Do You Need a Prescription for a CPAP Machine?

When your sleeping partner or roommate blames you for the crime of snoring, it’s not always because of the heated and unresolved debate you had the day before. If they also claim that your snoring has actually been going on for a while now and you seem to be having trouble breathing at certain periods during your sleep, it might even mean that you have a sleep disorder called obstructive sleep apnea (OSA), and you might have to go to a sleep clinic. You can guess how a disorder that blocks your airway and prevents you from breathing properly can have dire consequences when untreated.

Continuous Positive Airway Pressure (CPAP) is one of the treatments for sleep apnea and it can be prescribed by sleep physicians and sleep specialists upon diagnosis. CPAP therapy will open the blocked airway by applying pressurized air while you are sleeping, so your breathing will be normal and your snoring will be minimized if not completely eliminated.

Before getting into what a CPAP machine is and how you can acquire a CPAP prescription, though, let’s see what sleep apnea is in a bit more detail.

What Is Sleep Apnea?

The briefest definition is having your airway obstructed during sleep, which causes snoring and sometimes a complete arrest of breathing for a couple of seconds. That might result in wakeups, nightmares, sleep paralysis, or worse. Moreover, if you suffer from sleep apnea, there is a possibility that you will not feel rested after waking up and will still feel an overwhelming sleepiness because it greatly reduces the quality of your sleep.

There is not only one version of sleep apnea, and it may manifest in three types:

  • Obstructive Sleep Apnea (OSA): There might be a couple of reasons for obstructive sleep apnea, including unusually big tonsils which block your breathing during sleep – especially when you are lying on your back and breathing through your mouth. But in general, it happens due to over-relaxation of the throat muscles.
  • Central Sleep Apnea (CSA): The culprit of this type of apnea is again the throat muscles that don’t allow you to breathe regularly during sleep. However, the cause behind the misguided actions of the muscles are far more serious, as it is the brain that fails to send the necessary signals to them.
  • Complex Sleep Apnea Syndrome: It might sound far scarier than it should, but rest assured, it’s just a combination of the two types of sleep apnea we mentioned above, and it’s as treatable as they are with the right diagnosis and CPAP equipment.

Sleep apnea might be hard to diagnose since its symptoms surface only when we are sleeping, and it’s mostly pointed out by those we share our sleeping quarters with. Still, 9% of the global adult population is estimated to be suffering from a subtype of this sleep disorder, and considering the possible consequences, it’s quite a big number. It’s a disorder that has to be dealt with whenever diagnosed.

What Is a CPAP Machine?

You may be happy to learn that the CPAP device was invented by a fellow Australian physician, namely Colin Sullivan, in 1980 so that the airway of a patient suffering from OSA would be unobstructed during sleep. Nowadays, the leading manufacturer of the device is a healthcare company that goes by the name of ResMed.

The device has three main components:

  • The machine – it’s the part responsible for producing and delivering the pressurized airflow throughout the night.
  • The CPAP mask – of course, it would be nice if the air produced by the machine found your nostrils and mouth miraculously, but unfortunately you need a mask to guarantee the air goes where it’s supposed to go. There are various types of masks that can be used with CPAP machines: full face masks, nasal masks, nasal pillow masks, pediatric masks, and so on.
  • The tube – it connects the mask and machine together and is responsible for carrying the air from the machine to the mask and then to your lungs.

Today, the CPAP machine is not the only medical device used and recommended for treating or minimizing the effects of sleep apnea, because it’s seen the birth of two siblings since its invention: BiPAP machines and APAP machines (also known as Auto CPAPs). BiPAP machines feature a bi-level airway pressure and different air pressure settings customized in accordance with the individual inhalation and exhalation needs of the patient. APAPs take that one step further: they automatically adjust to your pressurized air needs during the night.

When you go to a sleep study center with a complaint of apnea, the expert there will probably tell you which of these medical equipment is the most suitable one for your CPAP treatment.

There are also other CPAP accessories that you might benefit from during your treatment, like humidifiers that prevent your throat from getting sore overnight. Those accessories are labeled as CPAP supplies and you’ll also need a prescription for those.

Why Do You Need a Prescription for a CPAP Machine?

In the United States, the FDA considers CPAP devices as Class II Medical Devices, which means that the regulations are not all that tight but you still need a prescription for it just to be on the safe side.

In Australia, on the other hand, there is no prescription requirement on paper, but you might need one in practice because only a sleep specialist will be able to tell you how much air pressure you need, what type of mask, mask parts, or machine to use, and whether you need other CPAP supplies as well.

To determine all these, it’s necessary to visit a medical doctor’s office or apply for a home sleep test. Both options will let the examiners come up with your apnea/hypopnea index that shows the pattern and frequency of abnormal breathing. How much obstruction your breathing suffers and how much air pressure you need depend on the numbers shown on this index.

Also, if you go and buy a CPAP machine without consulting an expert first, you might run the risk of overlooking other disorders. You might self-diagnose with sleep apnea but the real reason you are having problems might be something else. If that happens, having CPAP therapy will not hurt you (because there are no known serious side effects), but the real reason will remain undiagnosed and untreated.

That’s why decent medical equipment stores will decline selling you CPAP supplies without a prescription.

Who Can Prescribe a CPAP Machine and How?

There are a number of symptoms common in all sleep apnea types: loud snoring, breathing problems, gasps and subsequent awakenings, sleepiness the next day, waking up with a headache in the morning, and sometimes a sore throat. If you have these symptoms or if your sleeping partner says you do, you have to visit an expert or apply for a home sleep study.

Whether it’s an office study or a home one, you’ll have to take a sleep apnea test, polysomnography, which will require you to sleep under observation for at least one night. With that test, your doctor or sleep specialist will be able to assess how your breathing pattern, heart rate, oxygen levels, and other related data change when you are fast asleep.

Depending on the results, any medical doctor available will be able to write a prescription detailing the number of refills required, the right mask for your therapy, and other CPAP supplies you may need – that is, of course, if you are diagnosed with sleep apnea.

Then you can go and get your supplies from sleep clinics, medical equipment stores, or online retailers with the prescription. In most cases, Medicare will cover the expenses at least partially. If you have private health insurance, it is better to consult with your insurance provider first to assess how much coverage you get.

Wrapping Up

Sleep apnea might seem like an inconsequential disorder at first, but acting on it as soon as it is diagnosed is crucial because it can lead to serious ramifications. And although CPAP machines used for treating sleep apnea don’t require a written prescription in Australia, having the details of your disorder written down by a medical expert is quite important. Sleep apnea comes in many forms and with different effects on your breathing and other relevant functions. Only a professional will be able to tell you what exact supplies you need for your CPAP therapy, and they are the only ones who can recognize if there are any underlying causes for symptoms you might mistake for a type of apnea.