Why CPAPs Need to Be Available
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Splitting off a discussion...
@MattSpeller said:
For once I 100% disagree with you! CPAP should absolutely be a controlled device. If I needed to use one I'd want to know that it was designed by a competent engineer who has his license and reputation on the line. No different than a pacemaker in my book and my degree showed me how they hold the engineers responsible. If you design and manufacture a medical device you can be held legally liable for a very very long time for the device's safe operation.
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IMHO it's the same reason an aircraft bolt costs $20 where the hardware store costs $0.20.
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This is hard to do as a split because the context is all missing now. But here we go...
Okay, but that is controlling the creation of the device, not the ability to buy one.
Let's say you NEED a CPAP or you might suffocate. You can't sleep without one. Now you have a situation where yours breaks, is lost, doesn't work or whatever. Now you are in a place where no doctor's office is open. You can't sleep until you can get a CPAP.
You could order one and have it overnighted, losing only one night of sleep. This might be doable for a lot of people. But humans can only skip so much sleep before they WILL fall asleep. Let's also assume you live or are in a place where CPAPs can't be bought on the corner.
Now what do you do? Because CPAPs are controlled you need access to both a doctor AND one that is willing to write a prescription for a CPAP which most will not (you are supposed to have a lengthy sleep study and all this expensive stuff to make money before you can have one, even if it is a necessity) AND you need access to a CPAP dealer. And you need it all in less than 48 hours to be remotely safe and you really need it in less than 12 hours to be actually safe.
Now to have any real chance of making this work and getting one, maybe you can get one if you drive around a lot (without any sleep) to try to put the pieces together. How many innocent people who need CPAP lives are okay to put at risk to make doctors get to write the scripts? How many innocent people on the road are you willing to put at risk with drowsy drivers trying to find a way to safely sleep?
Maybe an emergency room can help you, maybe. They probably have the gear. But we've escalated something really minor to something huge. And going to an ER that can't see you quickly might be exactly the thing that makes you fall asleep and suffocate.
Do the benefits of treating a CPAP like a drug outweigh the benefits of making it something that you can legally buy? Doctors do not pick out the CPAPs for you, so anything around the control of engineering is unrelated and there is no control via that method in the US currently.
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@scottalanmiller Alright so where we really disagree is acquisition and control of them.
You have some good points clearly from experience!
It really sounds like they should be treated more like a drug though. You have a perscription (of sorts), just need to buy one is the hurdle? I'm not sure how you can keep everyone safe without making a specific exception for this device without opening a hole for others to fall into.
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@MattSpeller said:
IMHO it's the same reason an aircraft bolt costs $20 where the hardware store costs $0.20.
But that's not related. A bolt isn't life or death if you don't get it promptly. You can just ground an airplane. Grounding a human from breathing is the opposite. Killing people to make a point - that certification is worth more than lives.
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Just do what I did - buy a used one off craigslist while you wait for all the bureaucratic bullshit.
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@MattSpeller Edit: as to having to get a referral, I also disagree with you. I think they're quite necessary (though damned annoying). Not everyone cares enough to educate themselves on these devices and many would make very poor choices. That's not even getting into Münchhausen cases etc.
You clearly are unaware of how this works in the US. There is NO oversight from the doctors here. None. You go to a doctor, get them to write you a prescription. Then you go to a store and are completely on your own. You have to know all the terms and pick out the device yourself, the same as if no doctor is involved. The only thing that the doctor does is make it legal for you to buy one.
So all of your logic doesn't hold up in the US. None of that applies at all. It is purely a barrier to getting what you need. There are no protections.
Even if there were protections, the risk is so high and the protection so pointless. You put the innocent at risk in order to protect idiots from harming themselves. That's just wrong.
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@scottalanmiller That's nothing like what I'm used to here!
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@Nic said:
Just do what I did - buy a used one off craigslist while you wait for all the bureaucratic bullshit.
That's a good idea. Although I've put together some ways to acquire one now. There are some tricks for people who really know what to do.
Or just get one in Europe where healthcare is sensible.
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@MattSpeller said:
@scottalanmiller That's nothing like what I'm used to here!
The idea of controlling the creation of the devices I totally agree with. A CPAP should be a regulated device made to certain specs. But they should be available to people who need them.
They treat them like a drug. But drugs (nearly any) can be bought anywhere. Pharmacies are everywhere. But only really large cities sell CPAPs. And only a few dealers. You can't run to the corner and pick one up.
And pharmacies are open 24x7 a lot of places. Long hours at least. CPAP dealers are often 8x5!!
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In general, getting a CPAP right this minute isn't a life and death situation, which is why it can take so long. But I agree that the process could be faster and easier. At least a loaner right after your sleep study until you get a permanent one.
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@Nic said:
In general, getting a CPAP right this minute isn't a life and death situation, which is why it can take so long. But I agree that the process could be faster and easier. At least a loaner right after your sleep study until you get a permanent one.
Problem is, for many people it really is life or death. Regulating something that might be life or death like it is a casual device isn't dangerously reckless and a complete disregard for human life no matter how infrequent it is.
Getting your first one is rarely life or death. But getting one later easily could be.
It's the people, typically, who develop central sleep apnea, not mechanical sleep apnea, who must have them no matter what. Thankfully at least I qualify for emergency power so that if the power goes out I get mine back earlier since I can't sleep until it comes back on.
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Why does @MattSpeller and @scottalanmiller feel that a CPAP needs to be prescribed?
I'm all for the device itself having to be created under regulation for safety - but here's my question - if a person who quote unquote doesn't need one uses one, will they die?
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@Dashrender said:
Why does @MattSpeller and @scottalanmiller feel that a CPAP needs to be prescribed?
I don't feel that. I feel that it's completely unethical to have a doctor get to hold your life hostage when life saving devices are available and well known.
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@Dashrender IMHO it's less about a specific device than it is about all of them. I am so unfamiliar with how it works down there that I'm only muddying the waters, I'll stay out of it.
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@Dashrender said:
I'm all for the device itself having to be created under regulation for safety - but here's my question - if a person who quote unquote doesn't need one uses one, will they die?
No, they are completely safe to use when not needed. It is only when you need one and don't get one that there is risk. Prolonged use could create a dependency, potentially, I suppose. But there is no real risk.
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Usually it isn't immediate life or death. Yes over the long term it will shorten your life and make you die of a heart attack, but usually you've been living with it for a while before you even get diagnosed.
There are some possible negative side effects, such as having the pressure too high and causing central apnea.
The thing you have to remember is that you and I, Scott, are 3+ standard deviations above the mean intelligence, so we're perfectly capable of purchasing and setting up our own system. The other 99.9% of people aren't that smart
