For over twenty years I have had the privilege of helping patients with their respiratory needs. As a trained Respiratory Therapist, I have spent many years in a hospital setting helping patients overcome their respiratory challenges. The leading cause of death in the hospital is infection usually caused by staff, patients, and visitors not washing their hands. Respiratory supplies were changed every forty-eight hours to help prevent respiratory infections. When I got into home health I recognized that patients were not changing their CPAP supplies. I discovered that a lot of patients did not know that most insurance companies would pay for these new supplies. They were very thankful; some of them had never received a new CPAP mask or supplies. Thus the Supply Program was born!
Sleep Apnea can be best defined as someone who stops breathing while sleeping. According to the American Sleep Apnea Association this affects more than twelve million Americans alone! There are three types of Sleep Apnea: Central, Mixed, and Obstructive Sleep Apnea (OSA). The most common form of Sleep Apnea is OSA, which is caused by an obstruction or collapse of the airway. For example, the tongue, palate, orepiglottis can obstruct the airway. Central Sleep Apnea is caused when the brain fails to tell the muscles to breathe. Mixed Sleep Apnea is a mixture of both Central and Obstructive Sleep Apnea. Untreated Sleep Apnea can cause Congestive Heart Failure, Diabetes, High Blood Pressure, Headaches, Weight Gain, and Motor Vehicle Accidents. Since most people are not familiar with the symptoms of Sleep Apnea it is most often overlooked and undiagnosed.
A Sleep Test is the most common tool used to diagnose Sleep Apnea. During the sleep test usually half the night will be spent diagnosing whether the patient does have Sleep Apnea. The second portion of the test will be spent using CPAP equipment to document any improvement and measure its effectiveness. The most common test for symptoms is the Epworth Sleepiness Scale. This is not a diagnosis but simply a guideline to indicate to your physician that you may have Sleep Apnea and may require a sleep study. If you suspect that you or a loved one may suffer from Sleep Apnea try answering the following questions:
How likely are you to doze off or fall asleep in the situations described below, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven't done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0 = would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
Situation Chance of dozing
Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in the traffic
Score:
0-10 NORMAL RANGE
10-12 BORDERLINE
12-24 ABNORMAL
CPAP (Continuous Positive Airway Pressure) is the most common treatment for patients who have been diagnosed for Sleep Apnea. The amount of pressure being delivered with a CPAP machine is usually determined by your sleep study and varies for each person. This equipment is only available through an order written by your physician. The biggest problem associated with CPAP is the patient's inability to tolerate air pressure, the type of cpap mask used, or poor cpap mask fitting. Over a period of time many patients do get used to the pressure from CPAP with practice. I have found that an excellent way to alleviate the discomfort especially during this learning phase is to use the "ramp" feature. The patient can use this feature anytime they are having difficulty tolerating the pressure from CPAP. The "ramp" feature reduces the pressure dramatically and within 30-45 minutes the pressure slowly builds up until optimal pressure has been reached again. The patient will usually fall asleep during this period and not notice the increased air pressure.
BiLevel or BiPAP (Bilevel Positive Airway Pressure) is designed for patients who have a high pressure prescribed or who have trouble tolerating the pressure associated with CPAP. BiPap has two pressures. Inspiratory (inhalation) and Expiratory (exhalation) The Expiratory pressure is dramatically reduced so the patient can tolerate BiPAP. Although this equipment is much more expensive than CPAP most insurance companies will pay for it with the proper documentation.
In conclusion, there are many types of equipment and supplies to treat Sleep Apnea. Selecting the right equipment to handle your personal pressure settings along with a comfortable mask and the right filters and cushions can be quite confusing. Therefore, it is important that you select a company that can not only provide you with quality CPAP machines and CPAP supplies but also with personal service customized for your particular needs. The very best durable medical equipment companies are awarded the Gold Seal of Approval by the Joint Commission so that is also something to look for when selecting a company. Lastly, select a company that specializes in Sleep Apnea equipment and service for your best chance at achieving your goal to sleep better now!
