Positive Airway Pressure (PAP) therapy is the most common treatment type for sleep apnea and is delivered using a PAP machine.
Typically, the PAP machine is about the size of a shoebox, or even smaller. The device has a flexible hose which connects the PAP machine with a mask or any other interface, which is worn over the nose and mouth.
A PAP machine works by pushing pressurized air through the sleep apnea patient’s airways at a pressure which can prevent apneic episodes. The air pressure is set by the sleep technician and the sleep doctor based on the severity of the sleep apnea.
Since the PAP machine is primarily a medical device, it must have the approval of the FDA (Food and Drug Administration) before it can be marketed.
It is precisely for this reason that the sleep apnea patient needs to have a prescription from the concerned physician for obtaining a PAP device.
Considerations While Buying PAP
The PAP devices market has several players who offer different machines having various features. Once diagnosed as having sleep apnea, the patient is prescribed a PAP therapy and based on the severity, comfort level, insurance availability, the person can choose the most appropriate machine.
A PAP device, covered by the insurance as a DME (durable medical equipment) benefit, is often either purchased or rented through a DME/HME (home healthcare equipment) company.
Of late, to meet the ever-increasing demand for PAP devices, many new as well as refurbished PAPs are also available on the Internet.
However, it is always preferred that the patient rents a PAP device for some time to ensure that the device is apt as well as to determine the settings are appropriate and can address the sleep apnea disorder of the patient.
The person should talk to his doctor as well as DME for determining the most suitable machine keeping in mind the lifestyle needs.
Cost & Convenience
One also has to factor in the cost restrictions as well as a panel of manufacturers which is approved by the insurance company. This is important since a majority of the insurance companies cover the only specific type of PAP machines.
While deciding the most appropriate PAP machine, one has to consider the features required as well as various other options such as carry case, conversion to different currents (either automatic or using additional equipment), the capability of efficiently functioning at higher altitudes, ramping, heated humidifier among others.
There are also devices which have two different sets of pressures for inhalation and exhalation, aimed at those who have problems with a single continuous stream of air pressure.
Additionally, the FDA has approved marketing of auto-adjusting devices, devices which use algorithms that sense the varying pressure requirements of a person and automatically adjusts the air pressure settings.
Th newer machines have constant air pressure setting for inhalation but flexible levels of exhalation. This exhalation pressure is decided partly by the user (by selecting one of the three settings available) and partly by a machine (based on the patient’s exhalation patterns).
Insurance & Compliance
Almost every sleep apnea patient buys PAP devices through insurance. In the PAP devices market, however, advanced machines with more sophisticated features may not always have insurance coverage.
These advanced machines may be covered based on the prescription from the sleep specialist as well as a documented failure with standard PAP therapy.
Some machines can monitor the compliance rate by the PAP device users, while another machine also can record apneic events during the use of a PAP machine.
The sleep specialist would like to view data periodically to assess the treatment efficacy and adequacy, and having a compliance monitor would also aid in offering objective verification on whether the patient is getting sufficient sleep.
Data can be downloaded at the local DME/HME, or if it is embedded in an SD card, the user can mail the same to the DME or sleep center.
Besides PAP machine, another critical component in the PAP therapy is the use of a mask, and the mask fit is essential for getting a proper air supply. The person should speak with their doctor or DME regarding their choices and choose the best one possible. Click here to know how to select the first mask.