Hey all,
I saw this mentioned in another thread but thought I would create a new one to hear some opinions.
Should XPAP's be available over the counter, without a prescription? Say at the local Wal-Mart, Walgreens etc. right on the shelf.
I'd love to hear some pros and cons to this.
My personal feeling is that they shouldn't. And no, this isn't because I'm part of "The Establishment" or because of $$$ or whatever. I would think that people would not be inclined to get, say, a full polysomnogram to fully investigate what all is going on (centrals, cheyene stokes, sufficient O2 saturation, etc.) if they could just go down to the local drugstore and buy an xpap.
So let's open the floor to discussion.
XPAP available OTC?
XPAP available OTC?
To know even one life has breathed easier because you lived. This is to have succeeded. -- Ralph Waldo Emerson
Maybe once diagnosed you could be given a card to show at walmart or where ever. Like the little valued shopper discount cards the supermarkets give out.
Brenda
Brenda
_________________
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: Love my papillow, Aussie heated hose and PAD-A-CHEEKS! Also use Optilife, UMFF(with PADACHEEK gasket), and Headrest masks Pressure; 10.5 |
Re: XPAP available OTC?
[quote="BrianRT"]Hey all,
I saw this mentioned in another thread but thought I would create a new one to hear some opinions.
Should XPAP's be available over the counter, without a prescription? Say at the local Wal-Mart, Walgreens etc. right on the shelf.
I'd love to hear some pros and cons to this.
My personal feeling is that they shouldn't. And no, this isn't because I'm part of "The Establishment" or because of $$$ or whatever. I would think that people would not be inclined to get, say, a full polysomnogram to fully investigate what all is going on (centrals, cheyene stokes, sufficient O2 saturation, etc.) if they could just go down to the local drugstore and buy an xpap.
So let's open the floor to discussion.
I saw this mentioned in another thread but thought I would create a new one to hear some opinions.
Should XPAP's be available over the counter, without a prescription? Say at the local Wal-Mart, Walgreens etc. right on the shelf.
I'd love to hear some pros and cons to this.
My personal feeling is that they shouldn't. And no, this isn't because I'm part of "The Establishment" or because of $$$ or whatever. I would think that people would not be inclined to get, say, a full polysomnogram to fully investigate what all is going on (centrals, cheyene stokes, sufficient O2 saturation, etc.) if they could just go down to the local drugstore and buy an xpap.
So let's open the floor to discussion.
Last edited by Snoredog on Sat Jun 23, 2007 7:27 pm, edited 1 time in total.
someday science will catch up to what I'm saying...
-
jabberwock
- Posts: 219
- Joined: Fri Apr 27, 2007 6:17 pm
- Location: Oakville, Ontario
Hmmmm, interesting concept Brian...
First of all, I can't imagine anyone not having a PSG done in order to determine whether they have sleep apnea at all. Would anyone really go out and buy an xpap just to see if it would "cure" their snoring??
Now, it's a little different here in Canada (in Ontario at least) in that PSGs are covered by our provincial medical insurance, and I understand that in the US, it costs to have the initial PSG done, and costs again to have a titration done, unless you have a split study. But say you had a split study, so that a px could be written after just the one night. Is there any expiry on that scrip? Could I use the same scrip five years later to buy a new machine from cpap.com for example? If so, I could see someone not wanting to go back for another PSG if their therapy was working well.
If a patient would have to pay for another PSG in order to get a new scrip to buy a new machine, then I would say that if therapy is working well OTC could be a good option.
The biggest bonus I can see (for Ontario anyway) is that presumably they would cost a lot less than the ridiculously overpriced machines sold by DMEs here. It would be interesting to see if it would still be cheaper for us to buy at cpap.com, even with the exchange rate and possible duty charges.
But would Walmart (or wherever) even want to stock/sell xpaps? I wouldn't think they would be a particularly hot seller. And definitely not an impulse buy item... "Oh, I have $800 burning a hole in my pocket... I think I'll buy an xpap today"
Just my .02 worth...
