I have previously written about sleep medicine being consumed into commodity economics but perhaps things are moving faster than we think. This week a colleague sent me a website belong to a hair salon (see below) that is now selling CPAP at reduced prices. While reducing inflated mark-ups for CPAP equipment is a good aim, I wonder whether the hair stylists can multi-task and actually diagnose the condition and perhaps explain to the patient why use CPAP instead of a dental splint, weight loss, modafinil, body position change, surgery etc. I know a CPAP mask can mess up your hair in the morning especially with a tight fitting chin-strap but surely this is taking things one step too far. What next – a UPPP operation with a curling iron ? My colleague wondered aloud whether the CPAP blower could be used to dry hair quicker than a standard blow dryer ?
I recently met both a lawyer and also a truck driver who confessed they had bought an auto-CPAP from a distributor some years previously without any medical advice or diagnosis. In th truck drivers case it was to avoid any issue with his licence and in the lawyer’s case it was seen as a quick strategy via Dr Google.. Both presented as patients with CPAP problems and persisting sleepiness.
In the totally deregulated setting we have in Australia, it is increasingly common that “patients” are being commenced on CPAP without having seen any medical practitioner. There is no requirement for a prescription. This is a potential minefield. Vertical integration industry models push for this approach as they see doctors as potential barriers to a CPAP sale as they may actually talk to the patient discussing need for treatment or treatment alternatives. We also see mindless automated reporting of home studies by doctors who seemingly only recommend a CPAP machine conveniently sold by the supplier of home studies. Perhaps even worse are untrained persons with even less qualifications than hair stylists posing as “sleep clinicians” or “sleep consultants”.
We have a real uphill battle in Australia (and in many parts of the world) to get sleep medicine recognised as a genuine professional activity and particularly that treatment of sleep apnea is not simple, may not be necessary or involves multiple treatment choices. We need to start by better marketing ourselves and explain why we choose to care for sleep disorders patients rather than create a new coiffure.