Do You Need a Prescription for a CPAP Machine?

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Why You Need a Prescription to Get a CPAP Machine

Although CPAP machines pose little risk of abuse, a prescription requirement ensures that your CPAP therapy will be safe and customized to your needs. In 2018, the FDA reclassified CPAP machines from Class III to Class II medical devices Trusted Source American Academy of Sleep Medicine (AASM) AASM sets standards and promotes excellence in sleep medicine health care, education, and research. View Source .

With this change, officials at the FDA hoped to break down regulatory hurdles, encourage product innovation, and improve access for patients. But even with the new designation, you’ll still need a prescription from your doctor before you can buy a CPAP machine and begin CPAP therapy.

If you’re experiencing any of the signs of sleep apnea, make an appointment with your doctor to discuss your symptoms. It may seem like a hassle, but requiring a prescription to buy a CPAP machine is actually in the best interest of patients. Your doctor can determine your diagnosis and write you a prescription for CPAP therapy. Once you have a CPAP prescription, you can begin shopping for the best CPAP machine.

When you consult with your doctor before starting CPAP treatment, you’ll have a better understanding of:

• Your sleep apnea diagnosis (there are different types)
• The best type of unit for your needs (CPAP, BiPAP, or APAP)
• The best CPAP mask and delivery system for your needs
• The right pressure setting for your symptoms
• When to replace key accessories

This oversight by a medical professional should improve the efficacy of your treatment Trusted Source Science Direct The leading platform of peer-reviewed literature that helps you move your research forward. View Source . Without the guidance of your doctor, CPAP therapy may fail to improve your symptoms. Additionally, a prescription allows you to receive reimbursement through your health insurance plan for your CPAP unit and other necessary CPAP accessories.

Be wary of any retailers willing to sell you a CPAP without a prescription. The CPAP units they’re selling may not be FDA-approved.

How to Get a CPAP Prescription

Obtaining a CPAP prescription is a straightforward process, but there are a few steps to follow.  

Evaluate Your Sleep Apnea Symptoms

Getting a CPAP prescription starts with recognizing the symptoms of sleep apnea. Obstructive sleep apnea (OSA) is the most common type of sleep apnea. Symptoms Trusted Source Medline Plus MedlinePlus is an online health information resource for patients and their families and friends. View Source include:

• Frequent and severe snoring
• Disrupted breathing
• Awakening with gasping or choking
• Frequent awakenings
• Nighttime restlessness
• Sleepiness during the day
• Morning headaches
• Changes in mood

A less common form of sleep apnea is central sleep apnea (CSA). Because the airway isn’t physically blocked, the symptoms of CSA can be harder to recognize compared to OSA Trusted Source Merck Manual First published in 1899 as a small reference book for physicians and pharmacists, the Manual grew in size and scope to become one of the most widely used comprehensive medical resources for professionals and consumers. View Source .

Schedule a Doctor’s Appointment

If you notice symptoms of sleep apnea, schedule an appointment with a doctor. Your primary care physician can be a good starting point. They can evaluate your symptoms and refer you to a sleep specialist, if necessary.

Healthcare providers who can prescribe CPAP equipment include:

• Primary care physicians (MD or DO)
• Sleep medicine specialists
• Pulmonologists
• Physician assistants (PA)
• Nurse practitioners

These options vary by state, and certain insurance plans have stricter requirements for reimbursement. Many online platforms offer virtual consultations with licensed physicians to help streamline the process. 

Take a Sleep Study

Before writing a prescription, a doctor will likely refer you to a sleep specialist who can administer a detailed sleep study Trusted Source National Heart, Lung, and Blood Institute (NHLBI) The NHLBI is the nation's leader in the prevention and treatment of heart, lung, blood and sleep disorders. View Source . This study gives a more complete picture of your symptoms than self-reporting and helps determine the best treatment. 

A sleep study is an overnight clinical test also known as a polysomnography. Sleep specialists often perform polysomnography at a sleep clinic, but some doctors may prescribe a simplified home sleep study (HST) that you can take on your own.

During polysomnography, specialists typically measure physical indicators such as heart rate, breathing, oxygen levels, respiratory effort, eye movement activity, muscle activity, and electrical activity of the heart and brain. The specialists record data while you sleep.

Get a CPAP Prescription

Once you’ve completed the sleep study, your sleep specialist will analyze the results, determine your diagnosis, and decide the best course of treatment. If you’re diagnosed with sleep apnea, you may be eligible to receive a CPAP prescription.

On a CPAP prescription Trusted Source Centers for Medicare and Medicaid View Source Trusted Source Centers for Medicare and Medicaid View Source , you’ll find the general information required on all prescriptions – patient’s name, description of the device (CPAP, BiPAP, or APAP), the prescribing physician’s signature, the physician’s National Provider Identifier (NPI), and the date. 

Your sleep study results may include additional information for your prescription, such as:

• The length of time therapy is expected to be necessary
• Diagnosis of sleep apnea, as well as the ICD (International Classification of Diseases) code 
• Apnea-hypopnea index (AHI), which records the number of sleep apnea events a sleeper experiences during the night
• Recommended pressure settings
• Device specifications and requirements, including special accessories such as a heated humidifier
• Recommended mask type

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Where to Buy CPAP Machines and Supplies

Once you’ve received your prescription for CPAP therapy, you can begin to shop for a CPAP machine and other CPAP equipment. You can find CPAP machines for sale through a number of suppliers including:

• Your insurance provider
• A local sleep clinic
• Online vendors
• Brick-and-mortar medical equipment retailers

If you choose to get a CPAP unit through your insurance, it’s important to note that some providers only allow you to rent your CPAP unit. Most insurance plans cover most – but not all – of the cost, so you may also need to pay out of pocket for your machine and equipment. And while brick-and-mortar stores allow you to look at items in person before you buy, they often have a limited selection. Online sellers tend to offer a wider selection and competitive prices. 

Whether you shop in person or online, you’ll need a prescription for your CPAP machine. Most online vendors specializing in CPAP equipment simplify the process. You can typically email, upload, or fax a copy of your prescription. Keep in mind that you’ll also need a CPAP prescription to purchase some CPAP accessories like masks and humidifiers.

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