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Normalizing CPAP - How the Use of PAP Therapy Devices Has Changed the American Culture

 

By Admin

 

Nightly PAP therapy has become a way of life for millions of Americans, and while a lot of the discussion surrounding the treatment has been focused on compliance rates and how patients can better adjust to regular use, not enough attention has been given to how society at large has changed to accommodate the devices. While adherence remains an issue for some patients, the use of CPAP therapy devices has exploded throughout the states and abroad, with the market size growing consistently, year after year, since the technology was first introduced in the 1980s. And with this increase in use there has been a corresponding increase in research, both on the effects of sleep apnea itself, and on CPAP as a primary treatment. One of the surprising discoveries of these studies was the pervasiveness of the disorder and its role in a number of long-term diseases and adverse health effects. As more people adopt the therapy and spread the word of its significance, a culture of acceptance has eclipsed early criticisms and continues to support and welcome the use of CPAP devices in all walks of life.

Getting Used to It

From the privacy of bedrooms to public transportation systems, the general public has become familiar with CPAP devices as a routine part of life for many, much like any other medical device or accessory needed Colin Sullivan, PhD, inventor of the original CPAP machine, compares the devices to eyeglasses, something necessary that you cannot live without. And just like eyeglasses, people are getting used to the sight of CPAP machines in bedrooms, carrying cases, and worn in the seats of trains, planes, and other forms of transportation. There are CPAP advertisements on television and on new media. We see the devices depicted on television shows such as HBO’s “The Sopranos” or even “The Simpsons,” both extremely popular programs. And images of CPAP machines and their use are now commonplace on YouTube and social media. And there are support groups not only for sleep apnea sufferers, but for their spouses as well. We have entered the age of XPAP, it seems, and as a society we are doing our part to support adherence. While a vast majority of sleep apnea sufferers still go undiagnosed and untreated, the progress is being made at every level of society, from healthcare to relationships to mass media and travel

Help from Celebrity Spokespersons

In recent years a number of celebrities have disclosed their own CPAP use and have become role models for those still insecure about having to use the devices. Shaquille O’Neal, one of the most famous basketball players of all time, released a video in 2009 titled “Shaq Attacks Sleep Apnea,” documenting his Harvard sleep study and CPAP model selection. O’Neal has since reported that CPAP has improved his sleep habits and helps him manage his weight. Another celebrity, the award winning actress and comedian Rosie O’Donnell, discussed her own testing and treatments on the television show “The View,” claiming that after a single night of CPAP therapy, she felt “a life-changing difference.” At the same time talk show host Regis Philbin documented his experiences with CPAP after years of complaining about sleep problems on his morning show “Live with Regis and Kelly.” Other celebrities with sleep apnea include William Shatner of “Star Trek” fame, “Saturday Night Live” comedian Amy Poehler, and sitcom star Roseanne Barr. Unfortunately, not everyone with sleep apnea receive the medical attention they need, and celebrities are no different in this regard. Actress Carrie Fisher of Star Wars fame died of complications from a number of health problems in 2016, but sleep apnea was among them, as her final hours involved choking incidents that were likely the result of apnea events. While deaths like these are tragic and affect not only the family and friends of the departed, but millions of fans worldwide, they also bring attention to the problem of undiagnosed illnesses. In order to treat health problems effectively, they must first be diagnosed and accurately assessed. Knowledge is always the first and most crucial step in the treatment of a disorder, and in some cases can change the lives of patients completely.  

 

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Airlines and Travel

Since the 1990s, CPAP machines have been protected by the Americans with Disabilities Act as carry-on luggage that does not count toward a person’s carry-on quota. They are classified by the U.S. Department of Transportation as assistive devices, used for health maintenance purposes. And railroad companies have adopted the same guidelines, allowing CPAP machines and related equipment as “required medical devices” that are not added to a carry-on baggage count. They do ask that you use a carrying case and take your device through security, rather than check it in with your luggage. On some CPAP forums, there is discussion of running into airline officials who are unaware of these guidelines, but this is a rare experience within a rising number of cpap carriers, both in the U.S. and abroad, where other nations are quickly following suit. A study published in the Journal of Travel Medicine reported that out of the entire CPAP patient population at one hospital that received questionnaires, 81% of those who had travelled were able to take their CPAP machines on their trips without issue, regardless of the mode of travel. While this shows that the process could be better standardized to make that number higher, it also show how much progress has been made.

