[CPAP] [Ireland] New to CPAP; "no" prescription

[efaj]

Hi all,

I've read a lot of similar stories, most are from the USA. But I live in Ireland, and talking in person with a few folks, the following situation seems... "normal". 

Upon being prescribed CPAP, my specialist just flat out refused giving me a prescription, telling me to await a call from their vendor, and has told me "that's the way it's done". I managed to get the prescription from that vendor, and proceeded with buying an AirSense 10 on my own, which is on its way.

But, as I'll also need a "Medical Fitness to Drive" form, I wonder if the specialist was in the right? if I have "burned a bridge", in that the specialist would be the one to make that form, and that otherwise my GP would not be able to make it, and now I'll have to start all over again with a new specialist who will want to run all tests from 0 again? or even that I've messed up my treatment by foregoing an specialist? (though it seems I'm in the right place now, being in this forum)

[DaveSkvn]

Hi efaj,

If you've not started CPAP yet you may not have been introduced to the notion of monitoring. I see you have ordered the same type of machine as me. Every morning at 9am it uploads what happened overnight to the internet using a mobile network. It can tell how many hours you used it, if the mask is leaking, how many apnea events there were per hour and how often you switched the machine off. Certainly in the UK, and I suspect in Ireland, the sleep clinic is supposed to monitor you. Monitoring machines from many different manufacturers would be horrendous so your specialist/sleep clinic will probably have selected one to keep things simple.

By far the greatest effort of monitoring is when someone first starts using CPAP. It can be quite a "journey". Bluntly the job of the specialist CPAP nurse is to badger newly diagnosed patients into using the machine. If they can't monitor what is going on (because the software is different) then that may not happen / they may decline to do so.

I had a quick look at the RSA website and it seems any doctor can sign the form. That doctor will want to see that your OSA is under control. In the Redmed myAir web app you can download a "Sleep Therapy Report" that includes your usage and the average AHI when using the machine. The AHI will have to be below some level - certainly below 5. Your mission is to find a doctor that will take that report and sign the form. GPs may be reluctant to do so due to lack of detailed knowledge of sleep apnea. Your original specialist will probably be willing to do so (with a look of distaste on their face).

I guess a key question is: are you still under the wing of the CPAP specialist nurse to coach you into using CPAP? If you are then there shouldn't be a problem. If you are outside the processes you may be in for a bumpy bureaucratic time.

Good luck with your new CPAP machine!

[efaj]

Hi Dave,

thanks for the reply, and for looking into the RSA.

Maybe I was too suspicious of my specialist... though they were initially having me go for a DV64, which I've learned is discontinued and not as good. And procuring within Ireland, all prices are at least twice as much as other online providers.

Your original specialist will probably be willing to do so (with a look of distaste on their face).

I guess a key question is: are you still under the wing of the CPAP specialist nurse to coach you into using CPAP? If you are then there shouldn't be a problem. If you are outside the processes you may be in for a bumpy bureaucratic time.

Well... the distaste will probably be palpable: I tried to get the prescription from the specialist via a GDPR request (which they never fulfilled). Maybe it's not toxic enough at this time, and I can just wrap this initial process with them, since as you say, it'll be bumpy and bureaucratic otherwise.