Maiden post; do I need md follow up after a year?

papaart · Post by **papaart** » Fri Apr 24, 2009 7:40 pm

Hello!
I haven't missed a night of using my machine for over a year. I was diagnosed with sleep apnea and started using the CPAP mid March 2008. I sleep great! No Problems. Love the "LT". I did have one follow up visit with the sleep MD after about a month. All was good. I don't recall him saying I should get back with him at any particular time. I've just noticed a number of folks here have a "card reader". I did have to send my card into the provider just before my one month follow up with the MD (replacing it with a new one). I haven't given it a thought again until now. What do you use the card information for? If all is well (as it is) do I still need to see the sleep Dr for some reason? Hope you all have a nice weekend.
Art

ww · Post by ww » Fri Apr 24, 2009 7:45 pm

papaart wrote: Hello!
I haven't missed a night of using my machine for over a year. I was diagnosed with sleep apnea and started using the CPAP mid March 2008. I sleep great! No Problems. Love the "LT". I did have one follow up visit with the sleep MD after about a month. All was good. I don't recall him saying I should get back with him at any particular time. I've just noticed a number of folks here have a "card reader". I did have to send my card into the provider just before my one month follow up with the MD (replacing it with a new one). I haven't given it a thought again until now. What do you use the card information for? If all is well (as it is) do I still need to see the sleep Dr for some reason? Hope you all have a nice weekend.
Art

It is such a shame that they dispense the "plus" machines that give the Doctor absolutely zero information about your therapy!!! All he could tell from reading your card is that you were using the machine x hours each night. Buying a card reader and software will NOT help unless you also buy a machine that is fully data capable!!! The doctor will have to put you back through another sleep test to see if the prescription he gave you is still working.

papaart · Post by **papaart** » Fri Apr 24, 2009 7:49 pm

Eventhough my old symptoms (dead tired all the time, snoring etc) seem to be gone, I still should go in for another sleep study?
Would you say it might be a good idea to try another Dr?

BleepingBeauty · Post by **BleepingBeauty** » Fri Apr 24, 2009 7:50 pm

papaart wrote: Hello!
I haven't missed a night of using my machine for over a year. I was diagnosed with sleep apnea and started using the CPAP mid March 2008. I sleep great! No Problems. Love the "LT". I did have one follow up visit with the sleep MD after about a month. All was good. I don't recall him saying I should get back with him at any particular time. I've just noticed a number of folks here have a "card reader". I did have to send my card into the provider just before my one month follow up with the MD (replacing it with a new one). I haven't given it a thought again until now. What do you use the card information for? If all is well (as it is) do I still need to see the sleep Dr for some reason? Hope you all have a nice weekend.
Art

Hi, papaart.

We all love to hear success stories, so congrats on that!

If the machine you have in your profile is the one you're using, the only data that's recorded on your "smart card" is your compliance (or usage) hours. The provider downloaded that information before your follow-up visit with the doctor to prove that you're using the machine so that your insurance will pay for the equipment.

Card readers are used with data-capable machines (ones that record AHI, leak rate, etc.). Since you don't have data-capability with your machine, and you feel like you're sleeping well and aren't experiencing any fatigue during the day, I would say a follow-up visit would pretty much be a waste of your time and money. The doctor won't have any data to go by to see if your AHI is below 5.0, which is where it should be if the therapy is working optimally for you. S/he'd probably just tell you to keep doing what you're doing, since you're feeling good. (Caveat: I'm just another user with no medical background, so take my opinion from whence it comes.)

Glad things seem to be working out so well for you! If you have more questions, by all means, post them. Lots of help to be found here. Welcome aboard.

papaart · Post by **papaart** » Fri Apr 24, 2009 8:02 pm

Thank both of you, ww and Bleeping Beauty! I'll give this some thought. Who knows, possibly I could feel even better! After all, I still like a nap a few times a week.

BleepingBeauty · Post by **BleepingBeauty** » Fri Apr 24, 2009 9:26 pm

papaart wrote:Thank both of you, ww and Bleeping Beauty! I'll give this some thought. Who knows, possibly I could feel even better! After all, I still like a nap a few times a week.

Well, that might be a horse of a different color. If you still need to nap a few times a week, then chances are that your therapy is not working as well as it should. Napping is not a good idea and goes against the goal of good sleep hygiene. (Check this site for more info on that: http://www.uihealthcare.com/topics/medi ... index.html)

Another option, instead of going back in for another sleep study, is to see if your doctor or DME will let you do a one-week trial with an auto-titrating machine, which will increase or decrease pressure as you sleep to prevent or respond to breathing events. They may charge you a fee to "rent" one of these machines, but it would be a lot more cost-effective than having another in-lab sleep study. A machine like this will have a data card that records your breathing events, so the doctor will be able to see what's happening while you're asleep and maybe adjust the pressure on your machine at home to get you optimal therapy.

