Finding Sleep Docs who are more than number readers

[victormiller]

I've been struggling with sleep problems my whole life. Starting in 1994, after hearing about sleep apnea, I started on a long, but fruitless struggle to try to do something about it. I've had 5 in hospital sleep tests, 3 at home sleep tests, 3 CPAP machine, 8 different masks and a dental device. When I hear talk about refreshing sleep I think of it as a cruel joke -- I've *never* had that in my whole life. But lately, for about the past 4 months, it's much worse -- sleep is *anti-refreshing* -- that is I'll go to sleep feeling slightly sleepy, and wake up after 8 hours feeling completely wiped out -- much worse than when I went to sleep. It takes me 2 or 3 hours after I'm up (aided by coffee) to finally feel reasonably decent. It gets gradually better during the day, until I go to sleep again, etc.

My experience with sleep doctors is that they're just number readers from your polysomnogram. They prescribe a setting on you PAP, and then let you go. If you have difficulty with it, or it's not working they implicitly blame the patient. For the past 8 months I've been using a dental device, after an examination by Dr. Stephen Park who found that when I stuck out my jaw that my airway opened up. I've had no problem getting used to it, and it seemed to be having some positive effect (sleep still not refreshing, but not as unrefreshing), and having two two in home tests from my dental specialist that made it showed that I had an AHI of 2.7 with it. I've tried going back a few times to my Auto BIpap, but in each case I wake up after 3 hours, and can't get back to sleep with it. Looking at the output of the machine shows that I have zero Obstructive Apneas, but an AHI of about 9 with almost all of them clear airway (central?) apneas, which start after about 2 hours, and minimal leaks. During the 1 1/2 years (most recently) I was using it every night, I would sleep through the night, but would feel really lousy in the morning. The first few months of using it, the machine reported an AHI of about 4, but then it started getting gradually worse, so that when I stopped using it in favor of the dental device, my AHI was up to 13, with almost all of the central apneas. My sleep doc tried fiddling with the pressure but it didn't help. When I said how tired I still felt, he sort of washed his hands of it and suggested that I use Nuvigil (which is a big cop-out in my opinion), which didn't do much more than a few cups of coffee.

So is it possible to find sleep docs that are more than automatons?

[Wonderbeastlett]

Just curious have you tried doing hybrid therapy? Using your dental device AND cpap together? I'm pretty new to OSA. Only been going at it for 1 month but I've read a few threads saying a hybrid therapy worked better for them.

Honestly my doctor had nothing to do with my study or results. All she did was sign the Rx and that's it! So she wasn't super helpful to me at all!

[victormiller]

I did try using my dental device and cpap at the same time, but I found that I would have difficulty falling asleep, and when I did, I would awaken after an hour or two. So after a number of tries, I gave up on that.

[Pugsy]

Looking at the output of the machine shows that I have zero Obstructive Apneas, but an AHI of about 9 with almost all of them clear airway (central?) apneas, which start after about 2 hours, and minimal leaks.

Could you please post a recent image of your report showing the centrals please? Typical report...not a really bad night nor a really good night.

[Megs]

Dentists and Doctors are profit motivated beyond all else. They want you in and out of their office in a few minutes.

You cant treat someone with a cold like that, much less something as complex as apnea.

I suspect you can learn more on this board than anywhere else.