Positive Airway Pressure - Availability

Availability

In many countries, PAP machines are only available by prescription. A sleep study at an accredited sleep lab is usually necessary before treatment can start. This is because the pressure settings on the PAP machine must be tailored to a patient's treatment needs. A sleep medicine doctor, who may also be trained in respiratory medicine, psychiatry, neurology, paediatrics, family practice or otolaryngology (ear, nose and throat), will interpret the results from the initial sleep study and recommend a pressure test. This may be done in one night (a split study with the diagnostic testing done in the first part of the night, and CPAP testing done in the later part of the night) or with a follow up second sleep study during which the CPAP titration may be done over the entire night. With CPAP titration (split night or entire night), the patient wears the CPAP mask and pressure is adjusted up and down from the prescribed setting to find the optimal setting.

• In the United States, PAP machines are often available at large discounts online, but a patient purchasing a PAP personally must handle the responsibility of securing reimbursement from his or her insurance or Medicare. Many of the internet providers that deal with insurance such as Medicare will provide upgraded equipment to a patient even if he or she only qualifies for a basic PAP. In some locations a government programme, separate from Medicare, can be used to claim a reimbursement for all or part of the cost of the PAP device.
• In the United Kingdom, PAP machines are available on National Health Service prescription after a diagnosis of sleep apnea or privately from the internet provided a prescription is supplied.
• In Australia, PAP machines can be bought from the Internet or physical stores. There is no requirement for a doctor's prescription, however many suppliers will require a referral. Low-income earners who hold a Commonwealth Health Care Card should enquire with their state's health department about programmes that provide free or low-cost PAP machines. Those who have private health insurance may be eligible for a partial rebate on the cost of a CPAP machine and the mask. Superannuation may be released for the purchase of essential medical equipment such as PAP machines, on the provision of letters from two doctors, one of whom must be a specialist, and an application to the Australian Prudential Regulation Authority (APRA).
• In Canada, CPAP units are widely available in all provinces. Funding for the therapy varies from province to province. In the province of Ontario, the Ministry of Health's Assistive Devices Program will fund a portion of the cost of a CPAP unit based on a sleep study in an approved sleep lab showing Obstructive Sleep Apnea Syndrome and the signature of an approved physician on the application form. This funding is available to all residents of Ontario with a valid health card once every 5 years.