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Sleep Apnea and CPAP Machines in Japan: A Comprehensive Guide
Introduction: Sleep Apnea in Japan
Brief overview of sleep apnea and its prevalence in Japan
Sleep apnea is a prevalent sleep disorder affecting millions of people worldwide, including Japan. In this comprehensive guide, we explore CPAP (Continuous Positive Airway Pressure) treatment for sleep apnea in Japan.
According to a study published in the Journal of Clinical Sleep Medicine in 2011, the estimated prevalence of sleep apnea in the Japanese population was approximately 9.4% among men and 2.3% among women.
Common symptoms and warning signs of sleep apnea
Sleep apnea can significantly impact your quality of life and overall health. Recognizing the warning signs is crucial for early detection and timely treatment. Here are some common symptoms that may indicate the presence of sleep apnea:
- Loud and Persistent Snoring: Excessive and disruptive snoring is a hallmark symptom of sleep apnea. If you or your partner notice loud, chronic snoring, it’s essential to investigate further.
- Pauses in Breathing: Sleep apnea causes interruptions in breathing during sleep. These pauses can be short but are often followed by choking or gasping sounds as breathing resumes.
- Excessive Daytime Sleepiness: Feeling excessively tired or fatigued during the day, despite getting a seemingly adequate amount of sleep, is a common symptom of sleep apnea.
- Morning Headaches: Waking up with frequent headaches, particularly in the morning, may be indicative of sleep apnea.
- Lack of Concentration: Sleep apnea can impair cognitive function, leading to difficulties in concentrating, remembering details, or staying focused throughout the day.
- Irritability and Mood Changes: Sleep deprivation caused by sleep apnea can contribute to irritability, mood swings, and even depression.
- Nighttime Urination: Increased frequency of urination during the night, known as nocturia, can be a symptom of sleep apnea.
- Dry Mouth or Sore Throat: Waking up with a dry mouth or sore throat can be a result of breathing through the mouth during sleep, which is common in sleep apnea.
If you experience one or more of these symptoms, it is essential to seek further evaluation and consult a healthcare professional for a proper diagnosis of sleep apnea and to rule out any other possible conditions.
Screening for Sleep Apnea in Japan
Getting screened for sleep apnea in Japan is covered under National Health Insurance and can be done in any city or town.
It’s not a particularly difficult or expensive thing to check under insurance and the whole process can be done for about 40,000 yen. The first step you should take is to visit a local internal medicine (内科 naika) or Ear, Nose, and Throat (耳鼻咽喉科 jibika) clinic in your area and consult with the doctor there about screening for sleep apnea.
You local doctor can refer you to a specialized sleep clinic if you need further evaluation.
Overview of the screening process in Japan
There are several ways to get screened for sleep apnea. The first way is by attaching a pulse oximeter to the finger while sleeping for one night and recording the data.
This is a cheap test that can tell your doctor if your blood oxygenation is falling below safe levels while sleeping, which could indicate sleep apnea. The next step up from this is to take an at-home screening that attaches a nasal flow monitor as well as a blood oxygenation test together. This test will indicate if you should get more detailed testing.
In the case you need more detailed testing, polysomnography (PSG) is the gold standard for diagnosis. This is an overnight test in a sleep clinic, where you are attached to various monitors and observed while sleeping.
In some cases, you may be fitted with a CPAP (Continuous Positive Airway Pressure) device in the same night, while other times you may be required to spend another night in the sleep clinic receiving CPAP training and guidance while sleeping under continued observation.
Standards for sleep apnea diagnosis in Japan
The standard for diagnosing Obstructive Sleep Apnea (OSA) in Japan is based on AHI (Apnea Hypopnea Index) which is the number of apnea events per hour on average.
5 – 15 AHI -mild (consider lifestyle factors, dental, nasal evaluation, etc.)
