There are people who think that CPAP is just another way for ‘them’ to get your money. Is it? Join me as I examine this quite reasonable viewpoint.
“This is a Racket!”
The patient sitting before me was a rather tough looking gentleman who voiced his opinions quite bluntly. I kept trying to discuss the sleep study, but he just wanted to talk about guns and knives, and how he ‘takes care’ of situations.
He even took out one of his knives and showed it to me.
“Oh, it’s still got blood on it,” he said, wiping the blade on his pants leg. Putting the knife down, he scrutinized me suspiciously, and said: “I think this is a racket!” And he was serious. This guy doesn’t say anything unless he is serious.
Then he went on to ask me some pointed questions. One of which was “How many people that you test end up on CPAP?’ It was a good question, and I answered him as accurately as I could. “About 50-75% + are started on CPAP”, I replied.
With that, he said, “Yeah, see. Now if you’d told me only a few people are put on CPAP, I’d be o.k. with that. But with that many, it sounds like a racket to me.”
I sure was glad he was no longer holding that bloody knife.
We continued this conversation as I proceeded to hook him up. As it turned out, He thought CPAP was a racket for several reasons. One of them was that he really didn’t understand the consequences of untreated sleep apnea.
However, he did listen as I talked. Maybe that was because I was up front with him. Or that I really tried to speak at his level. Actually, he didn’t have much choice; I kinda had him strapped in the chair. (LOL!!)
Standards of Care
We needed to find a way to treat people more effectively. Therefore, some kind of standard had to be developed. Something we could use as a reference to determine the severity of sleep apnea. Thus, the creation of the Apnea Hypopnea Index (or AHI).
This index categorizes the severity of sleep apnea and is based on the number of times you stop breathing in an hour. For instance, if you stop breathing 5 times in an hour, your AHI would be 5.
AHI categories are:
- Not significant: AHI less than 5.
- Mild sleep apnea: AHI 5-15.
- Moderate sleep apnea: AHI 15-30.
- Severe sleep apnea: AHI greater than 30.
Using this standard as a reference, it’s estimated that as many as 20% of Americans have some degree of sleep apnea; although that figure could actually be low. Also, many factors can impact the severity of OSA to a greater or lesser degree. These include age, disease, and sex.
Uncovering the Great CPAP Scam!!
But are these standards manipulated in a way that’s more focused on sales, as opposed to appropriate treatment? In other words, are these standards set intentionally low so that people who really don’t need treatment are started on CPAP anyway? Much research has gone into establishing accurate guidelines.
One such study is reported in an article in the American Academy of Sleep Medicine. It details an 18-year follow-up of 1,522 people. These people had anywhere from ‘no’ sleep apnea (AHI less than 5), up to severe sleep apnea (AHI greater than 30). The study shows that people with sleep apnea are 3 times more likely to die than those who don’t.
Also, we use at least 2 different standards to determine whether someone actually qualifies for CPAP. As a result, those who are more at risk of sudden death, such as people who already have heart disease, for example, can qualify for treatment with a lower AHI than those who have no known heart disease.
So no, we can’t just decide, ‘hey, let’s put this guy on CPAP because we’re a little short on money’. (And actually putting someone on CPAP when they don’t need it can be harmful in itself). That whole thing could be a lawsuit in the making.
Although it does seem like money, more than compassion is the driving force behind much of health care. Maybe it is. But the unfortunate by-product of that is many of us well-meaning healthcare folks get a bad rap.
To die or not to die, That is the Question
I’ve said this before, but it’s worth repeating. So many people don’t realize how threatening poor quality sleep is to your health. There’s also a direct link between sleep apnea, Heart disease and Diabetes.
What Would you do?
So, if you had a friend with sleep apnea, and you knew about the diseases it caused, would you talk to them about it? Yeah, I know, we can’t force anyone to do anything. It’s ultimately up to the person. But the more you care about someone, the more strongly you’ll try to help, right?
And while I really don’t know my patients very well. I do have a concern for mankind in general. And that is what drives me to help. And there’s a bunch of us out there.
I guess there will always be those who think we’re just out to scam people. It’s funny, though. The only people I’ve heard accuse us of that are the ones who aren’t using CPAP, and/or don’t really know anyone who is. And really, I don’t hear the scam word all that often.
But I think about the lives I’ve really helped. And the people who have actually experienced CPAP, and what they say about it.
Sure, there are people who want to ‘help’ you just because they’ll make money doing so. And yeah, I also make money helping you. But, honestly, even if I had all the money I needed so that I didn’t have to work, I’d still enjoy doing what I do.(But then again, maybe I’m a bit crazy!)
However, there are a lot of scams and insurance fraud out there. And I think it’s harder than ever to trust people. But Sleep Apnea really is a serious life-threatening disorder, and CPAP is still the gold standard of care.
I’d like to hear your thoughts. Have you ever experienced any medical or insurance fraud? Please leave out any names, but otherwise, be as specific as you can. Let’s talk.
Till next time…Blessings.