Michael Morgenstern, MD
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Michael Morgenstern, MD

About the author: Dr. Michael Morgenstern is double board certified in Neurology and Sleep Medicine and the founder of the American Sleep Apnea Society. He is the Director of the Morgenstern Medical in Lake Success, NY, where he treats patients with sleep disorders and other neurological conditions.
Michael Morgenstern, MD
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A durable medical equipment provider, or DME, can be a great partner in the care of individuals with sleep apnea. The DME can do a lot. That’s why I am shocked that many people are unaware of their existence. If I ask them who provides their cell phone services, electricity or gas, I would expect to get an answer pretty fast. But when I ask who their DME company is, patients give me a strange look sometimes. Like I am asking them to solve some complex math problem. Remember the scene from A Beautiful Mind where John Nash presents a math problem to the class at MIT that he tells will take some of them “many months to solve, for others among you it might take a lifetime”? The look that question invoked of students in the classroom at MIT, is the look I get from people when I ask them who is their DME.

DME – OSA helpline

dme cpapDMEs can be a key part of the team caring for an individual with OSA.  When I order a CPAP device, the DME will usually bring a new device to the patient’s home. They will call to arrange a time that is convenient to deliver the device and have a respiratory technician teach the person (or an aide, if present) how to operate it. They can try out different masks to find the best fitting mask at this visit. In fact, I sometimes write the prescription that way. Sometimes, after delivering the device the therapist provides a number to the patient to call them directly if there are any problems with the CPAP. The DME supplier that I routinely use has an 800 number that serves as a helpline. They also have a location in the area where patients can show up without an appointment, bring in their device and get hands on training or troubleshooting for free.  If you’re mask doesn’t work after you have received it, the DME can usually replace it for free within the first month.

DME – CPAP troubleshooters

If there is a problem with a CPAP device,  you can call your doctor, but the DME might be easier to reach and sometimes they are more knowledgeable (I shouldn’t admit this) than many doctors about individual devices or masks–not me of course:). That is because if it’s an experienced company, that’s what they do.   They live and breathe CPAP machines. The respiratory technicians that are employed have a degree in CPAP. They specialize in CPAP devices. They should be experts in the technical issues related to the CPAP devices. Sometimes, side effects that develop (eg burping, feeling of too much pressure with the CPAP mask on) can be related to device settings that can be adapted. Contacting the DME can be a good first step to find out if any difficulty being experienced is related to the device. Of course, contacting your health care provider, like a sleep specialist, can’t hurt either. One suggestion might be to contact your physician and leave a message if you can’t speak to them right away like “Dr. Morgenstern, I am experiencing a lot of burping since starting my CPAP. I plan on calling my DME to help out.” Dr. Morgenstern will then review the message. He will call you if he thinks it might not be related to the device or if it is an emergency. For example, if someone left me a message like: “Dr. Morgenstern, I am experiencing chest pain related to the device. I am calling my DME now.” Firstly, I would hope my staff would recognize the urgency and retrieve me immediately. If somehow they did not (though I suspect they would), I would call the patient back pronto to get clarification on this pain. (By the way, if you are experiencing chest pain at any time, please strongly considering calling 911, call your primary care doctor as this could be a life threatening emergency).

The point is that a DME can be another great tool to help with the management of OSA and CPAP. When patients give me that strange look when I mention their existence, I know it’s time to tell them that they should take advantage of all the DME has to offer. After all you are paying for them (through your insurance company whom you pay every month). Why not use the DME for all they can offer?

(Note: Regarding usage of  “DME”, DME is an acronym for durable medical equipment. This includes CPAP or any other portable medical equipment (oxygen etc.). Commonly, the term can be used to refer to DME suppliers, for example, “My DME is Landauer Metropolitan.” But DME could also be used in a phrase like, Medicare covers 100% of my DME costs. Both are correct. )

References:

1. https://en.wikipedia.org/wiki/Durable_medical_equipment
2. picture credit

About the author: Dr. Michael Morgenstern is a board certified Neurologist, expert in Sleep Medicine and  founder of the American Sleep Apnea Society. He is Director of the Cedarhurst Sleep Center in Long Island, New York and also sees patients with neurologic conditions.