When the elbow 1170 is engaged with the frame 1140 (see, e.g., FIG. 23), the annular projections 1171 of the elbow 1170 are positioned on the opposite surface of the sandwich tabs 1145(2), such that the sandwich tabs 1145(2) are sandwiched between the collar 1149 and the elbow 1170. In this manner, the sandwich tabs utilize the retaining force of the elbow to hold the shroud on the frame during use. The elbow 1170 has a distal shoulder 1173 adapted to extend under the edge of the frame 1140 to retain the elbow to the frame. The snap fingers 1145(1) allow the shroud to connect to the frame independent of the elbow.

[0137] In an alternative embodiment, as shown in FIG. 24, the lower portion of the shroud can be constructed to clip at a single point below the collar. As shown, the lower end of the shroud 1320 includes snap fingers 1345 that engage or clip, e.g., by a snap fit, with a projection 1349(1) spaced below a collar 1349 of the frame 1340. In this embodiment, the projection 1349(1) extends from a cover surrounding the auxiliary port. This configuration may facilitate molding of the collar on the frame, e.g., a uniform thickness of the collar prevents molding distortion. Additionally, by removing the projection 1149(1) / indentation 1449(2) from the collar, the risk of leakage may be reduced.

[0138] 5.1.3 Finger grip In one embodiment, an exterior surface of the frame 1040 may include finger grips or recesses 1097 positioned so as to be exposed beneath the shroud 1020. The finger grips are adapted to provide the patient with an improved ability to grip the frame and / or shroud, which is particularly useful when separating the shroud from the frame.

[0139] 5.1.4 Alternative Interface Structures In an alternative embodiment, as shown in Figures 27-30, the shroud 20 includes an open structure providing an annular or partially annular retaining portion 22 constructed to retain the frame 40 and elbow 70. As shown, the annular retaining portion 22 includes an interface structure 23 along an inner edge adapted to interface with or otherwise removably connect to an interface structure 48 (see, e.g., Figure 28) along the outer periphery of the frame 40. In the embodiment shown, the interface structure 23 has the form of opposed flanges 23(1) adapted to interlock with respective locking structures 48(1) disposed on either side of the frame 40. However, other suitable configurations for attaching the frame 40 to the shroud 20 are possible, such as a friction fit, a snap fit, a mechanical interlock, or other suitable attachment mechanisms.

[0140] For example, the frame 40 may be coupled to the shroud 20 in some manner that allows the frame 40 to be locked in various angular positions relative to the shroud 20, eg, a pivotally mounted shroud 20.

[0141] 5.1.5 Alternative Upper Headgear Connector 40-1 through 40-7 show a frame and clip-on headgear connector or rigidizer according to another embodiment of the present invention.

[0142] The frame 442 includes an opening 449 adapted to engage a shroud and / or elbow. Around and below the opening 449 are u-shaped slots 402 for gas washout, and on either side of the opening 449 are auxiliary ports 443.

[0143] In this embodiment, each side of the upper portion of the frame 442 includes a retaining member 433, and a middle portion of the upper portion of the frame 442 includes a retaining groove 435 constructed and arranged to retain an upper headgear connector or rigidizer 424.

[0144] As best shown in Figures 40-6 and 40-7, the upper headgear connector 424 includes a pair of elongated arms or rigidizers 426 joined by a pair of wire members 428. The rigidizers 426 each include a slot 427 at its free end adapted to receive a respective headgear strap in use.

[0145] The upper headgear connectors 424 are adapted to be clipped onto the frame 442 in use (see, e.g., FIGS. 40-1 and 40-2). Specifically, intermediate portions of the wire members 428 are received within respective grooves 435 of the frame 442, ends of the wire members 428 extend through respective retaining members 433, and the rigidizers 426 provide shoulders that interlock with the respective retaining members 433. The tops of the retaining members 433 are shown in FIGS. 40-4 and 40-5 to show the grooves 433(1) adapted to receive the respective wires. As shown, the ends of the grooves 433(1) include tapered side walls 433(2) that drop off towards the rear surface 433(3) to position the rigidizers 426 in interlocking engagement with the retaining members 433.

[0146] 41-1 through 41-12 show the top of the frame and clip-on top headgear connectors or rigidizers according to another embodiment of the present invention.

