Sleep Apnea Diagnosis?  21 FAQs About a CPAP Prescription for a Great Night’s Sleep

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Sleep Apnea Diagnosis?  21 FAQs About a CPAP Prescription for a Great Night’s Sleep

How do you know if you have Sleep Apnea or if a CPAP machine will work for you?  These are great questions!  I recently began using a CPAP machine and have gone through the process from diagnosis to prescription to treatment.

This guide full of frequently asked questions is here, so you don’t have to figure it out from scratch as I did!  Let’s dig in!

What is Sleep Apnea?

Sleep apnea is a chronic condition involving nighttime breathing that interrupts your sleep three or more nights per week.  Sleep apnea can impair your ability to function at full capacity in your daily life.  There are two well-known types of sleep apnea: Central Sleep Apnea and Obstructive Sleep Apnea.

Central Sleep Apnea (CSA) is rooted in a problem with the central nervous system.

The more common of the two sleep disorders is Obstructive Sleep Apnea, which is caused by the muscles in the back of the throat relaxing and blocking the airway while sleeping.  With Sleep Apnea, this blockage can cause a drop in blood oxygen levels and other health concerns.

Some Facts About Sleep Apnea from Single Care

  • 50 to 70 million adults in the US are affected by a sleep disorder (American Sleep Association [ASA], 2021).
  • Twenty-five million adults in the US have obstructive sleep apnea (ASA, 2021).

What are the Signs of Sleep Apnea?

The signs of sleep apnea vary from person to person, but here is a list of the most common symptoms you may be exhibiting if you have Sleep Apnea:

  1. Loud and chronic snoring.  Not all snoring is sleep apnea.
  2. Waking to gasping or choking in the night, although sometimes the gasping and choking can happen without waking.  In that case, a sleeping partner may report these episodes.
  3. Daytime sleepiness
  4. Morning headaches
  5. Memory or learning problems
  6. An inability to concentrate
  7. Feelings of irritability, depression, or mood swings
  8. Nighttime urination
  9. Dry throat when you wake up

Why Should I Be Concerned?

If you have sleep apnea, you are at risk of not getting enough air in your lungs while you sleep due to a blocked airway.  A blocked airway can cause loud snoring and a drop in blood oxygen levels.

When your brain detects this dangerous drop in levels, it sounds an internal alarm and awakens you.  When you awaken, fully or even partially, your body automatically tightens the upper airway muscles and re-opens your windpipe to allow airflow.  You will begin breathing normally again, but that process often comes with a loud snort or a choking sound.  Sexy, right? 

When this drop in oxygen level happens frequently and your sleep is disturbed repeatedly, your body releases extra stress hormones.  These excess hormones raise your heart rate and increase your risk of high blood pressure, heart attack, stroke, and irregular heartbeat.

When untreated, Sleep Apnea can increase your risk for obesity and diabetes.  When you are not getting proper sleep due to this cycle of snoring, snorting, and lack of oxygen, you’re naturally more tired during the day. 

You must also consider how your poor sleeping habits affect your sleep partner.  My very gracious husband doesn’t complain but rather giggles at my nighttime antics, snorting and gasping.  However, even though he is good-humored, I know he is not getting proper sleep.  I get to sleep in because I work from home.  He has to be up and out the door by 6 am and doesn’t have that luxury.

Even though you may be able to sleep in as I do, untreated sleep apnea can cause daytime drowsiness and difficulty getting up and moving in the morning.  I felt like I couldn’t get enough sleep and had very little energy to get chores done during the day. 

Printed graphic of the sleep apnea cycle
An informational poster on the wall in the DME office.

What Treatments Are Available for Sleep Apnea?

If your apnea is very mild, you can take steps to improve your situation by altering some of your lifestyles, such as:

  1. Avoid alcohol and medications that make you sleepy.  These can make your muscles relax even more than usual, making it even more difficult for your throat to stay open while you sleep.
  2. Lose weight.  Ugh.  I know.  It’s hard.  But even a slight weight loss can help improve your symptoms.
  3. Try to sleep on your side instead of your back.
  4. Consult with your Primary Care Physician or a medical doctor about nose sprays or allergy medications that may help you keep those air passages open while you sleep.
  5. Stop smoking.

Although changes in your lifestyle may help if your symptoms are mild, moderate to severe symptoms may require a more robust approach.  And that brings us to the CPAP treatment.

