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Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
#1
Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
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 Too-funny ...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?


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#2
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
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?
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
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.
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#4
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
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.
Mask Primer

Positional Apnea

Attach OSCAR, etc.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
Andy, read Deborah K's thread on going from CPAP to bilevel. Lots of information there that may be useful to you https://www.apneaboard.com/forums/Thread...t=aircurve Any doctor can prescribe bilevel and nearly every supplier will provide it with that prescription without question. An alternative you might want to consider is to look up CPAPspecials (can't write out he URL per rules), and check out the availability of a Resmed Aircurve 10 Vauto. This company drop-ships units to international clients without any prescriptions at a very low cost. We have had quite a few members in AU, Asia, Europe and Canada obtain equipment from them.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
Thanks Sleeprider, that thread you linked has been extremely helpful to read and I'm only about a quarter of the way through it.


So, I've already ordered an Aircurve 11 from 1800Cpap. They told me they don't mind I'm buying without prescription as I'm an international customer, however, they said there's a slight chance that customs in my country might ask for one when it arrives. 

The physical in-store CPAP-equipment supplier where I live told me that a signed doctor's note or even past prescription wasn't enough to buy the BiLevel from them, it was still mandatory to then book a consult with one of their Sleep "Specialists" after (which cost ~$500 a session btw). Who would then determine based on whatever data you brought to the consult if they'd grant you the privilege of being able to buy a BiLevel or not. 

The last time I saw one of the doctors at my GP practice, even after showing her my at-home sleep study with a Moderate OSA diagnosis, she told me that she wasn't able to subsidize a regular CPAP for me via public healthcare. She told me I'd have to stay on the public waiting list (average wait time: 2+ years) to get a "more official" sleep study overnight at the hospital, and that they could then send me one shortly after.

I'm going to give my GP practice another shot, this time with a different doctor who I've got a good rapport with, and ask him if he can authorize a prescription for BiLevel. Thing is, there's all sorts of silly statutes where I live that can sometimes restrict doctors from prescribing things that they might even want to do with purest intentions. Hopefully there's not something stopping him from writing me a prescription just because I haven't "officially" been diagnosed with sleep apnea by the public health system here yet.
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#7
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
I have not found our members in AU have any issues with receiving a device ordered from the U.S. other than potential payment of import taxes and tariffs. The tax man is not so involved in what medical devices you can have, but they like your money. Glad to hear you're reading Deborah's thread. It really tells a story of success worth reading.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
So, a quick update. 

1800 CPAP ended up being a real hassle to deal with. Despite saying the prescription wasn't a requirement for International customers, they started demanding one off of me, and tried to lie by saying that I told them I had one over the phone with them when I did not! They also asked for a document with proof of my address and a screenshot of my government-issued ID. Their reasons for this was to mitigate chances of "fraud" considering my purchase was over $1,800 USD. I did exactly as they asked, sent them a Utility bill and a screenshot of my Passport, and they told me they still needed time to further "review" them and would be in touch if they wanted more information from me. So, I quickly contacted my bank and cancelled my card, and luckily as the transaction was still pending, I was able to get my money back. This has made me a lot more hesitant to hand over my money to an online retailer in the future. 

Anyways, I'm seeing my Doctor on Wednesday to see if he's able to prescribe me a BiPap. I've read through all of Deborah's thread, and am going to say words to the effect of what she said to her Doctor about why a BiPap's capable of better treatment for sleep apnea than a CPAP. I'm going to also emphasize how I'm still feeling tired using a CPAP and how I believe a BiPap will dramatically improve my quality of sleep & health. There's just one issue--If he is able to prescribe it, he might ask me what settings to titrate it towards? I know the local supplier I tried buying a BiPap from told me their specialists had to have a confirmed titration study done for BiPaps on top of a prescription before they could sell one to me.
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#9
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
I live in the usa and have a prescription for a bipap. This morning I ordered a backup aircurve 10 vauto from an online vendor because they are so heavily discounted right now. I called and cleared the purchase with them over the phone, then made the online order and I already have a tracking number. I have an old prescription for bipap but I didn't tell the vendor a number or anything. Its the same model I already have so I'm going to move my settings over when it arrives. Being in the usa there is no point trying to use my insurance since my deductible is so high.
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#10
RE: Been recommended a BiPap instead of APAP-Why do I need a prescription to buy??
Some great news folks.  Smile

Today I saw my doctor and had a discussion with him about getting a BiPap, and how CPAP doesn't seem to be eliminating 100% of my sleepiness. I showed him how choppy my flow rates were during REM sleep, and how I'm still getting obstructions and flow limitations despite being on such a high pressure on CPAP.

He just asked if I was confident that BiPap would be the key to a better quality of life for me, which I answered with a resounding yes. He then immediately began writing up a signed note/prescription for me stating he was in full support of me buying a BiPap machine to treat my Sleep Apnea.

In his note he hasn't put down any titration/pressure settings. I've talked to a few overseas retailers this evening. They're happy with the signed note my Dr. provided, they just want to know what settings to program the BiPap with before they ship it.


Can anyone here tell me what titration settings I should include when ordering a BiPap? Any starting settings to recommend based on my OSCAR charts attached in the first post of this thread?
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