First of all, I can't imagine anyone not having a PSG done in order to determine whether they have sleep apnea at all. Would anyone really go out and buy an xpap just to see if it would "cure" their snoring??
Now, it's a little different here in Canada (in Ontario at least) in that PSGs are covered by our provincial medical insurance, and I understand that in the US, it costs to have the initial PSG done, and costs again to have a titration done, unless you have a split study. But say you had a split study, so that a px could be written after just the one night. Is there any expiry on that scrip? Could I use the same scrip five years later to buy a new machine from cpap.com for example? If so, I could see someone not wanting to go back for another PSG if their therapy was working well.
If a patient would have to pay for another PSG in order to get a new scrip to buy a new machine, then I would say that if therapy is working well OTC could be a good option.
The biggest bonus I can see (for Ontario anyway) is that presumably they would cost a lot less than the ridiculously overpriced machines sold by DMEs here. It would be interesting to see if it would still be cheaper for us to buy at cpap.com, even with the exchange rate and possible duty charges.
But would Walmart (or wherever) even want to stock/sell xpaps? I wouldn't think they would be a particularly hot seller. And definitely not an impulse buy item... "Oh, I have $800 burning a hole in my pocket... I think I'll buy an xpap today"
Just my .02 worth...
_________________
| Mask | ||||
 | ||||
| Additional Comments: Pressure: 8 | ||||
Why not OTC? Not much chance of overdose. BTW, XPAP isn't to stop Snores, it's to allow you to continue to breath through the night, without your airway closing off.
OTC, won't be for everybody, but it should be a option especially for the informed customer. The majority of patients that can be helped by XPAP, don't have other problems that cause loss of sleep, and the ones that do can have the PSG. Fix simple first, as cheaply as possiable. XPAP won't fix the other problems, the PSG finds, so fix the easy first.
Another thing that needs to come about, Require that all XPAPS collect and report data, and are sold with the software and equiptment to read them. Also make them smart enough to help the patient with compliance.(comfort addins such as expiration relief, and the ability to reduce treatment pressure to the level needed.) Ban the manufacture and sale of all low tech XPAPS. Jim
OTC, won't be for everybody, but it should be a option especially for the informed customer. The majority of patients that can be helped by XPAP, don't have other problems that cause loss of sleep, and the ones that do can have the PSG. Fix simple first, as cheaply as possiable. XPAP won't fix the other problems, the PSG finds, so fix the easy first.
Another thing that needs to come about, Require that all XPAPS collect and report data, and are sold with the software and equiptment to read them. Also make them smart enough to help the patient with compliance.(comfort addins such as expiration relief, and the ability to reduce treatment pressure to the level needed.) Ban the manufacture and sale of all low tech XPAPS. Jim
Last edited by Goofproof on Sat Jun 23, 2007 7:39 pm, edited 1 time in total.
Use data to optimize your xPAP treatment!
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire
Well, I'm sure I am in the minority here. But I'm inclined to say "No, not available OTC - but - available via script from local and chain pharmacies. Discount pharmacies would most likely drop the price down as the online DME suppliers have.
And I most wholeheartedly agree that ONLY fully data capable machines be produced and sold.
There is absolutely no reason or excuse for the software and necessary reader/cable to be withheld from patient availability and purchase.
And I most wholeheartedly agree that ONLY fully data capable machines be produced and sold.
There is absolutely no reason or excuse for the software and necessary reader/cable to be withheld from patient availability and purchase.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
**************************************************************
First of all, I can't imagine anyone not having a PSG done in order to determine whether they have sleep apnea at all. Would anyone really go out and buy an xpap just to see if it would "cure" their snoring??
**************************************************************
You can't????? Meet me. My apnea is very mild, the least of my sleep problem. The biggest part is MY SNORING WAKES ME UP ALL NIGHT preventing me from getting stage 3 or 4 sleep.
Stopping the snoring was incredible in restoring my ability to sleep a full night in decent percentages of the different types of REM.
My apnea in fact was so mild, the sleep doc was almost not going to recommend cpap at all. I told my primary doc who was writing the prescription that I wanted to try anyway and he agreed. Thank goodness.