Insurance Coverage

Another benefit of all the research on PAP therapy treatments is the increase in support for insurance coverage of the devices. By now, most insurance policies on the market cover CPAP machines and equipment under Durable Medical Equipment (DME) provisions, as well as the sleep study or related tests needed for diagnosis. While some insurers, like Medicare, may ask that you show compliance and progress rates for milder cases, it is not difficult to show that your CPAP is helping you. In most cases, a doctor’s follow-up prescription will be all that is necessary. Another way the insurance companies deal with this is by leasing the device to the patient. Either way, a simple demonstration of the device’s benefits will suffice in order to convert to full ownership following the lease period. As time goes on and the benefits of CPAP, APAP, and BiPAP continue to prove the value of these devices for multiple health needs, the easier it will become to receive full coverage for all your PAP-therapy needs.

Public Awareness

Some estimates put the global sleep apnea rate at over a billion people. That’s nearly a seventh of the current population. Some find these estimates unbelievable, but the more we know about sleep apnea, the more we learn just how undiagnosed the disorder is, despite the increases in public awareness. There is no question that the word is spreading, but there is still a long road ahead for diagnosis and treatment. In America, over a million CPAP users are currently addressing their sleep apnea and related health problems, and the numbers are going up in most countries throughout the world. And though there are effective home tests on the market, there are over 4,000 sleep labs in the United States alone. With this growing need for sleep medicine and research, many universities and academic health centers are expanding their curriculums in favor of sleep specialization and related practices. The overall effect of all this progress in the treatment of sleep apnea and related health concerns is a change in our cultural response to patient needs. At this point it is clear that this is no trend. The use of PAP therapy devices has become a normal part of life and an important transition toward healthier living for a growing segment of the population. As a first line of defense against a life threatening disorder, every accommodation should be encouraged. Most likely, we will be seeing even more PAP therapy devices in the years ahead.  

 

Sources

AASM - https://aasm.org/shaquille-oneal-brings-attention-to-sleep-apnea-and-cpap-in-harvard-video/

ASA - https://www.sleepassociation.org/sleep-treatments/cpap-machines-masks/starting-on-cpap/

Chest - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3087456/

Medicare.gov - https://www.medicare.gov/coverage/continuous-positive-airway-pressure-devices

FundAiring.com - http://www.fundairing.com/journal/2017/6/15/19-celebrities-with-sleep-apnea

Grand View Research - https://www.grandviewresearch.com/industry-analysis/sleep-apnea-devices-market

Healio - https://www.healio.com/family-medicine/pulmonology/news/online/%7Bbd38b6d8-bf75-40eb-8c7a-5ff5e3f6b612%7D/what-you-should-know-about-sleep-apnea

Journal of Thoracic Disease - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561280/

Journal of Travel Medicine - https://www.ncbi.nlm.nih.gov/pubmed/29232460

Mareketresearch.com - https://blogb.marketresearch.com/top-6-things-to-know-about-the-28-billion-sleep-market

Sleepapnea.org - https://www.sleepapnea.org/carrie-fisher-yes-you-can-die-from-sleep-apnea/

Sleep Review - http://www.sleepreviewmag.com/2018/05/nearly-1-billion-people-worldwide-sleep-apnea-international-sleep-experts-estimate/ Transportation.gov - https://www.transportation.gov/individuals/aviation-consumer-protection/wheelchairs-and-other-assistive-devices

USA Today - https://traveltips.usatoday.com/tsa-rules-cpap-machines-110222.html