Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??

[AndyJ.]

Hi everyone,


I've been using an APAP for over a month now with mixed success. Some days I feel great, but many days I'm still feeling way sleepier than I thought I'd be after getting this machine. Ever since I first got my APAP, I got an SD card, installed OSCAR immediately, and have been researching online nonstop to try and optimize its settings.


Recently, I've had a few people look over my OSCAR data, including a paid Zoom session with a guy who runs a YouTube channel dedicated to Cpap therapy. They've all come back with the opinion that I'd probably have much better results if I changed to a BiPap/Bilevel machine. Main reasoning being that I currently need a pressure of 15.0 or higher to treat my events, and that my flow limitations seem to be a common problem according to my data.


When I got my APAP machine (Resmed Air 11), I paid the full price for a new one but was able to do so without a prescription. However, every single online store I've checked out, regardless of country, requires proof of prescription to get a BiPap machine. I asked the person working at my local CPAP supply store why this was the case and he told me it's because BiPaps are usually reserved for those with severe heart/breathing problems, and in some rare cases, can even make some people's health worse if they were to use a BiPap with wrong settings.


I was told even if my doctor agreed to write a note saying he approved of me getting a BiPap, this still wouldn't suffice, as it needed to be signed off by a Sleep Specialist. And currently, I've been on the waiting list to see one just for a SLEEP TEST for almost 2 years ...Which is the whole reason why I ended up getting a private at-home sleep test and buying the APAP out of pocket myself.  I've tried looking on local markets (facebook/craigslist/gumtree/etc.) for my region (Aus/NZ) to see if I can snag a second-hand BiPap, but there's not even a trace of one anywhere to be found. 


So, is there any way to get around the prescription requirement online? Is there even any REASON why the prescription would be so necessary for a BiPap but not an APAP?

[SarcasticDave94]

Then that local supply store doesn't know what they're talking about regarding BiPAP. This is similar to CPAP, mainly it's 2 pressure instead of 1. Their answer is attempting to include all bilevel machines in their answer, in an attempt to keep you from getting this. Why, I don't know.

BiPAP and bilevel are the same, BiPAP is a trade name for Philips Respironics brand of bilevel.

There are bilevel that are basic, others automatically adjust within a range, others add breath timing, another specifically treats Central Apnea, then there's those that are for patients with lung conditions. Just like cars, there's lots of sub groups for different needs.

Since you have the ResMed AirSense 11 AutoSet, your best bet for bilevel is likely the "ResMed AirCurve 10 or 11 VAuto". Are you asking for this specifically?

[AndyJ.]

Well, I've even heard LankyLefty on Youtube say that a BiPap can potentially "mess people up", and every online store seems to be really hard-nosed about requiring a prescription for a BiPap. I can't imagine why, since it seems the most it does that's different than the APAPs is that it has more control over the EPR range and a few other functions.

[SarcasticDave94]

Isn't that kinda like saying you don't need a car because people might crash them?

Your OSCAR chart shows you remain between 12-15 pressure, and for me that itself can be a legitimate reason for bilevel. You need the higher pressures, so why not allow it to be delivered comfortably like the bilevel would.

Both AutoSet and VAuto give ranges of pressure. The AutoSet delivers pressure differential to treat flow limits with EPR, that's limited to 3. The VAuto delivers pressure differential with PS that is not limited to 3. Then the VAuto has some timing controls for inhale.

I've no clue why they're against you getting a Bilevel, but certainly it's not harmful. Look at the users of this Apnea Board. There's a lot of VAuto users, and other bilevel too.