More on Sleep Apnea

[Buck52]

Opportunities Missed to Contain Spending on Sleep Apnea Devices and Improve Veterans’ Outcomes

Veterans Affairs Office of Inspector General (OIG) sent this bulletin at 01/14/2020 12:34 PM EST

Opportunities Missed to Contain Spending on Sleep Apnea Devices and Improve Veterans’ Outcomes

01/13/2020 07:00 PM EST

 

The VA Office of Inspector General (OIG) conducted this audit to determine if the Veterans Health Administration (VHA) is efficiently managing positive airway pressure devices (sleep apnea devices) and supplies for veterans diagnosed with sleep apnea. The number of veterans diagnosed with sleep apnea who receive devices and supplies increased dramatically between fiscal years 2014 and 2018.

This has significantly increased the financial risk to VA. If VHA does not change its practices and leverage opportunities to save money, the OIG estimates it risks spending about $261.3 million over the next five years on devices and supplies veterans will not use. VHA did not efficiently manage sleep apnea devices and associated supplies. The OIG found that almost half of the 250,000 veterans issued a device from October 2016 through May 2018 used it less than half the time. This can reduce therapy effectiveness.

The mismanagement occurred in part because VHA did not identify and follow up with veterans who were not using their devices as recommended. The OIG also found that VHA did not have a sleep medicine staffing model to help ensure it conducted patient follow up. A model will determine staffing to help ensure follow up is conducted. VHA could save up to $39.9 million per year by loaning devices to veterans rather than issuing them for permanent use. A loan program would allow unused devices to be returned and reused. VHA could save up to an additional $12.4 million per year by not purchasing device supplies for veterans who do not use their devices. The OIG made three recommendations to the under secretary for health regarding sleep apnea device management. The recommendations include studying staffing levels, looking at using existing technologies to better monitor device use, and looking at alternatives to purchasing devices.

[Vync]

@paulstrgn Have you tried other types of face/nasal masks? I remember my full face mask would leak and make fart noises that woke up my wife.

I use a saline nasal rinse before bed. I figured out how to keep my mouth closed without using the chin strap. You know how you use your tongue when you are eating candy? Do the same thing. Just create a mild suction to keep your tongue to the roof of your mouth. That coupled with a night guard really helped me.

[vetquest]

@paulstrgn, see if you can get a new mask.  I had leaking problems before and got issued a new mask and headset that eliminated leaks where previously the CPAP was not working due to leaking.

[paulstrgn]

21 hours ago, Vync said:

Just create a mild suction to keep your tongue to the roof of your mouth. That coupled with a night guard really helped me.

I will try that, I really hate the chin strap.

21 hours ago, vetquest said:

see if you can get a new mask.

I will try the tongue trick first, if that does not work I will go back and ask for a new type of mask. With the mouth being open I wake up with dry mouth, not to mention the noise will wake me up at night.

I am sure everyone that uses these CPAPs wish they did not need them, it really sucks using them every night.

Thanks for the advice.