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What is a CPAP machine anyway?

CPAP therapy involves using a continuous positive airway pressure (CPAP) machine.  These handy little medical devices deliver pressurized airflow through your nose and/or mouth while you sleep.  This airflow helps to keep your airway open, allowing the proper amount of oxygen to get to your lungs. 

You’ll also be more likely to sleep through the night without snorting, honking, and gasping for breath.  And you won’t suffer the dreaded “honey, roll over!” moment that we all love so much.  Not.

Why Do I Need a Prescription for a CPAP Machine?

At first, it made no sense to me why a CPAP machine was prescription-based.  I mean – what’s the probability of abusing the machine?  It’s really just a fancy air blower, after all.  But the reasons are relatively simple.

If you have a prescription, you need to consult with your physician.  As a patient consulting with a doctor, you will receive appropriate training and further monitoring as you put your machine to use. 

Consulting with your physician allows for monitoring after using your CPAP and helps you better understand your diagnosis.  In addition, working with a certified respiratory therapist to fit you with the best mask and machine for your needs, enables you to troubleshoot, and allows you support in beginning therapy and when to replace the accessories that are part of the equipment.

It is not easy to know which machine will work best or how and when to replace accessories without professional assistance.  Overall, professional input will help you use the device correctly for the best results.

And finally, because this is a Class II medical device a prescription requirement is in place, and your health insurance can help with the cost of the machine and its accessories, which are not inexpensive.

If you encounter a website or someone trying to sell you a CPAP machine over-the-counter (no prescription), know that this may be a non-FDA-approved device.

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How do I Get a Sleep Apnea Diagnosis and a Prescription for CPAP Therapy?

Now that we’ve covered the basics of what Sleep Apnea is and what CPAP devices are all about let’s talk about how to go about getting diagnosed and hooked up (no pun intended) with your shiny new breathing apparatus!

If you suspect you have sleep apnea, your first step will be to see a doctor for a diagnosis.  You can begin with your primary care physician.  Simply talk with your doctor and tell them of your concerns.  In my case, my doctor asked me a few questions about my sleeping habits (or lack thereof) and referred me to a Sleep Specialist.

A few short days later, I had a Zoom appointment with the Sleep Physician, who explained all the options available for treatment.  She also explained that I would need a sleep study administered by a local sleep lab to determine if my diagnosis was positive for sleep apnea.

Are the Rules the Same for me if I live outside of the US?

I live in the United States, and our Food and Drug Administration requires a new prescription for CPAP therapy.  If you live in another country, rules and regulations for an international prescription may be different.  Check with your physician to learn how the process works for your country.

What is a Sleep Test, and Do I Have to Sleep in A Strange Place?

A sleep study consists of an overnight test known as polysomnography.  There are two options for a sleep study.  One study is conducted at an authorized sleep clinic, and the other while you sleep at home. 

Believe it or not, one of my main concerns in this whole experience was if I would have to sleep in a strange place with strange people looking at me.  I breathed a big sigh of relief when my new sleep doctor told me that I qualified for a home sleep test.

If you are diagnosed with an additional medical health condition such as congestive heart failure (CHF), COPD, or other complex medical conditions.  In that case, you will likely need to conduct your sleep study at an authorized sleep center.

How does a Home Sleep Study Work?

The home sleep test is a simple process.  My sleep specialist hooked me up with the local sleep center, and we made an appointment for me to pick up the home sleep study kit.  This appointment took about 15 minutes.

I received quick instructions on how to put everything on.  Then the health care worker efficiently packed all the pieces into a small, soft briefcase-style bag and sent me on my way.  I was relieved that he included written instructions for everything in the bag.

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Is The Home Sleep Study Kit Difficult to Use?

At home that evening, I got wired up with a few pieces of medical monitoring equipment.  Here’s a quick summary of what the sleep test measures and how to set up each piece:

ORAL AND NASAL AIRFLOW.  Using the included paper tape, you will secure a thin wire to your cheeks, so a small sensor placed near the openings of your nasal passages stays put.  This sensor collects the airflow coming in and out of your nasal passages.

RESPIRATORY EFFORT.  Next, you’ll strap a couple of disposable elastic belts to your torso:  one on your waist and the other around your chest.  These two straps measure your respiratory movements.