First of all, I can't imagine anyone not having a PSG done in order to determine whether they have sleep apnea at all. Would anyone really go out and buy an xpap just to see if it would "cure" their snoring??
**************************************************************
You can't????? Meet me. My apnea is very mild, the least of my sleep problem. The biggest part is MY SNORING WAKES ME UP ALL NIGHT preventing me from getting stage 3 or 4 sleep.
Stopping the snoring was incredible in restoring my ability to sleep a full night in decent percentages of the different types of REM.
My apnea in fact was so mild, the sleep doc was almost not going to recommend cpap at all. I told my primary doc who was writing the prescription that I wanted to try anyway and he agreed. Thank goodness.
-
cpapernewbie
- Posts: 685
- Joined: Fri Oct 13, 2006 5:53 pm
XPAP is not some glamorous device that movie-stars enjoy wearing
1) it is UNCOOL
2) it is difficult to adjust to (esp the mask)
3) high % of failures
OTC or not OTC, consumers are not going to rush to buy.
The impact is more on the existng clients and cpaper with no insurance
OTC will help the patients while a newcomer with no insurance will also have the benefit.
Nobody want to use CPAP just for fun and looks cool to boy/grilfriend
1) it is UNCOOL
2) it is difficult to adjust to (esp the mask)
3) high % of failures
OTC or not OTC, consumers are not going to rush to buy.
The impact is more on the existng clients and cpaper with no insurance
OTC will help the patients while a newcomer with no insurance will also have the benefit.
Nobody want to use CPAP just for fun and looks cool to boy/grilfriend
_________________
| Machine: DreamStation Auto CPAP Machine |
| Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
| Humidifier: DreamStation Heated Humidifier |
| Additional Comments: CPAP history: dumb tank, auto, PR M, PR System 1, PR BIPAP, PR System 1 model 60, Resmed S9, Resmed S10, Dreamstation |
-
jabberwock
- Posts: 219
- Joined: Fri Apr 27, 2007 6:17 pm
- Location: Oakville, Ontario
Snoregirl, I wasn't suggesting that xpap couldn't or wouldn't relieve snoring, thereby helping patients to sleep better.
You presumably had a PSG done in order to determine that you had mild sleep apnea, and that you were experiencing a lack of stage 3 and 4 sleep.
I questioned whether a person who wanted to stop snoring because it was annoying to them or to their partner would invest a lot of money in an xpap without seeing a doctor and having a sleep study done in order to verify that it could actually stop them from snoring. Maybe a person would, I don't know.
Do all people who snore have sleep apnea? Is it a cure-all for snoring? If it is, then I guess I would understand someone putting out the money for an xpap instead of many times that much for a PSG.
I certainly didn't mean to suggest that snoring isn't a major factor in keeping one from a good night's sleep. Apparently I snored loud enough to wake the dead; I just didn't hear myself doing it, so I didn't realize that was one of the things keeping me from sleeping soundly.
I'm sorry if I offended.
Bonnie
You presumably had a PSG done in order to determine that you had mild sleep apnea, and that you were experiencing a lack of stage 3 and 4 sleep.
I questioned whether a person who wanted to stop snoring because it was annoying to them or to their partner would invest a lot of money in an xpap without seeing a doctor and having a sleep study done in order to verify that it could actually stop them from snoring. Maybe a person would, I don't know.
Do all people who snore have sleep apnea? Is it a cure-all for snoring? If it is, then I guess I would understand someone putting out the money for an xpap instead of many times that much for a PSG.
I certainly didn't mean to suggest that snoring isn't a major factor in keeping one from a good night's sleep. Apparently I snored loud enough to wake the dead; I just didn't hear myself doing it, so I didn't realize that was one of the things keeping me from sleeping soundly.
I'm sorry if I offended.
Bonnie
_________________
| Mask | ||||
| ||||
| Additional Comments: Pressure: 8 | ||||
Sorry, but I disagree with the majority here. I do not think xPAPs should be available OTC.