[0147] As shown, the upper portion of the frame 542 includes retention members 533 on either side of the frame 542 and retention grooves 535 along a mid-portion of the frame 542 that are constructed and configured to retain the upper headgear connectors or rigidizers 524.

[0148] As best shown in Figures 41-5 and 41-12, the upper headgear connector 524 includes a pair of elongated arms or rigidizers 526 joined by a connecting portion 528. The rigidizers 526 each include a slot 527 at a free end thereof adapted to receive a respective headgear strap in use. The upper headgear connector 524 further includes clip structures 525 on either side of the connecting portion 528.

[0149] The upper headgear connectors 524 are adapted to be clipped onto the frame 542 in use (see, e.g., FIGS. 41-1 and 41-2). Specifically, the connecting portions 528 are received within grooves 535 of the frame 542, and the clip structures 525 releasably interlock with the respective retaining members 533. As best shown in FIGS. 41-3 and 41-4, the retaining members 533 each provide a crossbar, and the clip structures 525 each provide a v-shaped profile adapted to resiliently deflect through the crossbar and provide a shoulder that releasably interlocks with the crossbar.

[0150] 42-1 through 42-7 show an alternative embodiment for engaging the upper headgear connector with the frame. As shown, the retaining members 533 each provide an open-ended crossbar, and the clip structures 525 each provide an elongated arm. In this embodiment, the crossbars are constructed to be resiliently biased to allow the clip structures 525 to extend therethrough and releasably engage the crossbars, for example, by a friction fit. Additionally, the upper headgear connector 524 of FIGS. 42-1 through 42-7 includes a c-shaped clip structure 529 adapted to interlock with a tab 549 (see FIGS. 42-1 and 42-2) formed on the frame 542.

[0151] 5.1.6 Grommet installation Figures 44 and 45 show an alternative mask configuration in which the shroud is attached to the frame by grommets.

[0152] 44, frame 740 includes a (e.g., rubber) grommet 745 and shroud 720 includes an opening 725 adapted to receive the grommet 745 to secure the shroud 720 to the frame 740. As shown, shroud 720 includes elongated upper and lower arms 724, 726, each including a slot 727 at its free end adapted to receive a respective headgear strap during use.

[0153] 45 illustrates an alternative shroud 820 including a single arm including slots 827 at either end thereof adapted to receive respective headgear straps in use. The shroud 820 further provides an elongated inner slot 825 adapted to receive a grommet 745 of the frame 740. In contrast to the shroud 720 which provides a single fixed position, the elongated slot 825 allows the grommet 745 to be fixed in one of multiple positions along the length of the slot 825. In one embodiment, the shroud 820 may be slidable relative to the grommet 745 to allow an infinite number of positions relative to the frame 740.

[0154] In each embodiment, a (e.g., rubber) grommet 745 secures the shroud in place, but the inherent flexibility of the grommet separates the shroud from the frame and provides a flexible connection that allows some range of movement between these two components, such as a ball-and-socket joint or gimbal. Such a configuration aids in the fit and seal of the mask against the patient's face. That is, the flexible connection allows the mask to be selectively adjusted and / or automatically fit to the patient's face.

[0155] 5.2 Connection of cushion and frame 1-8, the non-face-contacting side of the cushion 1060 is connected to the frame 1040 in a tongue and groove relationship. A tongue 1066 (see FIGS. 1C, 1D and 8) of the cushion 1060 is inserted into a groove 1041 (see FIGS. 1C and 1D) formed along the periphery of the frame 1040. This tongue and groove relationship may further include a locking or sealing lip 1068 (see FIGS. 1C, 1D and 8) on the cushion adapted to interlock with an undercut bead 1042 (see FIGS. 1C and 1D) in the frame groove to fixably hold the cushion relative to the frame.

[0156] In the illustrated embodiment, the cushion 1060 further includes one or more positioning features disposed about the periphery of the cushion to aid in proper alignment of the cushion with the frame 1040. As shown in Figure 7, the cushion 1060 includes notches and / or protrusions (e.g., two notches 1067 and one protrusion 1069) adapted to engage complementary features on the frame, e.g., in an interlocking relationship.

[0157] 5.2.1 Co-molding of frame and cushion In one embodiment, the frame 40 and cushion 44 may be co-molded together to form a single piece, integral component, as shown in Figures 27-30. For example, the frame 40 may be molded from a first material adapted to interface with the shroud 20, and the cushion 44 may be co-molded onto the frame 40 from a second material adapted to interface with the patient's face.

