Can you use APAP nighlty or is it a temporary thing?

[ptisme17]

HI,
I am in the midst of a battle with my sleep Dr. I was diagnosed with severe OSA 10 years ago and have used my CPAP religiously with good results. Being 10 years old my machine is starting to make loud noises and the humidifier isn't working as well. I want a new machine but my sleep Dr. is refusing to write me a script for a new one unless I go through the horrid sleep study again. He insists on doing yearly studies with 2 office visits...one prior to testing and one after which in my opinion is a way to line his pocket and is one reason I stopped going to see him on an annual basis - the other reason is I have been doing great with my machine as is and don't have any need to see him. I called the office yesterday and requested to get a prescription for an APAP rather that a CPAP so that there is no need for another study as the machine adjusts to my needs automatically..but his office is telling me that the APAP is only used on a temporary basis such as when needed in a hospital setting and is not used in the home setting on a routine basis. From what I have read this does not seem accurate...can anyone tell me if they use an APAP every night at home and if it works as well or better than a CPAP? I am really frustrated by this whole process especially since I can't even get into the sleep Dr for 6 weeks for the first office visit and then will have to schedule the study and then schedule another appt before I can even get a script...that could be 2 months! He refuses to write me a prescription in the mean time. I have a call into my family Dr. but am doubtful they will give me a prescription. Can any one give me any answers or advice...thanks!!

[cowlypso]

Here's the thing about all the APAPs out there... They can all be operated as CPAP. So it's 2 machines in one. Also, there's no reason why you can't just run it in APAP all the time, if you have it set to an appropriate range.

[xenablue]

I have a straight CPAP, which is OK, however after spending much time reading here, I decided my next machine will be an APAP. Mentioned this to my neuro and my DME - both shrugged and said it was a good idea and there would be no problem from them.

Cheers,
xena

[chunkyfrog]

Ask for a prescription for an APAP, and if he refuses, ask for a referral to another doc who will.

[Bluecat]

I have been using an APAP nightly since February 2011 and no intention of changing that state of things! Doesn't seem like a temporary thing

[Zboatman]

While I am a newbie to the process, I believe my PR System One REMstar BiPAP Auto with Bi-Flex is both a APAP and CPAP. It has been an awesome experience for me. I love this thing as I am now a month in. It would be my humble but accurate opinion that you need a new Doctor.

[Goofproof]

You doctor seems to be only money oriented, good for him, bad for his victims. You should have gotten you script, then you could have bought another on line. You could watch for one HERE, they do come up at times. Jim

[nanwilson]

I have 2 machines....a straight cpap that I was sold by the dme 2 years ago and an apap that I bought from a member here about a year and a half ago. The cpap only runs one way...straight, the apap can run both straight and auto. My pressure was set at straight 11 when I started, so I set my apap at 10 to 15 and it usually stays between 10.2 and 11........I have a choice....and I choose apap. I have not been back to the sleep doctor or the dme in 2 years..I am my own therapist and I don't charge myself any $$$$$$$

[avi123]

Many Docs insist that you use the type of machine as you were tested on. This gives them protection from being sued. Even if CPAP and APAP have the same insurance classification number

[nanwilson]

Many Docs insist that you use the type of machine as you were tested on. This gives them protection from being sued. Even if CPAP and APAP have the same insurance classification number

Sued for what???????? I don't get it, I know I'm old...but I don't understand that statement. Please enlighten me.

[avi123]

Many Docs insist that you use the type of machine as you were tested on. This gives them protection from being sued. Even if CPAP and APAP have the same insurance classification number

Sued for what???????? I don't get it, I know I'm old...but I don't understand that statement. Please enlighten me.

See here that APAPs are not recommended for persons with certain ailments. So if you are under a Doctor guidance then firstly this Doc wants to make sure that if you suffer from any of these ailments YOU WILL NOT USE AN APAP! Next, if you don't suffer from any of these ailments the Doc wants you to be tested with APAP in a sleep clinic to ascertain that it is working OK for you. Do you get it now that the Doc has a responsibility in this matter?


Rules from the American Academy of Sleep Medicine

(5) certain
APAP devices may be initiated and used in the self-adjusting mode for
unattended treatment of patients with moderate to severe OSA without
significant comorbidities (CHF, COPD, central sleep apnea syndromes,
or hypoventilation syndromes); (6) certain APAP devices may be used
in an unattended way to determine a fixed CPAP treatment pressure
for patients with moderate to severe OSA without significant comorbidities
(CHF, COPD, central sleep apnea syndromes, or hypoventilation
syndromes); (7) patients being treated with fixed CPAP on the basis
of APAP titration or being treated with APAP must have close clinical
follow-up to determine treatment effectiveness and safety; and (8) a reevaluation
and, if necessary, a standard attended CPAP titration should
be performed if symptoms do not resolve or the APAP treatment otherwise
appears to lack efficacy.

[nanwilson]

No. Avi, I still don't get it... you stated they can be sued and I asked "for what".............what can they sue for??????????
If you have already had a sleep study and have an rx in hand, there is nothing that you can sue for, the doctor is not resposible if you buy a different machine than what is on the rx.....and in this country and yours a dme cannot sell you a machine without an rx..................so........

[avi123]

nanwilson, I was posting to ptisme17.

[nanwilson]

nanwilson, I was posting to ptisme17.

Thank you..you are telling me to shut up and its none of my business. I saw that you answered to ptisme17 with an answer that I did not understand...I only wanted clarification, but I guess I am not to get it, and yes your reply was to answer my question, or why else did you quote it. Fine...I'll shut up and not try to help!

[kong]

Many Docs insist that you use the type of machine as you were tested on. This gives them protection from being sued. Even if CPAP and APAP have the same insurance classification number

It protects the doctor from being sued. However, it also protects the patient from being harmed.

My doctor order an auto-CPAP without having performed a titration study. However, she likely considered my physical condition before making such an order.