Should a prescription be required for CPAP?

[CHanlon]

I agree that there should be at least an initial prescription. One thing I *don't* think should be part of it, is a restriction on CPAP vs APAP - and issue I had. I had weeks of data from a loaner APAP machine that APAP was more effective for me then CPAP... yet my 2 hour, fitful sleep during my titration study didn't "qualify" me for one. I had to argue for it, and in the end, buy it outright because my Dr. wouldn't submit that I needed one.

In the UK we have the choice, I ask for an APAP as I thought it felt better so I swapped over but I believe in the states this is not possible as it depends on a person called a DME?

I'm in Canada, actually... Ontario healthcare apparently wants your doctor to provide a reason that you need APAP over CPAP before they will cover 75% of the machine cost. That said, before I got my machine, my stepfather was diagnosed, given a titration of 14 cm, couldn't tolerate it to keep the mask on more then a couple hours, complained to his Resperatory Therapist (our version of a DME, I think) who then said, "no problem, we'll get you set up on an APAP..." One call to his doctor, and it was done. Total time from initial sleep study to APAP machine, 2 weeks. I took from August 23rd (sleep study) to Dec. 21st. Titration was Nov. 21st. For the first 2 months after the sleep study, I had a loaner APAP, and the first night I used it, I was on it for 9 hours. Slept well for the first time in 5 years. They put me on APAP because the lab recommended it, since they didn't do a split study. That showed that I was varying between 14 cm and 19+. The next couple of months they had me on fixed CPAP, on a couple different machines, at 16cm (eventually) which I *hated.* I had constant issues from the first day, it kept waking me up, blowing the mask off my face, etc. But "we can't justify..." So I just said that this was what I wanted, write the prescription, and don't bother trying to justify, I'll buy it myself... and I did. And I'm happy with it. And compliance is 100%...

[CHanlon]

Oh, and, during the last month of all this, my stepsister went in for a study (at the same clinic my stepfather used, I went where my GP sent me, silly me...) and was diagnosed, titrated to 10 cm, prescribed a CPAP, said "my dad and step brother said APAP machines are easier to adjust to, could I have one instead?" and got it...

My theory on it is...I went to the wrong sleep doctor.

[mummerse]

I agree that there should be at least an initial prescription. One thing I *don't* think should be part of it, is a restriction on CPAP vs APAP - and issue I had. I had weeks of data from a loaner APAP machine that APAP was more effective for me then CPAP... yet my 2 hour, fitful sleep during my titration study didn't "qualify" me for one. I had to argue for it, and in the end, buy it outright because my Dr. wouldn't submit that I needed one.

I insisted on the xPAP when getting the machine, but they set it up as a straight CPAP. That is why I wanted the Clinician's manual to change to the APAP Flex on the System One. Didn't understand the problem when getting the machine. They couldn't set it up with a pressure range using the script value as the top limit. It I can get by with less pressure, why not do it?

[CHanlon]

I agree that there should be at least an initial prescription. One thing I *don't* think should be part of it, is a restriction on CPAP vs APAP - and issue I had. I had weeks of data from a loaner APAP machine that APAP was more effective for me then CPAP... yet my 2 hour, fitful sleep during my titration study didn't "qualify" me for one. I had to argue for it, and in the end, buy it outright because my Dr. wouldn't submit that I needed one.

I insisted on the xPAP when getting the machine, but they set it up as a straight CPAP. That is why I wanted the Clinician's manual to change to the APAP Flex on the System One. Didn't understand the problem when getting the machine. They couldn't set it up with a pressure range using the script value as the top limit. It I can get by with less pressure, why not do it?

I agree. And... if you need more, again, why not? They have these machines that are capable of adjusting, second by second, to the needs of the user. Why stunt that, by fixing on an arbitrary number, gained by a titration study, during what it most likely the most uncomfortable nights
sleep that most of us have had?

[Schnauzers 5]

Rx should be required especially if we want the insurance companies to pick up at least part of the tab. That being said, I don't think a script should be required for mask parts, new masks, filters, hoses etc.

I agree, once we have the c-pap it should not be so hard to get replacement parts such as nasal pillows exactly like the ones that wore out. The machine and its' settings are a different story. But ya know, Insurance and Medicare have to get into it. My basal pillows seem to wear out before I am qualified to replace it. I also like to keep up on the headgear and feel 3 mos can be too long for a new one.

[zonk]

Understand now it,s to do with insurance.
I don,t have insurance so voted NO.

[PollCat]

I agree that a prescription is needed for the _PAP machines, but do not believe it's necessary for the consumable supplies. I'm reasonably certain that I did not need scripts for masks, filters, etc. during the late 90's and early 00's It was recently that my online DME started requiring scripts for the supplies.

Besides, what is someone going to do with the masks other than use them for the purpose intended or possibly create Halloween masks!

[priti36]

lol. that makes me smile to think about me trick or treating wearing my full face mask with hose attached. That is funny.

[greatunclebill]

Besides, what is someone going to do with the masks other than use them for the purpose intended or possibly create Halloween masks!

my mind immediately wanders back to the '60's and woodstock era when....... (you know the rest).

[priti36]

*gasp* oh my. I hadn't thought of that.