OXIMETER FINGER PROBE.  Finally, you’ll clip a little device onto the end of your fingertip.  This little gadget evaluates the oxygen level in your blood while you’re sleeping.  Fancy technology does all of this with a simple red light.  Technology is cool!

Once you get yourself hooked up, it’s time to sleep.  That’s it.  Easy-peasy.  Some tests take more than one night of monitoring, in some cases up to three, but mine was just one night.  I also wrote down on an included worksheet what time I went to bed and what time I arose in the morning.

author with pink hair wired up with gear for the sleep test
Now, this is a sexy look! Especially with my mismatched jammies!
the home sleep study kit in its case
The home sleep study kit
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Printed instructions for the home sleep study
printed instructions on how to apply sleep test equipment page 1
Thankfully the instructions came with clear diagrams
Kids having birthday fun with horses at AJ's Farms - kid's party in Holland Michigan
All the pieces were super easy to use

What Happens After the Home Sleep Study?

The following day, I took everything off, discarded the disposable parts, packed up the rest, and dropped it back off at the same place where I had picked it up.  Just like that, I finished the test!

Once that process is complete, a sleep specialist will interpret your test results and send them back to your sleep doctor, who keeps a record of your sleep study.  Now you move on to the next step.

If your sleep study results in a diagnosis of sleep apnea, your specialist will discuss your best course of treatment with you.  At this point, you may receive your CPAP prescription.

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Is There Any Other Way to Treat Sleep Apnea?

If you’re wondering what other treatments are available, here’s a quick rundown.  I was pretty happy with my CPAP Prescription after hearing about a couple of these!

An Oral Appliance that fits in your mouth while you’re sleeping and either holds your tongue in place or brings your jaw into a forward position, opening your airway.

Upper Airway Stimulation. A small device (think pacemaker) is inserted surgically into your chest.  This device has an electrode that connects to the nerve that controls the muscles in your tongue.  While you sleep, a small electrical charge stimulates your tongue to stay in position and keep your airway open.

Corrective Surgery.  Some patients and their Medical Professionals opt for a uvulopalatopharyngoplasty surgical procedure. The surgeon removes some of the excess soft tissue from your throat and the back of your palate.  Sometimes she will also remove your tonsils and adenoids.  It sounds scary to me!

Will My Insurance Company Cover the Cost of CPAP Therapy?

Even though it’s not written out on a standard prescription pad, CPAP therapy is a medical prescription and therefore does qualify for insurance coverage in most cases.  You will need to do a little research and contact your insurance company or look through the coverage literature they provided to see what is covered.

In my case, they will cover 50% of the machine until I meet my deductible.  My device came to me as a rent-to-own.  I will pay a monthly fee for ten months, and after that, the machine will be mine forever.

If you are concerned about the expense of this endeavor, I strongly encourage you to contact your insurance company and find out what coverage you have so you are not caught off guard with unexpected expenses.

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I Have My CPAP Prescription.  What Comes Next?

Once you and your sleep doctor have decided that CPAP therapy is the way to go, she will send the prescription to a local Durable Medical Equipment (DME) supplier.  They will get the machine ordered and have you come in for a fitting and instructions with a Respiratory Therapist to get you started.

Enjoy this little montage of me getting my machine fitted with my new Respiratory Therapist friend, CPAP Sue.  Lots of information comes at you fast.  Don’t be afraid to record your appointment or bring a friend to help you remember the details!

After receiving your equipment, you will need to have a follow-up appointment with your sleep doctor to ensure that the therapy is working for you.  To cover the expense of the machine, my insurance company requires that this visit take place between 31 and 90 days after beginning to use the device.

I also need to use the machine for a specified percentage of my sleeping hours to show that it is beneficial to my health.  My friendly respiratory therapist, also known as CPAP Sue, explained this to me at my appointment.

Now that you are all fitted and ready to roll, here are some other general questions I had before this journey began.

How big is a CPAP Unit, and What About Travel?

Mine is surprisingly tiny.  Here I am holding it so you can see it.  Because your CPAP is Medical Equipment, you can carry it on with you at no extra charge if you are flying.

a CPAP machine ready to use
Isn’t she lovely?

Will my CPAP unit be noisy?

I was shocked to realize how utterly silent my new CPAP machine was.  The only noise it makes is in full running mode and the mask comes off my nose.  Then it makes a loud blowing noise for about 3 seconds until it automatically pauses itself.

Even better, this piece of modern medical equipment has an included cell signal and sends my information directly to my medical chart and a specialized app on my phone for my daily review.