[0158] In such an embodiment, the cushion 44 may be made from a relatively soft elastomeric material (e.g., silicone) for sealing, and the frame 40 may be made from a harder material than the cushion 44 (e.g., polycarbonate, polypropylene) for interfacing with the shroud.

[0159] Co-molding the frame 40 and cushion 44 provides a chemical bond and does not necessarily need to form a mechanical interlock. As a result, the connection is crack-free and includes an airtight seal and a smooth interface. Additionally, such a co-molded connection relaxes tolerances because the molding material is flexible enough to fill gaps at the frame 40 / cushion 44 interface. Additionally, a co-molded frame / cushion reduces part count (reducing cost) and facilitates easier assembly / disassembly with the shroud 20.

[0160] In an alternative embodiment, the frame 40 and cushion 44 may be integrally formed as a single piece, for example from a silicone material, as shown in Figure 33. That is, the frame 40 has the same shape and structure as the frames described above, but may be molded from the same material, for example silicone.

[0161] In one embodiment, the integrally formed frame 40 / cushion 44 may be co-molded to a shroud 20 made, for example, from polycarbonate or polypropylene. For example, the shroud 20 may be made from a relatively hard material (e.g., polycarbonate or polypropylene) and the frame 40 / cushion 44 of a relatively soft elastomeric material (e.g., silicone) may be co-molded onto the shroud 20.

[0162] 5.3 Vent configuration In Figures 1, 1B, 1C, 1D and 2-5, the frame is provided with a vent arrangement 1076 that includes a plurality of holes 1077 (e.g., 5-100, e.g., 20-50 or about 35) that are positioned at an angle (e.g., 45 degrees) relative to the outer surface of the frame to ensure that, when the patient is sleeping, the exhausted air is directed away from the patient and preferably away from anyone sleeping with the patient. As shown in Figures 1C and 1D, each of the holes 1077 may include a contour or taper along its length. However, it should be understood that the vent arrangement may include other suitable configurations, such as a different number of holes, different configurations of holes, different locations on the frame, or the vents may form part of an interlocking structure with the shroud.

[0163] FIG. 35-1 illustrates a vent arrangement 276 for gas washout provided in the frame 240. In the illustrated embodiment, the vent arrangement 276 has the form of a vent insert (e.g., an elastomeric vent insert) adapted to be removably supported within the outlet opening of the frame 240. The vent insert may be similar to those described in U.S. Patent Nos. 6,561,190, 6,561,191, and 7,207,335, each of which is incorporated herein by reference in its entirety. However, it should be understood that the vent arrangement may have other suitable forms (e.g., vent holes drilled in the body, etc.).

[0164] 37-3, 39-2 and 39-4 show a frame 340 including a u-shaped slot 302 that receives a u-shaped plug vent 305 for gas washout. As shown, the plug vent 305 is located around and below the opening of the frame 340 for the elbow 370. The plug vent 305 includes a number of tracks or grooves 307 on both sides of the frame. In use, the grooved plug vent 305 forms a seal with the slot 302 such that exhausted air can exit between the walls of the slot and the grooves 307 on the plug vent 305. In one embodiment, the port cap 347 can be integral with or built into the plug vent 305 (e.g., integrally formed as a single piece). Further details of such plug vent configurations are provided in U.S. Patent Application Serial No. 12 / 230,120, filed August 22, 2008, which is incorporated herein by reference in its entirety. 39-2 through 39-6 show frame 340 with slotted plug-type vent 305 removed to more clearly show u-shaped slot 302 and auxiliary ports 343 on either side of frame 340. FIG.

[0165] It should be noted that the elbow may also be provided with a vent arrangement. For example, as shown in Figures 27-30, the vent arrangement 76 has the form of a vent insert adapted to be removably supported in the outlet opening of the elbow 70. In one embodiment, the vent arrangement 76 includes a base adapted to be supported in the outlet opening, one or more lattice elements or media (e.g., filters, membranes or other porous materials) provided in the base and constructed to diffuse the vent flow, and a cover that maintains the lattice elements / media within the base. Only the cover 77 of the vent arrangement 76 is visible in Figures 27-30.

[0166] Exemplary embodiments of such vent configurations are disclosed in US patent application Ser. No. 12 / 230,120, filed Aug. 22, 2008, which is incorporated herein by reference in its entirety.

