This may just be the delusions of a sleep deprived person (diagnosed with severe obstructive sleep apnea 10 days ago), but have a couple of questions for members of the forum

1. Since sleep centers make money selling CPAP machines, do they tend to overdiagnose/exaggerate the study results to keep the bottom line healthy. Assuming the sleep study data collected by the sleep technician is on the up and up (you have to have some faith in people at some point), are there pretty well established measures of what is OSA and what makes it severe, medium or mild.  I see a lot of terms winged around in the forums that seems to imply there are some fairly objective measures of what defines this condition.

2.  Will a regular family doc be able to explain the data from night oximetry studies and the raw data from a sleep study and explain to a layman (me) why a diagnosis of OSA would be a logical/highly probable conclusion from tests.  (Just want someone without a financial interest to look at the this and put this to rest)

3.  What would be the some signs that the CPAP treatment is working and what would be a reasonable expectation of how long it might take?  Or what have been peoples experiences. I'm curious how long to give the treatment before I go back for an adjustment or reassessment.  Since I've felt so cr*ppy/tired for so long, I pushed to start CPAP, even with my suspicions, as soon as I could (finished 3rd night, last night).  Just getting used to it and am waking up more than I was before from the machine, but its getting better and I anticipate that tonight I'm gonna make it the whole night.  The pressure (12.0) has not been a big deal, just getting used to a nose pillow.  the only thing different I feel is that I actually worked out in a pool today, used to be a workout fanatic, but been just too worn out at the end of the day/weekends to think about attempting it.  Don't know if this is the CPAP or a placebo effect, because I'm supposed to be feeling better.

Thanks for listening, in a cyber sorta way

bigskyguy wrote:

Since sleep centers make money selling CPAP machines, do they tend to overdiagnose/exaggerate the study results to keep the bottom line health

Hmmm....I didn't know that there WERE sleep labs that also sold CPAP.   Does yours?  If so, that would bother me as well.  

My sleep lab was run by the local hospital which doesn't sell equipment.  All my equipment came from a DME (Durable Medical Equimpent) provider so the sleep lab could care less and would make no money if I got one or not.

bigskyguy wrote:

Will a regular family doc be able to explain the data from night oximetry studies and the raw data from a sleep study

In my experience, no.  My family doc was the one who ordered the sleep test on my (and really my wifes) suggestion.  He simply took the lab result summary and prescribed CPAP at the suggested pressure.  Now, when I started asking him about various machines, C-Flex, Data capable machines, etc, his eyes glazed over.  Now in his defense, a GP can't really be up to speed on everything.  He probably wouldn't know what to do if I had a Brown Recluse spider bite either, and would refer me to a specialist.  After I was in deep around this forum, I found a Neurologist/Sleep Specialist in my insurance plan and scheduled a visit for a second opinion.  HE answered all my questions and confirmed what the sleep lab had suggested, so in the end my family Doc did the right thing...but he had no clue WHY.

bigskyguy wrote:

What would be the some signs that the CPAP treatment is working and what would be a reasonable expectation of how long it might take?

The signs are that your energy returns, you stop snoring, you aren't falling asleep in all the wrong places and your wife moves back into the bedroom.    As for how long it takes, it is different for everyone (there is a poll in one of the forums here).  However if someone has been using CPAP for months with zero improvement, I would say something isn't right.  Personally I felt a change right away and was a new man a week later.   And yes...the wife moved back from the spare room down the hall.  

1) Neither of the 2 sleep clinics that I went to, nor the one my husband went to, sold equipment.  If it happens, I don't think it's common.

2) I don't think it would be very difficult to diagnose an uncomplicated case of obstructive sleep apnea.  The scoring is done by the technicians who do the studies and the result probably then goes to a sleep specialist to go over the study before the results were sent to your physician.   He/she shouldn't have much trouble explaining it to you.

3) My husband has always said that he knew after his titration study that it was going to work because it was the best sleep he'd had in a long time.  It took a while to get the mask problems worked out but I think he felt the benefit even then.

Thanks for such a swift reply.

The sleep center I went to in the Denver area is a chain of sleep diagnostic centers that my doc referred me too. I do have to say that they were very professional, considerate, comfortable, throughly explained what was going on and what was going to happen and the tests seemed to be very well executed and monitored.  It just seemed odd that they also sell the equipment for the condition we were looking for and that raised my eyebrows.  They were also clear that they were not going to interpret the results for me and I needed to talk to my Doc.  When I received a copy of my sleep study, but there was no observational data, just a 3 pager summarizing the results. When I saw the bottom line results that indicated that I needed to be on CPAP, that got the alarm bells ringing in my head.  They never tried to sell me the gear or suggest that that I needed it.

However, when I peruse this forum and compare with what are in my results, the diagnosis seems like a no-brainer, if the numbers being bantered about (AHI's, SPO2, sleep efficiency, etc) are common definitions of OSA. Net/Net, I may be smart, but I know better than to practice medicene w/o a license. I'm going to discuss with my GP tomorrow.

My wife just commented to me that since I'm still awake and writing this note at 9:45pm and not sound asleep in front of the TV, might be a clue. I also remember dreaming the last few nights, which rarely happened the last few yrs. Maybe its gonna work.

Quote:

The sleep center I went to in the Denver area is a chain of sleep diagnostic centers that my doc referred me too. I do have to say that they were very professional, considerate, comfortable, throughly explained what was going on and what was going to happen and the tests seemed to be very well executed and monitored.  It just seemed odd that they also sell the equipment for the condition we were looking for and that raised my eyebrows.

My knee jerk reaction was the same as yours... raised an eyebrow....but after fairly thinking about this, is it really any different than the eye care chains that examine your eyes and also have walls filled with the very products you will likely need... and this goes for private practices as well.


_________________

CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

PuhJommies wrote:

My knee jerk reaction was the same as yours... raised an eyebrow....but after fairly thinking about this, is it really any different than the eye care chains that examine your eyes and also have walls filled with the very products you will likely need... and this goes for private practices as well.

Good call PJ!