Sleep specialist

[Josiah]

How important is it to seek out the best sleep specialist in the vicinity? Unlike many I've been quite satisfied with my healthcare in the VA system, but there I have little choice as to who would treat my SA. I'm in a position to seek a private specialists if I felt that that would significantly improve my success in dealing with my problem. Any advice?

[USMCVet]

I go to VA as well and used choice program to get my sleep study. I just got my results today in fact.
I'm usually good judge of character in general and honestly unless VA covers it I would seek help her first before paying on your own.
If you're like me you have to stay on top of your medical issues with VA and even then you will miss stuff that you won't find out about until later.
That said I would give this place a try before paying out of pocket for a specialist who won't give you same attention to detail I think this place will.

[TedVPAP]

How important is it to seek out the best sleep specialist in the vicinity? Unlike many I've been quite satisfied with my healthcare in the VA system, but there I have little choice as to who would treat my SA. I'm in a position to seek a private specialists if I felt that that would significantly improve my success in dealing with my problem. Any advice?

You are responsible for your health. The medical community is a resource to help you. Use the resource; escalating as necessary.

[USMCVet]

How important is it to seek out the best sleep specialist in the vicinity? Unlike many I've been quite satisfied with my healthcare in the VA system, but there I have little choice as to who would treat my SA. I'm in a position to seek a private specialists if I felt that that would significantly improve my success in dealing with my problem. Any advice?

You are responsible for your health. The medical community is a resource to help you. Use the resource; escalating as necessary.

Great post, it would be helpful to know what issues the OP faces .

[kteague]

It may be that you you have a standard case of OSA and will have little trouble adjusting to treatment. If so, any doctor can take the report recommendations and write a prescription. Going outside the VA system doesn't guarantee a doctor can or will do anything that one within the VA system won't do. My thought is to keep it simple unless there's a demonstrated need to do otherwise. However, another consideration is time. Inquire about the wait time for testing, for results, and for equipment with both in and out of system scenarios. And try to find out which machine gets dispensed through the VA. Some investments are worth the extra cost, others may be a waste of money. A few inquiries could make your decision clear.

[Sheriff Buford]

I don't know anything about the VA, but I have never seen a sleep doctor. There are a lot of folks here that haven't either. My doctor writes my scripts and I have educated and manage my treatment thru this site. I understand this may not work for everybody and some folks with heavy duty issues may need to see a sleep doctor. But for me, I had straight up sleep apnea and I have managed very well on my own.

Sheriff

[Julie]

Having a sleep MD is relative to most here because Sleepyhead software (that works with most, but not all machines) gives such comprehensive info on every night's sleep (or wkly) that you become your own MD - with the help of people here - except for particular needs (or fulfilling VA regs). As was said, many of us never see one at all unless we need a script or something.

[Josiah]

Thanks for all the useful suggestions. My situation is that I haven't undergone the sleep study (scheduled in mid January @ VA) but I did monitor my O2 saturation with a recording oximeter and the results indicated a severe case of SA (67 desaturation events during 6 hours of sleep avg duration 35 sec). So I know I have a problem. Keeping up with this forum promises to have me well prepared to face the challenges (I'm 83) that SA therapy will demand.

[Cardsfan]

My PCP diagnosed me with a basic at home study. I supposed I am a lucky one that was easily treated. I learned a lot here, and after a year, saw a sleep specialist. The specialist said I was doing fine and to come back in one year. That was 2 yrs ago. I would go back to the specialist if I though something was wrong that the good people here couldn't help me with. My PCP , grateful for this, did send me for the sleep test after I told him I snored. But the only follow up question (at 6 months into it) was "do you use your machine?" I said yes, and that was it. He was happy with that, but didn't ask to see the data. After that was when I figured I better check in with an Official sleep Dr. who I though should actually look at my data. I think it is good if you are established with one, but I don't go unless there is a problem. If you are an established pt., I think they can get you in sooner if needed.

[Julie]

How low were the desats?

[ChicagoGranny]

How important is it to seek out the best sleep specialist in the vicinity?

Do you suspect you have plain obstructive sleep apnea (OSA)? Or do you think you have some other sleep issues? (The great majority have simple OSA.) If you have a simple case, you just need a study with a positive diagnosis and a prescription for an auto CPAP machine that is data capable. Any decent sleep doc should be able to do this. We will advise you not to take delivery of a CPAP machine until you are 100% certain the supplier is providing a data-capable APAP.

I did monitor my O2 saturation with a recording oximeter and the results indicated a severe case of SA (67 desaturation events during 6 hours of sleep avg duration 35 sec)

Try to avoid backsleeping until you get your CPAP. OSA is often more severe on the back because gravity is pulling the soft palate and tongue directly into the airway. On you sides or stomach, the effect of gravity is reduced, and OSA may not be as severe.

[Josiah]

How low were the desats?

My lowest was 85 and my average was 88. when breathing properly my average is 92 ... a number I'd love to raise. I confess I don't know how consequential 88 or 85 is.

[Okie bipap]

At your age (83), I would assume you are on Medicare. If you are retired military, you should also have Tricare For Life. I use Medicare and Tricare For Life and never use the VA. Since retiring from the military, I have the VA only for one knee surgery, and hearing aids for several years. Medicare and Tricare have covered all four sleep studies I had, paid for my equipment and doctor visits with no out of pocket expenses. I have found that dealing with Medicare and Tricare is less of a hassle than dealing with the VA. Our local VA hospital has not been very good in the past, but they are working on getting better.

[Josiah]

How important is it to seek out the best sleep specialist in the vicinity?

Do you suspect you have plain obstructive sleep apnea (OSA)? Or do you think you have some other sleep issues? (The great majority have simple OSA.) If you have a simple case, you just need a study with a positive diagnosis and a prescription for an auto CPAP machine that is data capable. Any decent sleep doc should be able to do this. We will advise you not to take delivery of a CPAP machine until you are 100% certain the supplier is providing a data-capable APAP.

I'm not aware how much I snore (I sleep alone but that's no excuse for not finding out) my desaturation/arousal sequences seldom wake me up entirely. So in theory I might have Central SA.

I did monitor my O2 saturation with a recording oximeter and the results indicated a severe case of SA (67 desaturation events during 6 hours of sleep avg duration 35 sec)

Try to avoid backsleeping until you get your CPAP. OSA is often more severe on the back because gravity is pulling the soft palate and tongue directly into the airway. On you sides or stomach, the effect of gravity is reduced, and OSA may not be as severe.

I'm entirely a side sleeper but alas I'm almost entirely a mouth breather when I sleep. Sorry I haven't got responding to several quotes down properly.

[Julie]

Hi, the desats aren't terrible (could be lots worse) and many consider 88 to be borderline... I was just trying to get a pic of what's what.