Is SoClean Covered by Medicare

Christian Worstell
In this article...
  • Learn about sleep apnea and find out if SoClean sanitizing systems are covered for use by sleep apnea patients through Medicare health insurance programs.

While obstructive sleep apnea affects approximately 26% of adults between the ages of 30 to 70, at this time Medicare does not cover SoClean systems. 

SoClean and SoClean 2 and 3 are sanitizing systems manufactured by SoClean, Inc., that utilize activated oxygen to clean and dry CPAP machine parts.

CPAP (continuous positive airway pressure) machines are attached to the nose and mouth, which can lead to germ and bacteria buildup. This is where SoClean sanitizing systems come in.

How SoClean Systems Work

SoClean CPAP cleaning systems are efficient in eliminating germs and bacteria from CPAP machine parts. When CPAP users clean the machines by hand, all washable parts must be thoroughly washed and dried to remove germs and bacteria that come from the mouth and nose during the night. Parts that must be manually cleaned include hoses, masks and the CPAP humidifier. 

A SoClean system consists of a disinfecting machine that connects to the CPAP machine and its humidifier (when applicable depending on CPAP model) directly. The disinfecting machine creates activated oxygen when powered on, and the oxygen enters the CPAP and all of its components via the SoClean connection tube. The activated oxygen eliminates all bacteria and germs from the machine and CPAP mask. Once the components are sanitized, the oxygen flows through a specialized filter that allows clean air to exit the machine. 

Obstructive Sleep Apnea Explained

Obstructive sleep apnea is a (sometimes chronic) sleep disorder in which the throat muscles relax during sleep to the point where breathing is temporarily hindered. The back throat muscles are responsible for supporting the tonsils and the tissue that hangs down from the soft palate, also referred to as the uvula, the tongue and the throat walls. Obstructive sleep apnea causes all of these muscles to relax, which can narrow the airway to the point where air can't flow freely, which can lead to choking or gasping. 

In many cases, individuals with obstructive sleep apnea wake up briefly as the throat is closing, unknowingly releasing the relaxed muscles and opening the airway. This can occur several times throughout the night in individuals with sleep apnea, which can significantly disturb sleep patterns. Additionally, complications arising from obstructive sleep apnea include irregular heart rhythm, high blood pressure, stroke risk and weakened immune systems due to the body's overall lack of sleep. Because of all the potential health risks, it's important for those who suffer from sleep apnea to seek medical attention. 

Symptoms of Obstructive Sleep Apnea

Individuals with obstructive sleep apnea may not be aware of their condition because the actual act of relaxed throat muscles occurs during rest. However, there are several symptoms to look out for that occur as a result of sleep apnea. 

  • Snorting, snoring and gasping for breath upon waking in the middle of the night 
  • Headaches upon waking
  • Night sweats
  • Irritability and tiredness during the daytime hours
  • Consistent high blood pressure readings
  • Decreased libido

Risk Factors for Sleep Apnea

Obstructive sleep apnea is more common in men and women between the ages of 30 and 70, but the condition can also develop in people younger and older than the average. Common risk factors and causes of obstructive sleep apnea include:

  • Use of alcohol and sedatives that encourage relaxation of the throat muscles
  • Cigarette smoking
  • Congested nasal passages that encourage mouth breathing
  • Genetics
  • Natural physical traits such as large tonsils
  • Obesity

Obesity is the most common risk factor due to the fact that individuals who are severely overweight often develop pockets or folds of fat around the upper airways that can hinder breathing during sleep

Role of CPAP Machine in Obstructive Sleep Apnea

CPAP machines or continuous positive airway pressure machines are generally prescribed by physicians when patients are diagnosed with obstructive sleep apnea. They work by supplying a continual stream of air through the nose and mouth (sometimes only the nose or only the mouth). This constant air flow helps prevent the muscles in the back of the throat from collapsing and blocking the airway. 

While Medicare does not cover SoClean sanitizing systems, it may allow coverage for a three-month trial of a CPAP machine. Coverage may be provided for longer lengths of time if recipients meet certain requirements that include physician documentation that CPAP therapy is proving to be beneficial. 

Central Sleep Apnea: A Less Common Form

Central sleep apnea is a less-common form of sleep apnea in which throat muscle relaxation is the result of brain signal disruption as opposed to a physical blockage. Common underlying causes of central sleep apnea include drug use, brain stem issues and obesity. In some cases, sufferers may be diagnosed with mixed sleep apnea, which is a combination of central and obstructive sleep apnea. 

Alternative Treatments for Sleep Apnea

Some people who suffer from sleep apnea cannot tolerate the CPAP machines due to the somewhat obstructive design of the face mask and breathing apparatus. While each case is different, alternative treatments may help certain individuals. 

  • Positional therapy: In some cases, adjustment of sleeping positions can prove to be beneficial in reducing sleep apnea symptoms. Therapies include propping the body up with pillows or cushions and sewing a tennis ball into the back of pajamas to help elevate the back and prevent shifting. 

  • Mouth guards: Mouth guards are less invasive than CPAP machines, and they have shown to aid in the treatment of sleep apnea. The guards can be purchased at any local drug store and do not require a prescription. 

  • Weight loss: For individuals who are obese and suffering from sleep apnea, losing weight may be all that is needed to alleviate symptoms. When the fat deposits around the neck are eliminated, there is less of a chance for the airways to become blocked or constricted. 
Christian Worstell
About the Author

Christian Worstell is a senior Medicare and health insurance writer with HelpAdivsor.com. He is also a licensed health insurance agent. Christian is well-known in the insurance industry for the thousands of educational articles he’s written, helping Americans better understand their health insurance and Medicare coverage.

Christian’s work as a Medicare expert has appeared in several top-tier and trade news outlets including Forbes, MarketWatch, WebMD and Yahoo! Finance.

While at HelpAdvisor, Christian has written hundreds of articles that teach Medicare beneficiaries the best practices for navigating Medicare. His articles are read by thousands of older Americans each month. By better understanding their health care coverage, readers may hopefully learn how to limit their out-of-pocket Medicare spending and access quality medical care.

Christian’s passion for his role stems from his desire to make a difference in the senior community. He strongly believes that the more beneficiaries know about their Medicare coverage, the better their overall health and wellness is as a result.

A current resident of Raleigh, Christian is a graduate of Shippensburg University with a bachelor’s degree in journalism. You can find Christian’s most recent articles in our blog.

If you’re a member of the media looking to connect with Christian, please don’t hesitate to email our public relations team at Mike@MyHelpAdvisor.com.