1. While this board is filled with many people who are very educated about OSA and the treatment thereof, one still see posts from people who are much less well informed. I see this even more on other boards I read. There most definitely are people with more money than brains, and yes, I could very easily see people buying xPAPs to treat snoring, and possibly ending up creating a central apnea situation for themselves.
2. Another problem I see with having them available OTC (and I mentioned this in the other thread on this topic) is that making them OTC would give insurance companies even more of an excuse not to cover them. Case in point, since Claritin and Prilosec became available OTC, many insurance carriers either don't cover these or other drugs in the same class, or they put the other drugs in the class (which are stronger and more effective) on the highest co-pay tiers (to encourage people to buy the OTC out-of-pocket). I agree that insurance coverage of xPAP for some folks isn't very good, but not very good is still better than nothing, for most people.
3. Advertising. Imagine the TV commercials. xPAP manufacturers touting the life-changing benefits of xPAP treatment, so everyone who is tired, sad, anxious, overweight, or any of a zillion other things can be convinced to run out and buy their magic bullet.
4. We educated ones know that not all machines or masks are good for all people. Those who have had good help from either a sleep center, hospital, or DME know the value of these services. Sell these products OTC, and no one will get the benefit of that help. Rather than make the products available OTC, I submit that qualified RT services should be more readily available.
5. Us educated folk know the value of having data. There are a lot of people, though, for whom this is too much information, might make treatment overwhelming, and thus decrease their compliance. (Not to mention that not everyone can afford all the bells and whistles, so more affordable machines need to be available as well.) Making data mandatory on all machines would not allow for different strokes for different folks. I do, however, agree that the data should be available to anyone who wants it.
6. Not everyone who has a sleep disorder has OSA and needs xPAP. If xPAPs were available OTC, everyone would self-diagnose, and no one would have sleep studies, thus not be accurately diagnosed. Whenever FDA has changed the status of a product from Rx to OTC, one of the main reasons is that the condition being treated is easily diagnosed by the patient, such as seasonal allergies or heartburn. I do not believe that the vast majority of the population (general population, not those on this board) can self-diagnose OSA.
Geez, who wound me up tonight?
1. While this board is filled with many people who are very educated about OSA and the treatment thereof, one still see posts from people who are much less well informed. I see this even more on other boards I read. There most definitely are people with more money than brains, and yes, I could very easily see people buying xPAPs to treat snoring, and possibly ending up creating a central apnea situation for themselves.
2. Another problem I see with having them available OTC (and I mentioned this in the other thread on this topic) is that making them OTC would give insurance companies even more of an excuse not to cover them. Case in point, since Claritin and Prilosec became available OTC, many insurance carriers either don't cover these or other drugs in the same class, or they put the other drugs in the class (which are stronger and more effective) on the highest co-pay tiers (to encourage people to buy the OTC out-of-pocket). I agree that insurance coverage of xPAP for some folks isn't very good, but not very good is still better than nothing, for most people.
3. Advertising. Imagine the TV commercials. xPAP manufacturers touting the life-changing benefits of xPAP treatment, so everyone who is tired, sad, anxious, overweight, or any of a zillion other things can be convinced to run out and buy their magic bullet.
4. We educated ones know that not all machines or masks are good for all people. Those who have had good help from either a sleep center, hospital, or DME know the value of these services. Sell these products OTC, and no one will get the benefit of that help. Rather than make the products available OTC, I submit that qualified RT services should be more readily available.
5. Us educated folk know the value of having data. There are a lot of people, though, for whom this is too much information, might make treatment overwhelming, and thus decrease their compliance. (Not to mention that not everyone can afford all the bells and whistles, so more affordable machines need to be available as well.) Making data mandatory on all machines would not allow for different strokes for different folks. I do, however, agree that the data should be available to anyone who wants it.
6. Not everyone who has a sleep disorder has OSA and needs xPAP. If xPAPs were available OTC, everyone would self-diagnose, and no one would have sleep studies, thus not be accurately diagnosed. Whenever FDA has changed the status of a product from Rx to OTC, one of the main reasons is that the condition being treated is easily diagnosed by the patient, such as seasonal allergies or heartburn. I do not believe that the vast majority of the population (general population, not those on this board) can self-diagnose OSA.
