In one of the creepier, more invasive – or brilliant, depending on your views – uses of the Internet of Things, smart CPAP machines are being monitored, and even adjusted, from across the Internet, and if you aren’t using yours often enough (known as ‘CPAP compliance’ or being ‘CPAP compliant’), your medical insurance company won’t pay for it, and your life insurance and health insurance premiums could go up. Now, for recent users of the CPAP (Continuous Positive Air Pressure) machines, this may be old news, but for the rest of us, HOLY CPAP!
As the Alaska Sleep Clinic so succinctly explains, “Many insurance companies want to make sure their clients are using the expensive equipment that was paid for. To ensure minimum CPAP usage, some of these insurance companies want a detailed report as often as every three months. For the most part, they want to know how many days a week patients are using their device and how many hours a night they are using it for. And if patients don’t meet a minimum standard (usually four hours a night/four days a week) they may ask patients to reimburse the company for the equipment.”
And that’s not all. Employers are starting to get in on the game too. As an employee named Paul wrote in an email to the site CPAPHelpDesk.com, which is run by a respiratory therapist with 20 years of experience working with people with sleep apnea (he says that on average he works with over 1500 CPAP users a year – what he doesn’t say on the site is his name), Paul was fired because his employer thought he wasn’t using his CPAP machine.
Wrote Paul, “I have sleep apnea and I was recently fired from my job for supposed non-compliance with my CPAP machine. I had been diagnosed with sleep apnea 4 months ago, place on a CPAP machine and was shown to be compliant with treatment with a report generated from data obtained via a wireless modem.”
However, Paul went on to say that the medical equipment company requested the modem back, and then someone complained at his job that he had fallen asleep, and so his employer demanded his CPAP data (and put him on leave in the meantime), and somehow two months worth of data had been lost, so he could not prove he had been using his CPAP machine.
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The CPAP Help Desk guy has a video response to the question here, primarily in response to Paul’s questions about other ways he might obtain the data to prove his innocence.
Now, Paul doesn’t mention in what industry he works, but this CPAP monitoring is very common in the transportation industry, where if an employee falls asleep (i.e. behind the wheel) the consequences could be dire.
As one commenter on that video points out, “truck drivers are being forced to take sleep disorder tests against their will because of a new DOT rule. the guidelines are overweight, large neck, or age which are all forms of discrimination. the tests are 1 to 2 thousand dollars. i slept like a baby all my life, never tired in the daytime until a year ago when i was wrongly diagnosed with sleep apnea. i have not had a decent nights sleep since. i am a walking zombie because i cannot sleep with this machine on my head. they will not give me anything to help me sleep, and threaten me i better not take anything to help me sleep. i am subject to random drug tests. i was told by my sleep apnea doctor if i used it 4 hours a night i would be compliant. i went to get a DOT physical last week and was told they (DOT) changed the rules and i was not compliant. i am to say the least, very you know what. i feel i am being scammed and a lot of other drivers feel the same. i believe we are heading for a slaughter house on the highways because of forced misuse of these guidelines. watch yourself and the big trucks on the highway, you may be the next person to be slaughtered by a sleeping semi driver. this is not a joke.” {Emphasis above added}
While this fellow’s plight is certainly lamentable, we’re here to talk about the online, remote monitoring and controlling aspect of this. So how is this happening?
Through apps that track your CPAP compliance, among other things (such as tracking your usage and sleep), or through an onboard cellular modem that reports back to the mothership, and through which various settings can be controlled – remotely.
Perhaps the best known of the smart CPAP apps is DreamMapper (nee Sleepmapper), put out by Phillips Respironics.
Others include MyAir, and DeVilbiss’ IntelliPAP.
And, again, some CPAP machines have a cellular modem onboard.
In addition to your CPAP, in your home, being monitored for compliance from afar, people at the other end of that connection can change your settings on your CPAP machine, remotely, and even without your permission or foreknowledge.
As one CPAP user discovered and explains, “So I’m 60 days into my therapy. The first month sucked. I used “prescribed” settings. I was tired, headachy, blah.Then I took charge of my therapy and have tweaked settings. In 60 days I have had TWO days of AHI over 5…and two more that barely topped 4. I think I’m doing just ducky. So I got compliance info sent to DME earlier, and she REMOTELY RESET MY MACHINE. No warning, even. How RUDE. I noticed tonight as I set myself up for bed that the pressure felt low…stuffy…settings were wrong. So I popped the SD card into the laptop to check against SH…yep. Back to wide open, humidity wrong, etc. As of TODAY. I changed it back. Monday I call my handler and tell him I’m too close to menopause for this to be healthy for the DME to pull again. Tomorrow DME gets an ear chewing, and I will tell them to shove the modem, if this is what they plan to do. I will find an alternate way to get them compliance data.” (‘DME’ stands for Durable Medical Equipment (supplier))
In the past couple of years, as the use of smart CPAP machines, and associated apps and cellular modems, has proliferated, the concern about CPAP machines as part of the Internet of Things has increased (although not always articulated that way). Consumers are concerned about their sleep machines being controlled remotely, and about snafus, such as Paul’s above, leading to unintended consequences, such as being fired for non-compliance when you were in fact compliant.
We’re not sure what the answer to this is, but at least now you know that there are questions to be asked.
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I have three CPAP Machines. One from the Army, One from my civilian employer’s insurance (after I retired), and then the VA gave me one that pulls digitized data without me knowing it.
I use the second one as it is an auto pap and works perfectly, and I use my Army one when I travel. But now that I don’t work I am forced to use the VA. When they asked why I didn’t want to use their CPAP I told the FEMALE doctor It has a digital tracking device in it. She said well it doesn’t have a recording device in it so what’s the problem. In which I replied. “Lady, I don’t know you, but I damn sure know the govt. since I served nearly 30 years with them. So this is what were going to do. I’m going to give you and electronic device that you MUST put in your bedroom and I’m going to pull digitized data from you bedroom while you sleep w/out your knowledge. I don’t know about you but that sounds disturbing to me!!”
The VA has refused to supply me masks, hoses or any other parts for the CPAP that I do use. does that sound like an organization that cares about the people that are the reason they have a job???
I ask people that watched the 80s movie “The Right Stuff” when one of the astronauts ripped his heart monitor off while he was in space. They all laugh and said I understand why he did that. What about the war movies where the soldier tells the medic “please, no more morphine”. and again I get the yeah, I understand that. Then why in the Hell as a war vet do you think BCBS or whoever feels its more important to wear a CPAP mask than my nightmares, scaring the !#!@! our of my family that seem to be coming from something strapped to my face while I sleep. And I wish to forgo a week. The bottom line is that the people in this country has gotten used to thinking that “I can’t make a decision for myself I need some over priced insurance company telling me what I need to do”. and since they know life insurance will go up they corner you. Now if the health insurance refuses to pay for CPAP (for any reason) then the life insurance should go down.
I now work for the medical side of the house. I see insurance companies requesting medical records from the family doctors for this. This is invasive. the people pay for their insurance, so the insurance needs to pay for what they promised. That said, if sleep apnea is one those things where you die in your sleep because you are not using the CPAP. Then what in the hell is the insurance worried about???
i am now having problems i think are remote control. my machine started shutting off after about 7 breaths.that stopped when i put it in airplane mode. now my monitor light will go on and off. this is irritating and interferes with my sleep.