How can Dr tell degree of apnea without another sleep study?

I was diagnosed in 2011 with borderline sleep apnea - meaning, I was told at the time, 3 or so episodes per night. My cardiologist said he really didn't want to do a cardiac ablation for my AFIB if I was experiencing apnea, however light. So I had the sleep study, was diagnosed and treated with CPAP. I changed the Dr I was seeing to a Dr in my town. He said that 3-5 was borderline, but I actually liked the CPAP. I felt it helped me sleep because it was like "white noise" and, for me, it also had a certain hypnotic quality. So it was easy for me to comply. I've seen the new guy about 3 times over the last 6 years. The last time was recently. Just a routine check of my card. No surprises - I thought. I started making a practice of reading my appointment notes from my doctors through my clinic's online system, because I have been surprised to find out some of the things they have entered into my records. This guy now says I have severe sleep apnea. My question is this: how can he tell without another sleep study? If he thought that at the last appointment, why didn't he change my settings or at least discuss this with me. If I had "borderline" apnea I wouldn't think my setting for that would be effective for "severe" apnea. I do remember discussing my lack of symptoms with him at my first meeting. No daytime sleepiness (NONE - ever), no falling asleep during the day driving, sitting, reading, watching TV or whatever, no snoring, no restless legs. I've never had ANY of the symptoms of apnea and I know what they are and look like because my husband had severe apnea and had ALL the symptoms, including falling asleep in court. I still remain symptomless, but I still like the CPAP for the same reasons above.

renne2001 wrote:This guy now says I have severe sleep apnea. My question is this: how can he tell without another sleep study?

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To answer your question: No, he can NOT.
Is he affiliated with an HMO, by any chance?

He could use his Magic Hat filled with notes on cards, or just use the Magic 8 Ball, sitting on his desk. Jim

Goofproof wrote: just use the Magic 8 Ball, sitting on his desk

I like the Magic 8 Ball...nice almost clear answers.

renne2001 wrote:This guy now says I have severe sleep apnea. My question is this: how can he tell without another sleep study?

He can't.

I would question it at the next office visit. Maybe he got your information confused with someone else and messed up the dictation or something.
Clear it up one way or another. You don't want incorrect information in your medical records.

Pugsy wrote:

Goofproof wrote: just use the Magic 8 Ball, sitting on his desk

I like the Magic 8 Ball...nice almost clear answers.

renne2001 wrote:This guy now says I have severe sleep apnea. My question is this: how can he tell without another sleep study?

He can't.

I would question it at the next office visit. Maybe he got your information confused with someone else and messed up the dictation or something.
Clear it up one way or another. You don't want incorrect information in your medical records.

But, then again the Doctor using the Magic Hat, might have a really nice looking assistant holding the hat! Jim

Things are very wrong here!

I never heard of somebody liking CPAP without needing it! You must be deriving a benefit!

If you have fewer than five apneas/hypopneas per hour, they do not diagnose Sleep Apnea.

The correlation between pressure setting and severity is a very loose one. A patient can have more severe apnea than another, yet have a lower pressure setting.

I have no idea how he can now decide that you now have severe apnea; short of another test. Is it possible that he confused you with your husband?

D.H. wrote:Things are very wrong here!

I never heard of somebody liking CPAP without needing it! You must be deriving a benefit!

If you have fewer than five apneas/hypopneas per hour, they do not diagnose Sleep Apnea.

The correlation between pressure setting and severity is a very loose one. A patient can have more severe apnea than another, yet have a lower pressure setting.

I have no idea how he can now decide that you now have severe apnea; short of another test. Is it possible that he confused you with your husband?

A person that has a AHI of 1, is that good if it lasts eight minutes? Jim

Goofproof wrote:

D.H. wrote:Things are very wrong here!

I never heard of somebody liking CPAP without needing it! You must be deriving a benefit!

If you have fewer than five apneas/hypopneas per hour, they do not diagnose Sleep Apnea.

The correlation between pressure setting and severity is a very loose one. A patient can have more severe apnea than another, yet have a lower pressure setting.

I have no idea how he can now decide that you now have severe apnea; short of another test. Is it possible that he confused you with your husband?

A person that has a AHI of 1, is that good if it lasts eight minutes? Jim

A person would wake up before eight minutes (or die) with a complete cessation of breathing! It didn't last that long! With that said, I don't think that they have a specific index to track the total amount of time spent not breathing (although the data are present to make that calculation).