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CPAP Without Prescription
#1
CPAP Without Prescription
Hi All!

I'm 46, BMI 25.1, moderately active, high anxiety. I've had various nagging health complaints over the years that seem to be getting worse, such as daytime tiredness, intermittent back pain, and waking up throughout the night. So I'm getting old. But I recently made the connection that I meet criteria that could possibly indicate sleep apnea:

- daytime tiredness
- waking throughout each night, sometimes with headache
- morning dry mouth and sometimes morning headache
- neck size > 40 cm
- age over 40
- family history of OSA (dad on cpap)
- snoring (though only intermittently)
- waking up gasping for air (also only intermittently)

So I got a SleepU device to measure my oximetry and it indeed shows some significant SpO2 drops throughout the night (some nights down to <80%; but often lowest at 87%). In fact, the drops seem to be just before I wake up, thus apparently the cause of at least some of my sleep disruptions. So next I got my doctor to order an at home oximetry study, which confirmed SpO2 drops. And I will next take the full at home sleep study to get more data. 

The problem is that I fear and suspect my sleep study results will indicate only a "mild" level of OSA and thus no treatment will be prescribed. That will depend on their interpretation criteria, of course, as well as how I happen to sleep on that single night that will be measured.

I use O2 Insight Pro and OSCAR at home for my own studies and their interpretations vary. For example, for last night, O2 Insight Pro shows ODI 4% of only 2.1/hour. If my doctor uses similar criteria, I assume I will be categorized as mild. The same data in OSCAR, though, shows a "SpO2 drop index" of 11.76. That sounds less mild. I believe Insight Pro looks at 4% drops over 15 seconds, while OSCAR looks at 3% drops over 8 seconds. 

Either way, the possibility remains that my sleep disturbances, some perhaps triggered by apneic events, affect my quality of life, if not also my health, and that some type of treatment may be worth attempting, perhaps even CPAP.

So my question is: Is it feasible, or even possible, to obtain a CPAP machine if your doctor does not recommend or prescribe one? Of course, without an Rx it would not be covered by my insurance. But would it then be possible to purchase one anyway without an Rx? I gather that CPAP requires personalized settings determined by your doctor. So are there ever cases where your doctor takes the approach that you don't meet the criteria for them to prescribe a CPAP, but you can get your recommended settings anyway, in case you want to take on the expense yourself?

jwoodz
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#2
RE: CPAP Without Prescription
Here in Canada there is no requirement to have a prescription for the machines or masks. In fact I just ordered one online with no required submission of a prescription. Having said that depending where you live in Canada most brick and mortar and some websites ask for it for the machine only as a CYA.

Correct me if I'm wrong but you would need to have a prescription for the machine and masks as required by federal law. Not sure if private sales would be included by law.

My personal experience is that my insurance requires me to have a prescription to qualify for reimbursement and will only pay once every five years. Any secondary machine is out of pocket.
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#3
RE: CPAP Without Prescription
Under U.S. law, a prescription is required for a CPAP device or complete mask. With that said, many CPAPs are sold without a script through 3rd party and private sellers.

Getting a prescription shouldn't be that big of a deal, it's not like a schedule 3 narcotic. In fact, Medical doctors, Doctor of Osteopathy, Psychiatrists (MD only), Physician assistants, Nurse practitioners, Dentists, and Naturopathic physicians can issue a valid prescription for a CPAP devices and masks. If you want insurance to help pick up the tab, then that will be a little different story. It appears that each insurance company has their own set of hoops to jump through.


Good luck!
Crimson Nape
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: CPAP Without Prescription
(06-14-2020, 04:55 PM)Crimson Nape Wrote: Under U.S. law, a prescription is required for a CPAP device or complete mask.  With that said, many CPAPs are sold without a script through 3rd party and private sellers.  

Getting a prescription shouldn't be that big of a deal, it's not like a schedule 3 narcotic.  In fact, Medical doctors, Doctor of Osteopathy, Psychiatrists (MD only), Physician assistants, Nurse practitioners, Dentists, and Naturopathic physicians can issue a valid prescription for a CPAP devices and masks.  If you want insurance to help pick up the tab, then that will be a little different story.  It appears that each insurance company has their own set of hoops to jump through.


Good luck!

Crimson Nape,

Thank you for clarifying.
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#5
RE: CPAP Without Prescription
On the other hand, there are a lot of people that don't tolerate or want their CPAP and will sell it on Craigslist, Facebook Marketplace, Offerup and other online markets. If you want to give this a try, just buy a Resmed Airsense 10 Autoset at a good price. The better way is to work through your personal physcian and let him know you want to try CPAP without going through clinical studies. He can prescribe auto CPAP without a sleep study, it's just not likely to be covered by insurance without a diagnosis confirmed by a home or clinical evaluation. May online suppliers even offer home sleep studies and prescription services. Check Supplier #30.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: CPAP Without Prescription
It is no problem to by a mask without a prescription. It is no problem to by a used CPAP machine without a prescription. I replaced my F&P Icon with a used $250 Resmed machine and the seller did not ask to see my prescription. Some suppliers will sell reconditioned machines without the power supply or humidifier chamber. Because such a machine is not functional by itself, the sale is "legitimate".

The next question is do you want to do this without a doctor's help. On one hand, you do not even know what you don't know. On the other, many doctors are not very helpful. If your father lives in the same area, you might go to the same doctor. Talk to him or a CPAP using friend about his experience.
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#7
RE: CPAP Without Prescription
Thanks, all! 

I'm kind of a germaphobe, so, though I really appreciate any and all advice,  a used device would not be my first choice.

RNeil, I definitely would prefer, and hope to get, a doctor's help - though as you note, many doctors are not very helpful. I fear they will dismiss my issue as not significant enough to treat. Hopefully I can convince them one way or another that even if they can classify me as a "mild" case, it's still worth treating considering I'm rarely able to get a proper night's rest.

I completed the sleep study last night using an "Alice Night One" device. Hope the results are bad enough to warrant some attention. 

jwoodz
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#8
RE: CPAP Without Prescription
If a used device isn't preferred, you are less likely to find one for sale without a script. It seems most I see available on Craigslist, etc. are used.

If you want to build the case for the script, make a diary of sorts on all the complaints and symptoms. Discuss these sleep issues with at least your primary doc. It could be your primary doc may be convinced to refer you to get a sleep study to add to the evidence of medical necessity. I have found that my medical oriented device requests are ones I had to fight for, ask for, present my case. It did not just happen.
Dave

OSCAR
Standard OSCAR Chart Order
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: CPAP Without Prescription
Thanks, SarcasticDave94 - good idea. 

It's been a bit of a struggle already convincing my doctor to progress to each next step (oximetry study, then full study). Not sure why the resistance. I'm new to this whole topic, but it seems to me even "mild" but recurring sleep disruptions should be taken seriously by doctors and insurance due to the potential health risks of ignoring them.
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#10
RE: CPAP Without Prescription
Just do what I had to do. I made the doc take time to listen to every aspect of my sleep problem. I told him about insomnia then alternating to sleeping for extended periods. I mentioned all things associated. Morning headaches, constant fatigue, fast heart and breathing upon or shortly after waking, etc. I got PCP doc to take me seriously. He then referred me for a pulmonary specialist. It wasn't a great relation with that pulmonary doc, but I learned here how to convey the symptoms and form reasonable complaints that were continuously presented until doc finally got the message. Then I got the sleep study. Then the wrong machine for me, CPAP then the BPAP. I then had to start over, new symptoms new complaints. And finally new studies and a different machine. Plan on how to present the issue, act on it, then don't quit until you get the results.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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