Why are CPAP machines prescription only?

[HuffnPuff]

I am wondering exactly why CPAP machines are prescription-only, when it appears that there are very few contra-indications, and also why it isn't possible for the user to control the settings. Why do the powers that be assume that CPAP users cannot tell for themselves how effective their treatment is being?

Has anyone considered lobbying for machines to be declassified as prescription-only? And if so, how one would go about it?

I ask because my husband has to wait such a long time between visits to his consultant, and if anything does go wrong with his machine he is likely to have to wait a long time to be referred to a technician who can do anything about it. Also, the wait for diagnosis and treatment is incredibly long - he was one of the lucky ones, having private health insurance at the time of diagnosis, which vaastly speeded up the process. If CPAP machines were not prescription only, people could be empowered to look after their own health rather than being totally at the mercy of long waiting lists, and in my husband's case, an unsympathetic and not very knowledgeable consultant.

Any thoughts, anyone?

[Joe McManus]

It's an interesting, and ongoing, debate. My point of view is that for someone to truly understand the intricacies of Sleep Apnea, you need to have done a hell of a lot more studying than reading Wikipedia and a forum like this. It's not as simple as "He stops breathing, bring in the pump!".

The prescription is a safeguard for the patient and that degree of safety will instill a sense of trust and comfort that this therapy will be right. CPAP can be daunting at first, not only because of the looks! Knowing a medical professional 'signed you off' for this is a big step towards treatment compliance.

The study and subsequent prescription allows that bit of patient-doctor interaction needed to iron out any doubts, answer any questions etc.

In my opinion, it's an essential part in the process of going from undiagnosed to being treated well.

But then again, an auto-titrating machine should be safe enough without much supervision.

[MoutheBreather]

Yes, it because it requires specialist medical know-how, accumulated by academic achievements and experience. If us consumers can't work out how to operate a microwave it's safe to say we can't be trusted with a device like CPAP as far as settings are concerned.

[giantswooddude]

Hi Huffnpuff,

As I understand it, you don't actually need a prescrition in the UK to buy a CPAP machine. What is prescritive is the treatment. The reason I say this is that I have been positively encouraged to go and buy my own cpap by my clinic over the last few weeks as they are so under funded that they can only supply crappy, noisy, cheap and nasty second vaccum cleaners. Well thats what my latest machine seems like.

However; A cpap machine is anything but plug in and play machine, and my personel experiences over the last ten months or so are a good example.

I was diagnosed with OSA in 2003 and have been on treatment since then running with a presure of 8cm/h20. Only a low presure, but at its worst I was having an apnea every fourth breath or 20 secs.

Now we are supposed to go back to the clinic every 12 months, but with the NHS operating the way they do, this dosen't happen and you only get to visit the clinic when there is a problem.

To cut a long story short, I thought every thing was fine. I was developing a side effect of a dry mouth and dry eyes toward the end of last year, but I could cope and it is common. Then during the last few months I was starting to feel tired again in a morning and wanting to nod off in the afternoons, so called my local clinic and went in to see them for the first time in two and a half years. First conclusion was that I needed more pressure, so they put me on an automatic data capture cpap to see how high pressure I would need. Straight away I felt better with the auto machine and within a few days I was back to being my old self.

I returned to the clinic yesterday with said machine, and the results supprised me greatly and have left me in a bit of a quandary. It turns out that instead of needing an increase in presure, I actually need a decrease, or I may actually come off the treatment altogether. The probelm I was having was that the pressure was too high for me and that was having the affect of being too invasive and causing me to wake. It was also the reason for my dry mouth and eyes which have all but gone back to normal.

So maybe this is a good example why you shouldn't just go and buy one off the shelf. I have been living with this conditon now for four and a half years, and I still don't know what treatment I need. But the hard pressed, hard working, under funded girls in the sleep department at Stoke City General do.

Hope that helps.

[MoutheBreather]

Nice first post there!

As I understand it, you don't actually need a prescrition in the UK to buy a CPAP machine. What is prescritive is the treatment.

That may the correct wording but the end result is the same. You need a piece of paper that says "You suffer from OSA and I, the doctor, recommend you seek such and such* treatment." *more often than not being CPAP.

Are you planning on a new sleep study to ultimately determine whether you still get apnea events and drops in oxygen saturation?

[giantswooddude]

Well, I'm glad you liked my first post. Just read it again and the spelling is awful, but never mind you understood me anyway.

My little tale moves on!

They sent me home with this second hand dyson vaccum cleaner cpap set at 6cm/h20 and an oxygen meter thing to clip on my finger. The idea is that I do one night with cpap and one night without to see what my oxygen levels are. During my sleep study in 03 my oxygen dropped to 58% which according to a paramedic friend of mine that is brain damage territory.
I am going to do the test over the weekend as my partner is a away at the moment and she is paraniod over the thought of coming home and finding my corpse in bed.

However, and when dealing with this sodding condition, the is always a however,I have now had three nights with the dyson cpap set at 6, and guess what, had a really bad night last night and woke up gasping on three occasions. (Havn't told the Mrs yet) So to me this isn't working. Feel pretty crap as well.

We will do the oxygen test at the weekend and see what they make of it, but I think it looks like I am going to have to buy an auto machine for my self.

I will keep you informed.

Dude

[MoutheBreather]

Your second hand dyson comment made me laugh out loud

But then the 58% oxygen saturation sounds indeed quite worrying! Would be interesting to say how much CPAP will change that percentage!

[acebass]

The other problem is that the patient may also have other problems and ultimately not be suitable for treatment by CPAP so as not to aggravate any other conditions the sufferer has. A severely depressed person may be mortified at having to have a "vacuum cleaner" attached to their face for the rest of their life, so the prescriptive element, though annoying to some, is, in my opinion necessary.

[mintra]

Proffesionals only profess

it requires specialist medical know-how, accumulated by academic achievements and experience. .

I am not so sure, the equipment is fairly basic and the world is full of non professionals without academic qualifications who do a good job.

I have had such great and instant result from my machine, that I can think of five people around me who want one, and you can be sure that the national health screening for such machines is based on financial criteria not intellectual knowledge.

I am willing to bet that the damage done to someone with a badly adjusted CPAP rig when they dont even need one would be minimal and would fix itself after a couple of days.

Am I wrong, is their any evidence of damage caused by CPAP machines?