15-30 AHI -moderate (start CPAP at 20AHI)
Over 30 AHI -severe (requires CPAP)
Starting CPAP therapy at 20 AHI is a much higher standard than in some western countries. In general, someone with more minor sleep apnea would be given options such as nasal or dental surgery, sleep mouthpieces, and weight reduction.
Obtaining CPAP Treatment in Japan
CPAP treatment in Japan is one sleep apnea treatment option available. As CPAP treatment is a medical therapy, it is covered under healthcare insurance.
In general, outpatient CPAP treatment costs about 4000 to 5000 yen monthly, including the rental of the CPAP machine and the necessary supplies such as tubes, masks, and filters. All major CPAP manufacturers are used in Japan (ResMed, Philips Respironics, Fisher & Paykel, DeVilbiss and others) depending on the vendor used by the particular sleep clinic where you are receiving treatment.
Typically, after a PSG diagnosis, a trial CPAP machine will be provided by the sleep clinic, and a follow up scheduled at a later date. If things go well with the trial machine, you can keep on using it, or it may be switched for a more appropriate machine. Some clinics may send you home without a CPAP and arrange for a vendor to deliver one to your home and set it up for you.
Since you are renting the CPAP in Japan under insurance, you must visit the prescribing clinic once a month to see the doctor and pay for the rental.
Buying a CPAP machine in Japan
Some people choose to buy a CPAP machine in Japan for their own use, mainly because they do not want to go to the doctor every month for regular checkups.
CPAPs sold through vendors in Japan are very expensive, often up to 10x the going rate overseas. We do not recommend buying one from a vendor in Japan.
Bringing a CPAP machine to Japan from overseas
If you are bringing a CPAP machine to Japan from overseas, we recommend that you bring a copy of your prescription, just in case you need to get CPAP treatment later from a clinic in Japan.
CPAP machines are medical items, and should be declared on a “Yunyu Kakunin-Sho” with the Ministry of Health prior to arrival in Japan. We are not aware of anyone being turned away at the airport or having their CPAP confiscated by customs.
We have heard of people purchasing CPAP machines and supplies from vendors abroad and having them sent to Japan, so this seems to be possible. Please keep in mind that if you are using your own personal machine, you are responsible for the upkeep and maintenance of the machine as well as all necessary supplies. You will not be able to purchase supplies from Japanese vendors for your personally-owned CPAP, as they consider tubes, masks, filters etc. to be prescription items that must be used under a doctor’s supervision.
Overall, we do not consider getting CPAP therapy in Japan to be particularly difficult or expensive. In many cases, the level of detail in diagnosis and treatment leads to a very high level of care and great improvements in quality of life. If you have symptoms of sleep apnea, we highly recommend getting a sleep study and seeing if CPAP treatment is for you.
For more information about working as an ALT with Interac, click here.
To read more interesting articles about Japan, visit our blog here.
Recommended sleep clinics
Tokyo
Kumada Clinic: http://kumadaclinic.com/en/ear-en/
Sleep Medicine Tokyo: https://www.sleepmedicine-tokyo.com/clinic/eng/
Good Sleep Clinic: http://www.good-sleep.gr.jp/hamamatsucho/english.html
St. Luke’s: https://medilocus.luke.ac.jp/outpatients/sas/index-e.html
Aichi
Aichi Medical Univ Hospital: https://www.aichi-med-u.ac.jp.e.gy.hp.transer.com/hospital/sh04/sh0401/sh040113/index.html
Osaka
Hannan Hospital: http://www.hannan.or.jp/english/jushin/senmon_suimin.html
Osaka Univ. Hospital: https://www.hosp.med.osaka-u.ac.jp/english/departments/sleeping.html
About the Author
Brian McDonough is a consultant at Interac, Japan’s largest provider of ALTs (Assistant Language Teachers). Originally from the US, Brian has lived in Japan for over 25 years, giving him a unique perspective on the cultural differences and challenges people face when moving to Japan. He has first-hand experience of working in Japan as an American.