Doctor will likely not diagnose me with OSA based on 1 study

[awaiken]

preface:my last 4 years of cpap results https://i.imgur.com/uOZCmPa.png


I called my doctor's office to get a doctor's note for work related to sleep apnea and the staff member said they looked at my charts on my sleep study last friday and that i have a "mild to none" case of sleep apnea. I was stunned as I was diagnosed with it in 2011, and it has triggered parasomnia episodes from frontal lobe seizures to sleep walking or waking up in a total confused state in the middle of the night. We initially assumed the seizures was epileptic but the neurologist picked up on zero abnormal brain activity or anything closely resembling a sufferer of epilepsy.. that study was done over the course of several days.

I still haven't seen the doctor to review the sleep study results, but his staff member said they couldn't draft a letter for me because my results were so mild.

So I am anticipating that he will say I have no problem, or refuse to acknowledge a relationship between the two problems (parasomnias and sleep apnea)..

If he determines I don't have OSA, how will he explain the fact that i have 100% textbook abnormal breathing/irregular snoring when I am sleeping? my family has witnessed me have approx 10 seconds of no breathing at all, turning purple according to them... I can't professionally diagnose myself obviously, but my family has witnessed all the textbook symptoms of OSA. I've suffered from memory loss and cognitive issues for sure from this.

How is one evening of a sleep study sufficient enough to paint a picture of how I perform when I'm sleeping?

I was not CPAP compliant for a long time because the mask was horrible and i'm sure that made things worse, the discomfort waking me up often at night pretty often.... After a seizure I had 3 weeks ago, I have been compliant with an amazing new mask I have...very comfortable and unobtrusive.

What should I do? What should I tell my doctor if he says I have no problem? Will he take me at my word that I"ve had severe parasomnia episodes even though it wasn't observed in a single sleep study?

[kteague]

Without knowing the results of the study it is hard to give much feedback. I would suggest you get a copy of the detailed report that includes things like sleep positions, sleep stages, etc. It's usually a few pages. Once you get it, go from there. It may be what the data turns out to show is not exactly the same as the tech's general impression. Your concerns may be self resolving. If it ends up your test is non diagnostic for sleep apnea, look at a few things in the report.
Sleep time - Were they able to capture a significant amount of time in sleep?
Sleep stages - Was there deep sleep and REM?
Sleep position - Was there time spent supine while in REM?
When my tests did not capture adequate info, my doc would state in the report that the study was technically suboptimal. In other words, the results may not be definitive. If you still have concerns after getting your report, feel free to post your study (minus personal identifiers) and see if anyone picks up on anything. I wouldn't give it too much of your energy just yet, as there are too many unknowns. It would really unusual for someone to go from diagnostic to non diagnostic on a study without something having changed. Let us know how this turns out.

[awaiken]

Without knowing the results of the study it is hard to give much feedback. I would suggest you get a copy of the detailed report that includes things like sleep positions, sleep stages, etc. It's usually a few pages. Once you get it, go from there. It may be what the data turns out to show is not exactly the same as the tech's general impression. Your concerns may be self resolving. If it ends up your test is non diagnostic for sleep apnea, look at a few things in the report.
Sleep time - Were they able to capture a significant amount of time in sleep?
Sleep stages - Was there deep sleep and REM?
Sleep position - Was there time spent supine while in REM?
When my tests did not capture adequate info, my doc would state in the report that the study was technically suboptimal. In other words, the results may not be definitive. If you still have concerns after getting your report, feel free to post your study (minus personal identifiers) and see if anyone picks up on anything. I wouldn't give it too much of your energy just yet, as there are too many unknowns. It would really unusual for someone to go from diagnostic to non diagnostic on a study without something having changed. Let us know how this turns out.

Thanks I appreciate that. What would happen for a doctor to decide if a test was suboptimal or not? What would be an optimal test? I can call on Tuesday and have the results of the last study emailed to me, so I'm looking forward to that.