You haven't stated what your prescribed pressure is, but many of us find that the setting, when determined by a one-night sleep study (in a strange bed, with wires all over the place, being watched by a technician, and which doesn't begin to replicate how you're sleeping at home), is often inaccurate. So a re-titration might be in order, and one of these machines could do that for you at home, in the comfort of your own bed.

So you have a couple of options to consider. Hope that helps, and keep us posted.

Regards.

papaart · Post by **papaart** » Sat Apr 25, 2009 6:22 am

Good Morning!
Thanks again Beauty. I believe I will take you up on your advise. Although I do "like" a nap every now and then, many years ago, I "liked" a cigarette every now and then.
Art

BleepingBeauty · Post by **BleepingBeauty** » Sat Apr 25, 2009 8:52 am

papaart wrote:Good Morning!
Thanks again Beauty. I believe I will take you up on your advise. Although I do "like" a nap every now and then, many years ago, I "liked" a cigarette every now and then.
Art

Good point.

Let us know how you make out, Art.

GumbyCT · Post by **GumbyCT** » Sat Apr 25, 2009 9:56 am

Do your homework, do some research so you know your machines. Then either find one at a reasonable price on Craigslist or have your doc write a specific make and model on your prescription so you can get a machine which can supply the detailed data you need. It doesn't have to be your sleep doc to write the script.

Good Luck

yardbird · Post by **yardbird** » Sat Apr 25, 2009 10:33 am

I nap occasionally. I'm 56. I'm entitled!

seriously though.... come to think of it... I think I only really NEED a nap when I had a bad night with mask leaks or mouth breathing or something.

Sometimes though... I just like to lie there and listen to the birds singing or the rain on the roof or the wind in the trees. It's meditative... and relaxing so I doze off. Personally, I don't see this as a big deal. It's occasionally, not every day. If I needed nap every day I'd be concerned.

Besides... my sleep doc is a schmuck who gives no advice and shows no interest in anything other than compliance. I stopped going to him 8 years ago. I get more interest from my regular doctor. A genuinely caring physician who cares more about her patients' well being than how much she can get from the insurance companies.

So I guess my advice would be.... go by how you feel. If you feel great then this isn't an emergency. If you're ahving issues... and you'll KNOW when you're having issues because you'll feel crappy again... THEN it becomes a priority.

If you have the spare cash, you might consider getting a machine that records more data so you can have a look if you're curious and see how things are going. At that point you'll already know more than the doctor about how effective your therapy is. Otherwise.... wait about 4 more years and get a replacement machine on your insurance. Like I said, if you feel good.... this isn't an emergency.

papaart · Post by **papaart** » Sat Apr 25, 2009 6:24 pm

Well Yardbird, at 58, I think you're right, I'm entittled to a nap now and then. However, to be honest to myself, a review of the past few months would show a little to much "need" for the naps. I'll be studing up as suggested by GumbyCT (thanks). My general MD is a good doc and If he can write a script, which the insurance co would honor, I believe that's going to be the direction I'll be taking. (after doing my "homework")

Bonnie · Post by **Bonnie** » Sat Apr 25, 2009 7:06 pm

There is a difference between wanting to take a nap and having to take a nap. We had stormy weather all day so I hosed up crawled into bed with a book, read for a while and the dogs and I took a nap. It was either that or laundry, no brainer there.

I saw my sleep doc 2 months after the inital stuff and went armed with the data print outs from my card reader. He never looked at them, rushed me out after a few minutes not before telling me "you really need to lose weight". Since then anything I need I talk with my MD. She is caring, compassionate and made a point to improve her knowledge on OSA. If you have the opportunity to get a data capable machine you will have much more success with your treatment that having another sleep study. Once you learn to read and understand your data you'll be able to make changes to optimize your therapy.

Congratulations on the great results you've had so far.

SleepyNoMore · Post by **SleepyNoMore** » Sun Apr 26, 2009 1:22 am

I haven't seen a Sleep Doctor ever, my primary or should I say the Pysiciian Assistant gave me a referral for a sleep study, I got my machine and that was in August or Sept. of 2007!
With this forum helping me tweak everything to the "T", and using my Auto with a-flex, I don't feel the need to go back unless I feel I am having a major problem with my machine, my lungs, or a cold or something like that.
Whatever you decide, good luck!

deerslayer · Post by **deerslayer** » Sun Apr 26, 2009 7:37 am

Welcome to the forum Art....stick around these parts to become empowered with cpap knowledge...... how long do you sleep at night ? ... since i sleep 8hrs+ normally ,do not need a nap unless i have done some really physical activity to get dogged tired

papaart · Post by **papaart** » Sun Apr 26, 2009 10:05 am

Hi Deerslayer,
During the week, I sleep an average of 7 to 7.5 hours. On the week end, 8 to 8.5.
This has always been my sleep averages. See you all later! Out for a day of frolicking with my wife at a big garden expo

Maiden post; do I need md follow up after a year?

Maiden post; do I need md follow up after a year?

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Additional Comments: straight cpap 12.20 AHI avg.0.79