Its worse than that. Before receiving a CPAP machine ~$1,000, most doctor's require a sleep study, which costs many thousands of dollars, and many times wait months to get the appointment. CPAP machines are usually the ultimate solution to reported sleep problems involving repeatedly waking up, and I don't see why they can't be prescribed immediately to see if they solve the problem.
Because (a) there are problems that are not sleep apnea that should not be missed, and (b) the cpap pressure needs to be titrated to your need, it’s not a binary device.
Admittedly, (b) is now less of an issue since there are a handful of auto-titrating machines on the market now. They’re less reliable than a sleep study, but they’re better than nothing.
Yeah, the newest modern CPAP machines auto-titrate. On your back? It ups the pressure if it detects less breathing. On your side, it will lower the pressure. Its quite nice. I have a ResMed AirSense 10 for two years now...but I imagine if I had got my machine a few years earlier it would have been different.
It is true that other things can be the issue. There is a place for sleep studies, and at home sleep studies can detect sleep apnea fast and cheaply, and should be the first option, unless some other ?neurological? symptom is already presenting itself.
My insurance wouldn't even pay for a monitored sleep study before I did an at-home study. Luckily, the at-home device showed moderate apnea, so I didn't have to do the lab study.
That's what they did for me as well, but not for other people I know living in a less affluent area of California. The take-home solution is much more cost-effective, it is a wonder that it hasn't been adopted universally. Also, I LOVE my CPAP.
That's fair, I only know what happened at Stanford. Side note to anyone reading this: don't go to the sleep clinic at Stanford. If your doctor refers to there, ask for another referral. There's a reason they have 1.5 stars on Yelp...
And I totally agree about the CPAP – any morning after I accidentally take it off in my sleep (pretty rare, but happens especially as the seasons change), I feel like absolute garbage. It's amazing what actually breathing through the night can do for you.
In most medical devices anything, prescription is justified the same (read in a mocking voice) "There could be another reason for those symptoms so if we don't gate your access behind an expensive doctors visit you could treat the wrong thing and die"
This is used to justify eyeglass prescriptions.
This bullshit really needs to go, especially for eyeglass prescriptions. Making people wait weeks for another eye exam when their glasses break after the first year is honestly bullshit.
> "There could be another reason for those symptoms so if we don't gate your access behind an expensive doctors visit you could treat the wrong thing and die"
Like all medical things they're (a) expensive (b) limited in supply (c) you don't have the knowledge, experience or impartiality to self-diagnose (d) you can't tell whether you need the device but buying it anyways removes limited supply from the market (e) you don't know how to calibrate it (f) you might hurt yourself.
Same reason it's insane Americans are allowed to self-refer to specialists: you don't know which specialist you need, you don't know whether you need a specialist at all, there's a limited quantity and you're likely just squandering a valuable resource.
In both cases letting unqualified end users have at it could just as easily increase the price not decrease it.
I though eyeglasses prescriptions were to assess the right "myopia settings" (not sure what the right word is)?? I guess they should stay valid for some period of time, like 1-5 years, in case you break your glasses, but presumably your sight can change (worsen) over time so another exam is a good thing.
cpaps are in a different ballpark than doctor visits! If you hunt around, you should be able to see a doctor for $100-ish. (Edit: of course, $100-ish is still a large amount of money)
(In some parts of CA, Heal will send a doctor to your house for a one-time fee of $159. And after my mom complained to said doctor about my snoring, their doctor ordered me a sleep study. So yes, that's one way to get it.)
That said, out here, most of the small independent offices that used to exist have been bought out by one of 3 medical groups. And with the large medical groups it's pretty hard to get a concrete number sometimes.
Completely agree. And the worst part is sleep studies are medically unnecessary - an APAP machine (automatic machine) can auto-set the necessary pressure, and no sleep study is needed.
Simply sleep with an APAP for a week, review the pressure graph and draw a line at the bottom of the values. Then set the minimum pressure to that number, or slightly less and done.
Review every few months.
If you ask a Dr. about this they'll talk about the 1% of less cases that will not be correctly adjusted by such a machine. But all you need to do is ask the patient after a week "do you feel better?". If they say no you can go for the more complicated options.
The vast majority of patients take months or longer to get acclimated to the machine. Most will say they feel /worse/, because the machine gets in the way of their sleep at first.
I look forward to hearing more medical pearls from the web design community.
Apparently I'm an outlier then, I got used to it in under a week, and swear by it. If my wife and I stay up late and get short hours on machine, or nap in the living room instead of upstairs and on machine, I know it the next day.
5, 6 hours in a base minimum for me to not feel sluggish and possibly even start the day with a headache.
I bought a CPAP off an Amazon seller here in Canada a few years back. I have a large neck and would wake up gasping for air in the night. It was going to be several months to get the sleep study so one day I impulse bought it. First night I slept 8 hours, couldn't remember the last time I did that. Best $600 I ever spent.
Or how about from people who have actually used them? I put getting a study for years because the whole thing seems such a massive scam. Shame on me: I really needed a bipap, and now I feel so much better. But I could have figured this out by trying one for a week, as others have suggested. It blows air into my nose, for heaven’s sake. How many years of med school does it take to learn about that?
Also: wore it 8 hours the first night, and every night since. Not that hard to get used to.
You know CPAP has 50% compliance right? A huge amount of patients never get used to it. And even of those that stick to it, they struggle through the night with it. They define successful CPAP treatment as 4 hours or more a night, when 4 hours is obviously insufficient.
I'll chime in with the sibling comment. I felt immediately better after getting an APAP, within the first few days of using it. And my doctor didn't set specific pressure point but rather a range which we've never adjusted. And from memory that conversation was "I'm going to put it within these broad bounds and let it find the right place during the night. If it's not working for you come back in and we'll figure it out."