[kteague]

Look at the three things I mentioned in italics. You need enough sleep in the different sleep stages and sleep positions to capture what is considered a "worst case scenario". Discussions on this stuff can be endless, which is why I suggested getting results before trying to sort through all the "what if" possibilities. I know, waiting is the hardest thing. I tend to rehearse every possibility too. Can't tell you how much time and energy I've invested in researching and trying to understand things that turned out to not even be an issue in my case. Trying to do better about that and rein in my busy mind. Once you have some hard data, you'll be better able to channel your efforts in ways that can actually help your situation.

Parasomnias are interesting. Sleep deprivation or sleep disorders with their effects can blur the lines. Addressing known issues, which is what you are working towards now, should give you a clearer picture of what parasomnias remain and any significance. If it turns out that getting to a better place with your sleep and daytime symptoms is a process of elimination for you, try to not be discouraged. You're going in the right direction. I look forward to you getting your study results.

[awaiken]

Look at the three things I mentioned in italics. You need enough sleep in the different sleep stages and sleep positions to capture what is considered a "worst case scenario". Discussions on this stuff can be endless, which is why I suggested getting results before trying to sort through all the "what if" possibilities. I know, waiting is the hardest thing. I tend to rehearse every possibility too. Can't tell you how much time and energy I've invested in researching and trying to understand things that turned out to not even be an issue in my case. Trying to do better about that and rein in my busy mind. Once you have some hard data, you'll be better able to channel your efforts in ways that can actually help your situation.

Parasomnias are interesting. Sleep deprivation or sleep disorders with their effects can blur the lines. Addressing known issues, which is what you are working towards now, should give you a clearer picture of what parasomnias remain and any significance. If it turns out that getting to a better place with your sleep and daytime symptoms is a process of elimination for you, try to not be discouraged. You're going in the right direction. I look forward to you getting your study results.

thank you for being so incredibly helpful once again. i'll keep you posted..

[ButtermilkBuoy]

I would suggest you get a copy of the detailed report that includes things like sleep positions, sleep stages, etc. It's usually a few pages.

Don't ask for the detailed report. Ask for the sleep study summary, and like kteague says, it should be enough for a positive diagnosis. It's usually one or two pages and will include the things she mentions.

[kteague]

I would suggest you get a copy of the detailed report that includes things like sleep positions, sleep stages, etc. It's usually a few pages.

Don't ask for the detailed report. Ask for the sleep study summary, and like kteague says, it should be enough for a positive diagnosis. It's usually one or two pages and will include the things she mentions.

Hey ButtermilkBuoy, I'm glad you brought this up. Are you in the sleep industry? I am not. I have often wondered what is the exact terminology one should use when requesting reports. One time my referring doctor got a summary letter and one attached page with just a skeleton of data. I thought that was a summary report. I would like to know so when I tell people they should get more detailed info than the page my doc received, I'm using terminology that actually has a defined meaning. Any input from our sleep professionals out there?

[awaiken]

I have the results, please see the pdf. any feedback would be highly appreciated

https://dl.dropboxusercontent.com/u/485 ... esults.pdf

[Julie]

Are you still taking the same meds (Provigil, etc.)? They could certainly affect your sleep if so... and stay off your back!

[awaiken]

Are you still taking the same meds (Provigil, etc.)? They could certainly affect your sleep if so... and stay off your back!

sometimes, these problems were happening way before Provigil though

[awaiken]

making sure this still works, prior clicks says thread deleted??

[ButtermilkBuoy]

an amazing new mask I have...very comfortable and unobtrusive.

When asking for help here, it is de rigueur to go to the User Control Panel and fill out your equipment profile.

[ButtermilkBuoy]

stay off your back!

This is rarely necessary.

Also, it's neither correct nor nice to shout this at newbies struggling with sleep problems and CPAP therapy.

[awaiken]

stay off your back!

This is rarely necessary.

Also, it's neither correct nor nice to shout this at newbies struggling with sleep problems and CPAP therapy.

I appreciate that, but unfortunately in my case, sleeping on my back complicates is a culprit of my condition so i have to stay on my side

[Midnight Strangler]

Yours is an interesting case (Never what you want to hear.), and I hope you soon get relief.

sleeping on my back complicates is a culprit of my condition so i have to stay on my sid

Just curious about what condition that is?