Will the Mask Cover My Whole Face?

It’s hard not to envision Darth Vader when thinking of your new face mask.  But you’ll be relieved to know that several options are available for face masks.  The three main styles are:

  • Full face mask.  This mask will cover your nose and your mouth, Darth Vader style!
  • Nasal mask.  This mask fits over your nose only, which is a little less intrusive than the full face mask.
  • Nasal pillow mask.  This mask, made of very soft material (hence the name pillow), presses against your nasal passages.  This mask is the most lightweight and allows for full visual range.  Perfect for those who have some reading or TV watching to do before drifting off.

The face mask connects to the large air hose that connects to the machine.  Is it just me, or are you humming along to “the hip bone connected to the leg bone, the leg bone connected to the knee bone?”  I bet you are now.  You’re welcome!

The thing to remember here is that the mask parts are interchangeable.  You can change your mask style as necessary to ensure you have the right fit.  I will be using the nasal pillow.  Don’t I look snappy!?

Modeling the mask I chose… Nasal pillow style! What an attractive look!

Won’t My Throat Get Dry?

It does make sense that your throat will get dry, considering this new machine will be blasting a stream of air through your nose and down your windpipe.  However, modern CPAP machines have taken this into account. Many include a CPAP humidifier, a fancy term for water chambers, that keeps the air you’re receiving moist and temperature-controlled.

How Can I Sleep with Air Blasting At Me?

Your medical team, specifically the respiratory therapist that gets you set up with your new machine, will help you determine what pressure setting to start with for your needs.  The goal is to get better sleep, and the pressure can make all the difference between blasting your face off and enough pressure to keep that windpipe open without feeling it.

When I was first fitted, I felt like I could feel the air blowing at me and wasn’t sure I would like it.  However, after just a minute or two in the clinician’s office, I could barely feel the pressure.

After just a few days of using it at home in the same setting, I can’t even feel the airflow.  It takes a slight adjustment in your pressure setting and a little time to adjust to the feeling, but overall, it doesn’t feel like a cold wind blasting in my face. I was originally concerned about that cold wind!

Will My Loved One Find Me Disgusting While Using the CPAP?

You may have a tiny case of vanity to deal with if you’re like me.  I talked to my therapist about this concern before I began the process.  I was concerned that my husband would look at me differently when I had this big ole machine connected to my face.

My therapist said it best when she related the story of her husband and his new CPAP.  She reasonably stated, “there’s nothing quite as sexy as a good night’s sleep,” and that made sense.  And if you have further doubts, consider this:  Just how sexy is it to be snorting and choking and gasping for air in between snores loud enough to shake the bed?

Put your vanity aside.  This whole experience is about your health, and a living spouse is better than the alternative!

Where Do I Purchase My CPAP Equipment in the Future?

As part of getting set up with your equipment, your Respiratory Therapist will instruct you how often you will need new CPAP supplies.  You will also learn how to regularly clean some items, such as the tubing and mask.

If your insurance covers your CPAP therapy, you should be able to purchase your supplies at the exact location where you received your machine.  Your insurance provider will decide what equipment they’ll cover and what you can get.

In my case, Sue instructed me to make a quick phone call to the DME retailer with my provided order number when I need supplies, and they’ll be able to supply me with what I need quickly.

If that location is inconvenient for you, you can find supplies at several online vendors, but you’ll have to check with your insurance company to see if they will cover supplies purchased that way.  If not, you can pay out of pocket for them if that works better.

Will I Need to Use My CPAP Forever?

Some people do have a lifetime need for their CPAP.  Some people can no longer need the CPAP if they can make substantive life changes, such as weight loss.  This question is very individual, and the answer requires discussion between you and your sleep doctor.

Because your physician will monitor your CPAP use, you won’t have to worry about an expiration date or the number of refills on your prescription.  You will be discussing your therapy with your doctor annually, at least.

Wrapping It Up

As you can see, sleep apnea is undoubtedly not an ideal condition, but it is manageable.  My new CPAP machine is taking some adjustment, but after only a few days, I am already beginning to feel more well-rested and ready to start my day when I awake in the morning.

Getting a prescription for sleep therapy is not a complex process but does take some maneuvering and patience.  If you are like me, you will find that the adventure of getting your CPAP will lead to better sleep and better overall health.  Empower yourself to take control of your health!

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