[0167] However, it should be understood that the vent configuration may include other suitable configurations, such as a vent insert having one or more vent holes.

[0168] The elbow may also provide alternative vent configurations in lieu of a vent insert. For example, as shown in dashed lines in FIG. 30, the first end 74(1) of the elbow 70 may include one or more vent holes 276 (e.g., along the interface structure 75) for gas washout. The one or more holes 276 may be formed in the soft portion (e.g., silicone seal, described below) and / or the hard portion (e.g., polycarbonate, polypropylene) of the elbow. The holes 276 may be distributed along the entire circumference of the first end 74(1) or along one or more portions of the first end 74(1). It is noted that arranging the vent holes along the entire circumference of the elbow may help distribute the vent flow during use. However, other suitable hole arrangements, numbers of holes and / or hole shapes along the first end 74(1) and / or other portions of the elbow are also possible.

[0169] 5.4 Ports 1-5, the base of the frame 1040 includes two ports 1043 positioned so that, during use, oxygen or other breathable gas can be delivered adjacent to the patient's nares or pressure monitoring equipment can be attached. The ports 1043 can also be used to attach additional medical equipment such as pressure sensors, flow sensors, etc. These ports can be selectively closed or sealed by port caps.

[0170] In an alternative embodiment, as shown in FIGS. 25 and 26, the frame 1040 may include a side port 1043.1 in addition to or instead of the port 1043, for example.

[0171] 35-1 and 35-2 show a frame 240 that includes an auxiliary port or spigot 243 on its upper portion, for example, supplemental oxygen, measurement devices, and the like.

[0172] 37-1 through 37-3 and 39-1 through 39-6, a frame 340 includes auxiliary ports or spigots 343 on either side thereof, for example, for supplemental oxygen, measurement devices, etc. A port cap 347 is provided to seal each port 343.

[0173] 6. Interface Seal In one embodiment, seals can be provided at the elbow-shroud interface, the frame-shroud interface, and / or the elbow-frame interface. For example, seals (e.g., ring-shaped elastomeric seals) can be formed separately from the modules and attached to the interfaces (e.g., by sandwiching between the modules, gluing, etc.). Alternatively, seals can be co-molded to one or more of the modules. In one embodiment, a silicone lip seal can be attached to the frame to seal against the elbow, thereby reducing leakage.

[0174] In other embodiments, as shown in Figures 27-30, the interface structure 75 of the elbow 70 may be fabricated from a relatively soft sealing material (e.g., silicone, which may be co-molded to the harder material of the elbow) constructed to provide a seal at the interface of the elbow 70 and the shroud 20. Additionally, this relatively soft interface structure 75 (e.g., silicone) provides a "soft" attachment to the relatively hard shroud 20 (e.g., polycarbonate, polypropylene) that may allow for an interference fit type of engagement. As previously mentioned, this softer interface structure and / or the harder elbow may have one or more vent holes formed therein.

[0175] Although the present invention has been described with respect to what are believed to be the most practical and preferred embodiments at present, it is to be understood that the present invention is not limited to the disclosed embodiments, but on the contrary, it is intended to cover various modifications and equivalent arrangements falling within the spirit and scope of the present invention. The various embodiments described above may be implemented in conjunction with other embodiments, for example, aspects of one embodiment may be combined with aspects of another embodiment to realize still other embodiments. Also, each independent feature or component of any given assembly may constitute an additional embodiment. Furthermore, each individual component of any given assembly, one or more portions of each component of any given assembly, and various combinations of components from one or more embodiments may include one or more decorative design features. In addition, while the present invention is particularly applicable to patients suffering from OSA, it is to be understood that patients suffering from other diseases (e.g., congestive heart failure, diabetes, morbid obesity, stroke, bariatric surgery, etc.) may also benefit from the above teachings. Moreover, the above teachings may be equally applicable to patients and non-patients in non-medical applications. [Explanation of symbols]

[0176] 10 Mask System 20 Shroud 22 Shroud retaining ring 26 Arm 31 Clip Receptacle 33 Headgear Clip 40 frames 44 Cushion 50 Bellows Section 70 Elbow 74(1) First end of elbow 74(2) Second end of elbow 75 Elbow interface structure 76 Vent Configuration 77 Vent Configuration Cover 79 Elbow Port 80 Swivel pipe fitting 82 Short tube 85 Antiasphyxiation Valve (AAV) 86 AAV flap part Clip part of 88 AAV 90 Headgear 92 Top Strap 94 Lower Strap 276 Vent Hole

