Open Access
Feature Article

Obstructive sleep apnoea – navigating the system

Open Access
Feature Article

Obstructive sleep apnoea – navigating the system

CLAIRE M. ELLENDER, CERYS JONES, CRAIG HUKINS

Figures

© chameleonsey/ istockphoto.com Models used for illustrative purposes only
© chameleonsey/ istockphoto.com Models used for illustrative purposes only
Dr Ellender is a Respiratory and Sleep Physician at the Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane; and Senior Lecturer at the Faculty of Medicine, Princess Alexandra Southside Clinical Unit, University of Queensland, Brisbane. Dr Jones is a General Practitioner at Eastbound Medical Clinic, Bentleigh East, Melbourne, Vic. Dr Hukins is a Respiratory and Sleep Physician at the Princess Alexandra Hospital, Metro South Hospital and Health Service, Brisbane; and Associate Professor at the Faculty of Medicine, Princess Alexandra Southside Clinical Unit, University of Queensland, Brisbane, Qld.

After renting an APAP device, patients can either self-fund a CPAP machine, with settings titrated from the APAP findings, or can be referred to a local public sleep disorders unit to obtain a government-funded machine. 

CPAP machines range in cost from around $750 to $2000, depending on the store and the type of device purchased. As a rough guide, however, most patients self-funding the machine should set aside $1500 in total for rental, mask and machine purchase. A machine will last eight to 15 years if cleaned regularly. Masks generally need replacing every three years if they are cleaned each morning. Funding is available in some states and territories for patients unable to self-fund CPAP equipment (Box 4).21 

Rebates

Private health insurance ‘extras’ will often reimburse around $500 of the initial cost of the equipment, depending on the policy; a supporting letter from a clinician may be required. 

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For those with financial hardship and no concession card, an application can be made to release superannuation for purchasing medical equipment. Forms can be found on the Australian Tax Office website (www.ato.gov.au; search for ‘Compassionate release of superannuation’).

Most electricity providers will provide a rebate and priority for restoring power in the event of supply issues. Concession or pension cardholders are eligible for an additional annual subsidy to Centrelink payments if an Essential Medical Equipment Payment Services Australia form is completed.

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Government CPAP programs

Despite the strong data in support of CPAP, devices are not accessible through Medicare or Federal funding. There are several state-based programs for accessing government-funded CPAP machines for people with pension or concession cards. These programs generally require a referral to a designated centre and a rental period on CPAP to confirm adherence to treatment. Patients have to purchase their own masks.

Conclusion

OSA is a chronic disease with increasing prevalence in the community and can be effectively treated at relatively low cost. Its management is becoming the domain of primary care because of its increased prevalence. Navigating the system to initiate effective treatment for patients starts with a thorough history, recognition of indications for specialist referral, and knowledge of local services. High quality local sleep studies can expedite investigation and can be arranged by GPs where there are no red flags for specialist care. The conducting of a CPAP review appointment will be covered in our article on CPAP therapy in a future issue of Medicine Today.     MT

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COMPETING INTERESTS: None.