Geez, who wound me up tonight?
_________________
| Mask | |
 |
I too am in the minority. I dont think XPAP should be OTC. For many of the same reasons others have stated. There are plenty of hypochondriacs out there who would spend the money on something like this. Don't underestimate the stupidity of the masses. Anyone who can make their way to webmd suddenly thinks they are dying of the most serious and rare thing they can find. Its insanity and by keeping certian things by script only we are protecting people who are incapable of looking after their own best interests.
As far as masks and hoses go......I am not so far out of my teen years that I cant imagine a few really stupid and seriously dangerous things someone could do with that kind of equipment.
As far as masks and hoses go......I am not so far out of my teen years that I cant imagine a few really stupid and seriously dangerous things someone could do with that kind of equipment.
Jab, I am not offended.
And yes, I would have tried it without a prescription if I could have and had I known it might stop the snoring as the price of the sleep studies was twice what I would have paid out of pocket for the APAP that I have.
I have been trying to get my brother to do just that for a while now since he snores worse than I do and he is up numerous times a night. Our father died of a massive heart attack at 50 (and autopsy evidence showed numerous smaller heart attacks) and my brother is 48. What is worse, trying this without a prescription or dying? I think dying is.
And yes, I would have tried it without a prescription if I could have and had I known it might stop the snoring as the price of the sleep studies was twice what I would have paid out of pocket for the APAP that I have.
I have been trying to get my brother to do just that for a while now since he snores worse than I do and he is up numerous times a night. Our father died of a massive heart attack at 50 (and autopsy evidence showed numerous smaller heart attacks) and my brother is 48. What is worse, trying this without a prescription or dying? I think dying is.
-
Wulfman...
Brian,
You've been reading my posts again.....
I can see both sides of this issue.....but I can envision a time when it COULD become OTC....they just need to get the titration part of it figured out. In reality, "it's just air"......but how much is needed is the question for "garden variety" OSA. The other problem(s) in diagnosis is whether there is Central sleep apnea (and the other things all those wires tell them) to deal with.
As I've repeated many times, they got my titration wrong (18 prescribed as opposed to 10 - 12 actually needed).....and that was by the "professionals".
Do THEY really know what they're doing? A few hours of lousy sleep on ONE night doesn't give a very good picture.
I wish the manufacturers would only make ONE XPAP machine (Bi-PAPs excluded) that has all the bells and whistles (APAP, data recording and exhale relief) and comes with whatever it takes to get it into a computer and with software to interpret it. I believe it would be more profitable for them.
I also know a number of users who don't want to bother with having to deal with determining how their therapy is working or don't have computers. If the LCD data would be accurate, that would help, but I don't consider it the BEST solution.....summaries don't give the full picture.
There are a whole lot of undiagnosed folks out there and far too many who give up or have less-than-optimal therapy......SOMETHING needs to be done.
I believe the MONEY/GREED/PROFIT-MOTIVE factor (by all parties) to be the biggest "problem" with the diagnosis and treatment of this ailment. Nobody truly cares about the health and well-being of the end-user.....it's ALL about money.
Den
You've been reading my posts again.....
I can see both sides of this issue.....but I can envision a time when it COULD become OTC....they just need to get the titration part of it figured out. In reality, "it's just air"......but how much is needed is the question for "garden variety" OSA. The other problem(s) in diagnosis is whether there is Central sleep apnea (and the other things all those wires tell them) to deal with.
As I've repeated many times, they got my titration wrong (18 prescribed as opposed to 10 - 12 actually needed).....and that was by the "professionals".
Do THEY really know what they're doing? A few hours of lousy sleep on ONE night doesn't give a very good picture.
I wish the manufacturers would only make ONE XPAP machine (Bi-PAPs excluded) that has all the bells and whistles (APAP, data recording and exhale relief) and comes with whatever it takes to get it into a computer and with software to interpret it. I believe it would be more profitable for them.