Claims

1. 1. A cushion module for a patient interface for providing air at continuous positive pressure to treat a respiratory disorder in a patient, the cushion module comprising: a cushion constructed from a first material and shaped and dimensioned to contact and seal against the patient's face in use; a frame molded from a second material, the second material being more rigid than the first material of the cushion, the frame having an inner surface that in use at least partially defines a breathing chamber, and an outer surface opposite the inner surface, the frame having a collar having an aperture formed therein, the collar being configured to releasably engage a shroud of the patient interface, the collar having a snap-fit ​​formation extending annularly about the collar; Equipped with the cushion is co-molded onto the frame, whereby the cushion module is a one-piece, integrated part; The cushion module, wherein the frame does not include headgear clip receptacles configured to receive headgear clips and interlock with each other to attach headgear straps.

2. The cushion module of claim 1 , wherein the second material is polycarbonate.

3. The cushioning module of claim 1 or 2, wherein the first material is silicone.

4. The cushion module of claim 3 , comprising the cushion and the frame.

5. The cushion module of claim 1 , wherein the cushion is co-molded onto the frame without a mechanical interlock between the cushion and the frame.

6. 6. The cushion module of claim 1, wherein the hole formed by the collar of the frame is configured to allow a continuous supply of air at positive pressure into the breathing chamber.

7. The cushion module of claim 1 , wherein the frame does not include a vent hole.

8. The cushion module of claim 1 , wherein the frame includes vent holes.

9. The cushion module of claim 1 , wherein the snap-fit ​​structure extends annularly around the collar.

10. 10. The cushion module of claim 1, wherein the cushion defines a single opening and is shaped and dimensioned to contact and seal against the patient's face around the patient's nose and mouth.

11. 10. The cushion module of claim 1, wherein the cushion defines a single opening and is shaped and dimensioned to contact and seal against the patient's face around the patient's nose while leaving the patient's mouth uncovered.

12. 10. The cushion module of claim 1, wherein the cushion is an oronasal cushion configured to provide a continuous supply of air at positive pressure directly to the patient's nose and to the patient's mouth.

13. 13. The cushion module of claim 1, wherein the cushion comprises a membrane configured to contact and seal against the patient's face, and an undercushion configured to support the membrane against the patient's face.

14. 14. The cushion module of claim 1, wherein the cushion is constructed from silicone and includes at least one polished surface area configured to contact the patient's face and at least one matte surface area configured to contact the patient's face.

15. 15. The cushion module of claim 1, wherein the snap-fit ​​structure has a first dimension in an annular direction of the collar and a second dimension in an axial direction of the collar, the first dimension being greater than the second dimension.

16. 16. The cushion module of claim 1, wherein the collar of the frame is configured to be annularly connected to a shroud of the patient interface around the collar and removable from the shroud.

17. the cushion is connected to the frame at a connection region and includes a contact and seal surface configured to contact and seal against the patient's face; 17. The cushion module of claim 1, wherein a portion of the cushion between the connection area and the contact and sealing surface extends radially outward beyond the connection area.

18. The cushion module of claim 17 , wherein the collar is disposed on a first surface of the frame and a shroud is disposed on the first surface.

19. The cushion module of claim 18 , wherein the first surface is oriented at a first angle relative to an axis of the collar.

20. 20. The cushion module of claim 1, wherein the cushion and the frame are joined by fitting a tongue formed on one of the cushion and the frame into a groove formed on the other of the cushion and the frame.

21. 21. The cushioning module of claim 1, wherein the collar extends from a base adjacent an outer surface of the frame to a free end opposite the base.

22. 22. The cushion module of claim 21, wherein the collar has an outer diameter at the base that is equal to or greater than an outer diameter at the free end of the collar.

23. 23. The cushioning module of claim 21 or 22, wherein the snap-fit ​​structure is spaced from a free end of the collar.

24. 24. The cushioning module of claim 1, wherein the collar has a circular cross-section.

25. 25. The cushion module of claim 1, wherein a silicone lip seal is formed in the opening in the frame.

26. 26. The cushioning module of claim 1, wherein the snap-fit ​​structure is disposed on an outer circumferential surface of the collar.

27. 27. The cushioning module of claim 1, wherein the collar comprises a plurality of snap-fit ​​structures.

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