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The CPAP Challenge

Woman Smiling CPAP (continuous positive airway pressure) can be a very difficult therapy to adjust to. But, with the right attitude and the help of a good support group, it can be made into an easier transition.

It's important for the patient to understand why the CPAP is needed and what health benefits are gained from correcting obstructive sleep apnea (OSA). At Pro2, a Respiratory Therapist reviews the sleep study with each patient to reiterate the findings made during the testing and to show the corrective outcome with continued use of the therapy.

Next comes the application of the mask and the subsequent pressure to follow. Talking with the patient and explaining the feelings he will have of resistance on exhalation is very important. Letting him know that the mask has an exhalation port and feeling the air escape from that mask helps him to realize he is able to exhale completely. Most patients are then able to relax within the first minute of therapy.

Each CPAP is also equipped with a ramp feature which allows the patient to press a button and initially reduce the pressure. The ramp pressure will slowly increase to the prescribed pressure all while giving the patient time to fall asleep and not even notice the gradual change. If at any time during the night the patient wakes up, we encourage the use of this comfort feature.

The use of the heated humidifier is then reviewed. A dry, bloody nose or sinus pain may signal inadequate humidity is being provided. Nasal congestion or a runny nose can be the body's attempt to compensate for dryness by flushing fluid to the area. Waking during the night after a few hours and removing the mask can also be due to congestion starting to develop. A gradual increase in humidity can eliminate these symptoms. CPAP units have various humidity ranges and the patient is encouraged to adjust his setting to find his own comfort level. During colder months, a high setting will usually create condensation in the tubing and we advise patients to place the CPAP unit on the floor so that any water can drain back into the chamber.

One of the biggest challenges with CPAP is obtaining a good mask seal for a patient who has a high pressure. We stock many masks and the patient is given the opportunity to try as many as he likes in order to find the best mask for him. With every mask, he has 30 days to exchange it for a different option.

Some people are unable to tolerate CPAP and after a strong attempt by the patient, our Respiratory Therapists may suggest AutoBIPAP, which automatically adjusts the inspiratory and expiratory pressures to the patient’s needs. When the patient is awake and not obstructing, the pressure will be minimal, but while sleeping and obstructing, it will deliver a higher pressures required to open the airway. AutoBIPAP will only be covered by insurance companies if the client fails at the use of CPAP.

Most important in the CPAP process is encouraging our patients to call us with any issues. Our follow-up care plan consists of frequent calls by our Respiratory Therapists to monitor patient progress and we encourage patients to call us if any problems arise.
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Major Changes for Medicare Patients Coming in 2013

You may have heard that Congress has changed the way Medicare determines who can and can’t furnish certain durable medical equipment and supplies. This new program is known as Competitive Bidding. It's already in place in nine metropolitan areas across the United States and will be implemented in the Buffalo-Niagara metropolitan area in July 2013.

Traditionally, Medicare has contracted with multiple home medical equipment (HME) providers throughout the country. However, the Competitive Bidding program will decrease the number of providers available to supply equipment and services. After July 1, 2013, only suppliers that are awarded a contract can provide equipment and supplies to people with Medicare in the Buffalo-Niagara area.

Pro2 has submitted a bid to become a Medicare contract supplier in the Buffalo-Niagara metropolitan area. Contracts for the Buffalo-Niagara area will not be awarded until the spring of 2013.

Competitive Bidding will affect you as a Medicare recipient in several ways:
-You may be required to change providers if your current provider is not awarded a contract.
-You may be required to use multiple suppliers to obtain the different products or equipment you need.

For more information on how you may be affected by this program, please visit peopleforqualitycare.org.
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