Saw a new Sleep Doc today

[JeffH]

Decided to finally see another sleep doc today after not having any medical help with sleep issues since 12/98.

Went to an accredited sleep doc, and he didn't like the thirty days worth of Encore reports I brought him, he didn't like Respironics APAP's, (he's a Resmed man). He thought I probably needed a higher pressure (this just by looking at me). Told him I mouth breathed so I taped my mouth and he didn't like that. Said I probably needed a full face mask and I didn't like that.

He doesn't sell machines or equipment, so that's a plus. Of course he wants to do a sleep study and scheduled one for thursday nite with a follow up the next day. He's even trying to change the schedule around to where I might be able to get the follow up before I leave town after the sleep study. (I live about 60 miles from Oklahoma City).

My issues are in the last two to three weeks not sleeping well, not sleeping a all (a couple of nights) waking up several times a night. I used to only wake up from none to a max of three with one or two times being the average.

My GP put me on Rozerem which has helped with falling asleep, but doesn't do much for staying asleep. What I like about it is it isn't a "controlled substance" so it's safe for an old recovering alky / druggie like me.

Even though I'm not 100% OK with this guys attitude, I'll probably go ahead and do the study because one thing he said I liked is that they look for more than just OSA when they do studies. They are NOT going to make me sleep without a mask, just start the night at my normal pressure. Will be interesting to see what happens from this.

[LinkC]

Best of luck with the study. I hope this guy knows what he's doing. I wouldn't worry about the things "he doesn't like"...not many of them like those things! Let us know what happens...

[Babette]

Best of luck, buddy! I know you'll stand your ground and demand what you want.

I sure hope they find an answer for you soon!!! Not liking all this not-sleeping. You're too crazy to be out there sleep-deprived.

Love & Hugs,
B.

[Catnapper]

Hi Jeff

I hope your study is just what you need to solve the sleep issues. When I had my last study, I made friends with the men in the study place. At first they were going to schedule my study with a new, fairly inexperienced "tech". Instead the more experienced tech took pity on me and decided that because I use a bi-pap he would do my study himself. That helped. He found (unlike my earlier study - done by someone else) that as the pressure rose to 13 cmH2O I would start to wake up. He tried it several times with the same result, so my upper IPAP limit was set at 12. I am not sure the less experienced person would have noticed that change. It turned out that I had tweaked my machine to stop there also, and the doc was pleased with me for somehow figuring it out on my own. I had both EPAP and IPAP set to what was found in the study as ideal - thanks to info I followed here.

The point of that for me is that a good tech can watch for the subtle changes in your sleep patterns and maybe that way can find what is disturbing your sleep. The place where I have my studies done apparently will hire someone and, after a couple weeks of training and without certification or supervision, will turn them loose to do studies. It must be hard to find people to work nights all the time. I hope you get a good tech who is well-trained and detail oriented. I am sure there are lots of them out there, just not at my sleep study place.

Sleep well, my friend.

Catnapper -Joanie

[JeffH]

Best of luck with the study. I hope this guy knows what he's doing. I wouldn't worry about the things "he doesn't like"...not many of them like those things! Let us know what happens...

Thanks LinkC, I'll let you know.

[rested gal]

I wouldn't worry about the things "he [the sleep doctor] doesn't like"...not many of them like those things! Let us know what happens...

I agree. You can always decide what you want to accept (or not) in the regard to whatever machine, mask, etc., that "he" wants you to use.

I agree absolutely with every word Joanie (Catnapper) wrote about the importance of having a good, experienced sleep tech running your upcoming sleep study. The number of years of experience, and even the credential "RPSGT" (registered polysomnograph technologist), are no guarantee the sleep tech is one as smart as the experienced tech Joanie described, but at least those things are a surer bet than banking on a tech who is still in the midst "on the job training."

I've always thought that getting a really good sleep tech to do the study, and an equally good one to do the scoring afterwards (they are not always one and the same) is FAR more important than having a good sleep doctor to "interpret" the study.

I've also always thought that many times, the sleep doctors (even top ones) are more often than not simply going to give the sleep study a passing glance and go almost entirely by what the sleep tech's summary notes in the report -- even to prescribing the pressure the sleep tech mentions worked well. Which is probably just as well... a really good sleep tech probably knows as much, if not more, than the sleep doctor, about what the diagnosis should be and what pressure should be used. But of course, that's the domain of the doctor, so the doc does the prescribing.

Best of luck with your study, Jeff! Do let us know what happens.