I also know a number of users who don't want to bother with having to deal with determining how their therapy is working or don't have computers. If the LCD data would be accurate, that would help, but I don't consider it the BEST solution.....summaries don't give the full picture.
There are a whole lot of undiagnosed folks out there and far too many who give up or have less-than-optimal therapy......SOMETHING needs to be done.
I believe the MONEY/GREED/PROFIT-MOTIVE factor (by all parties) to be the biggest "problem" with the diagnosis and treatment of this ailment. Nobody truly cares about the health and well-being of the end-user.....it's ALL about money.
Den
-
Rapunzel111
- Posts: 36
- Joined: Sat Sep 09, 2006 1:26 am
Should XPAPS be OTC???
Yeah!!! Whoo Hoo!!
Who in their right mind would buy them anyway but those who know what an XPAP is for??I can picture it now....
"Honey,I'm goin' to Walmart to get one of those sleep treatment devices-
do want me to pick up something for you?"
"Yes Dear,bring home one of those Home Brain Surgery kits too..I have been having a lot of headaches."
Actually I do wish that all machines were not prescription only.
That way,The Establishment would not be involve to block anything.
I can't wait for the day when CPAP machines are dispensed from a machine on the bathroom wall of the local gas station so I can buy a replacement instantly if mine ever breaks down!
Anyway,if you are worried about dumb people improperly using a CPAP or XPAP with bad results,just remember that this is part of life's ''natural selection process''.
-Rapunzel111
Yeah!!! Whoo Hoo!!
Who in their right mind would buy them anyway but those who know what an XPAP is for??I can picture it now....
"Honey,I'm goin' to Walmart to get one of those sleep treatment devices-
do want me to pick up something for you?"
"Yes Dear,bring home one of those Home Brain Surgery kits too..I have been having a lot of headaches."
Actually I do wish that all machines were not prescription only.
That way,The Establishment would not be involve to block anything.
I can't wait for the day when CPAP machines are dispensed from a machine on the bathroom wall of the local gas station so I can buy a replacement instantly if mine ever breaks down!
Anyway,if you are worried about dumb people improperly using a CPAP or XPAP with bad results,just remember that this is part of life's ''natural selection process''.
-Rapunzel111
I'm with Snoregirl on this one.
My brother snores VERY loudly, his wife complains that he regularly stops breathing while sleeping, he has been complaining about not getting enough rest, even bought one of those fancy therapeutic beds trying to make it better. It didn't help.
When I told him about what an APAP has done for me, he's ready to get on board. BUT.. He is afraid that being diagnosed will cost his employers insurance to jump, which might cost him his job.
Yes, I know..
His health is more important.
Doing the "right thing" and getting treatment should be rewarded, not punished.
Seeing a sleep Doc and getting a real study done could reveal important stuff.
I'm well aware of all that too, but right now he's seeking a used Auto machine so he can treat the problem without going through the "usual" channels.
One way or another I need to get him on a machine. I know his health is going down, and it doesn't need to.
So there's an interesting point for this discussion. How many people have OSA and want to treat it, but are not willing to be officially diagnosed?
If it were your brother or sister, would you help them?
Just asking..
LyleHaze
My brother snores VERY loudly, his wife complains that he regularly stops breathing while sleeping, he has been complaining about not getting enough rest, even bought one of those fancy therapeutic beds trying to make it better. It didn't help.
When I told him about what an APAP has done for me, he's ready to get on board. BUT.. He is afraid that being diagnosed will cost his employers insurance to jump, which might cost him his job.
Yes, I know..
His health is more important.
Doing the "right thing" and getting treatment should be rewarded, not punished.
Seeing a sleep Doc and getting a real study done could reveal important stuff.
I'm well aware of all that too, but right now he's seeking a used Auto machine so he can treat the problem without going through the "usual" channels.
One way or another I need to get him on a machine. I know his health is going down, and it doesn't need to.
So there's an interesting point for this discussion. How many people have OSA and want to treat it, but are not willing to be officially diagnosed?
If it were your brother or sister, would you help them?
Just asking..
LyleHaze