[JohnBFisher]

... I agree absolutely with every word Joanie (Catnapper) wrote about the importance of having a good, experienced sleep tech running your upcoming sleep study. The number of years of experience, and even the credential "RPSGT" (registered polysomnograph technologist), are no guarantee the sleep tech is one as smart as the experienced tech Joanie described, but at least those things are a surer bet than banking on a tech who is still in the midst "on the job training."

I actually spend more time interviewing the sleep lab than I do the doctor. Since I have problems with central apneas, I make certain they know how to find them, have experience with complex sleep issues, etc. As a result, the sleep lab tends to schedule me with their most experienced sleep techs.

[JeffH]

... I agree absolutely with every word Joanie (Catnapper) wrote about the importance of having a good, experienced sleep tech running your upcoming sleep study. The number of years of experience, and even the credential "RPSGT" (registered polysomnograph technologist), are no guarantee the sleep tech is one as smart as the experienced tech Joanie described, but at least those things are a surer bet than banking on a tech who is still in the midst "on the job training."

I actually spend more time interviewing the sleep lab than I do the doctor. Since I have problems with central apneas, I make certain they know how to find them, have experience with complex sleep issues, etc. As a result, the sleep lab tends to schedule me with their most experienced sleep techs.

Good points, Rested Gal and JohnBFisher. I noticed that he barely looked at my old sleep study. I too have had problems with centrals and will bring that up as they glue all those wires to me.

Thanks for the good ideas to bring up at the study.

JeffH

[Julie]

But in the end, if you need a full face mask, and are not feeling great, tape or not tape, maybe you should concentrate on finding one that works for you that you can live with. All the chasing around with new PSG's and other machines, etc. may just prolong the inevitable.

[JeffH]

Hi Jeff

I hope your study is just what you need to solve the sleep issues. When I had my last study, I made friends with the men in the study place. At first they were going to schedule my study with a new, fairly inexperienced "tech". Instead the more experienced tech took pity on me and decided that because I use a bi-pap he would do my study himself. That helped. He found (unlike my earlier study - done by someone else) that as the pressure rose to 13 cmH2O I would start to wake up. He tried it several times with the same result, so my upper IPAP limit was set at 12. I am not sure the less experienced person would have noticed that change. It turned out that I had tweaked my machine to stop there also, and the doc was pleased with me for somehow figuring it out on my own. I had both EPAP and IPAP set to what was found in the study as ideal - thanks to info I followed here.

The point of that for me is that a good tech can watch for the subtle changes in your sleep patterns and maybe that way can find what is disturbing your sleep. The place where I have my studies done apparently will hire someone and, after a couple weeks of training and without certification or supervision, will turn them loose to do studies. It must be hard to find people to work nights all the time. I hope you get a good tech who is well-trained and detail oriented. I am sure there are lots of them out there, just not at my sleep study place.

Sleep well, my friend.

Catnapper -Joanie

Excellent points, Joanie. I'll be sure and quiz the techs.

[JeffH]

But in the end, if you need a full face mask, and are not feeling great, tape or not tape, maybe you should concentrate on finding one that works for you that you can live with. All the chasing around with new PSG's and other machines, etc. may just prolong the inevitable.

Then I'd have to shave my beard and the world is an uglier place when my hairless face is part of the scenery...LOL.

JeffH

[kteague]

Sure hope they find some answers and solutions for you. About getting an experienced tech, the night you get there might be too late to get the attention of their best tech. I'd call in advance and ask who you are scheduled with, their credemtials and experience with your specific needs. An ounce of preparation...

[muskyjack]

Find out how much experience both the night tech who runs the study AND the tech who does the scoring the next day otherwise you are wasting your time and insurance money. Several years ago I had a study run by someone who had 10 years experience which was good but later discovered that the scorer just got off orientation. The report stated that I had like 75 shifts in sleep but the scorer never reported the cause of the shifts in the report. The sleep doctor offered to repeat the study at the same lab which I declined. It looks like all the sleep doctors do is just skim over the scoring summary and never see the raw data but I could be wrong. Since that experience I am much more assertive about any thing medical because insurance and I are paying inflated prices for the services so nothing should fall between the cracks.

[JeffH]

Sure hope they find some answers and solutions for you. About getting an experienced tech, the night you get there might be too late to get the attention of their best tech. I'd call in advance and ask who you are scheduled with, their credemtials and experience with your specific needs. An ounce of preparation...

Another good idea. No wonder I like this forum

Thanks, Kathy.


JeffH

[Patrick A]

Sure hope they find some answers and solutions for you. About getting an experienced tech, the night you get there might be too late to get the attention of their best tech. I'd call in advance and ask who you are scheduled with, their credemtials and experience with your specific needs. An ounce of preparation...

Another good idea. No wonder I like this forum

Thanks, Kathy.


JeffH

Very good Idea.