Tips for getting a doctor to take me seriously

[clarkgarg85]

So I show almost all symptoms of sleep apnea, and went to the doctor's about it a week or so ago, and just got given nasal spray to try for a month.. so far it's done nothing.

I've heard a lot of people who's doctors don't take you seriously about it and I'm worried that will happen to me too. Does anyone have any tips on how to get them to take you seriously?

Also - are there specific tests that I should ask for them to do incase there are other sleep related issues going on?

[LSAT]

Overnight Sleep Study is the only way to know for sure what sleep problems you have.

[Julie]

Have you been tested recently for e.g. thyroid problems, diabetes, any one of a slew of things that could cause sleepiness?

Have you looked into a new doctor?

[greatunclebill]

If your doctor doesn't agree with your self diagnosis and treatment plan, it does not mean he doesn't take you seriously. If you have a problem with any doctor, you need to find another doctor.

[Chris8243]

Did you say “I’d like to have a sleep study.”

And then did the doc say “No.”

There’s got to be more to this story.

[Grumpy48]

I have a doctor like that. For several years at routine checkups I would tell him of being very tired during the day and issues sleeping at night. He kept suggesting things that would supposedly help me 'sleep' better thinking it was insomnia or similar, but none of it helped. I was suspicious of apneas occurring at night and had read that during an apnea event ones blood oxygen levels dropped. I found a device I could wear at night to monitor O2 saturation and heart rate (Wellue O2Ring). The first couple of nights wearing it and looking at the results pretty much pegged the fact I was having apnea events. I took the results to my doctor and he scheduled up a sleep study of which I was diagnosed with severe sleep apnea. Now on CPAP and my nightly O2 levels are where they should be.

Fill out this questionnaire and if the numbers lean on the side of apnea symptoms print it and take it to the doc.
http://www.stopbang.ca/osa/screening.php

The readings and graph below are what I was looking like on one of the first few nights of monitoring O2 saturation.

[Julie]

That Stopbang thing is SOO out of date! Snoring is NOT a 'given' for apnea at all, neither is age, weight, gender or neck size.

There IS a test called the Epworth Scale (or close to that) which you could Google and take to get a real, if limited test.

[Grumpy48]

That Stopbang thing is SOO out of date! Snoring is NOT a 'given' for apnea at all, neither is age, weight, gender or neck size.

There IS a test called the Epworth Scale (or close to that) which you could Google and take to get a real, if limited test.

You are correct. I did a quick search for sleep/apnea questionnaire and the StopBang was the one that came up and I didn't look further. The questionnaire from my hospitals sleep lab (which I couldn't find readily) is more in line with the Epworth Scale evaluation.
https://www.harringtonhospital.org/wp-c ... naire-.pdf

[Julie]

That's a terrific one - more extensive than the Epworth!

[SleepGeek]

The questionnaire from my hospitals sleep lab (which I couldn't find readily) is more in line with the Epworth Scale evaluation.

I'm pretty sure that any certified sleep center would use the Epworth Scale.

Also - are there specific tests that I should ask for them to do incase there are other sleep related issues going on?

Find a certified sleep center then Ask your doctor for a Polysomnogram. IME if/when the doc doesn't order it properly the lab will coach them with what is needed. You will want a split night study - but the doc has to order it or the lab will have you come back for another nite. While some insurance will cover an at home Polysomnogram others may not. Call your insurance before you talk with your doc so you know.

[Julie]

Won't necessarily need a split (2) night study depending on how the first one goes... it's the lab's (and doctor's) call.

[SleepGeek]

Won't necessarily need a split (2) night study depending on how the first one goes... it's the lab's (and doctor's) call.

Unless things are different where you are in Canada the dx portion will determine if you get the titration portion, the point is it must be ordered by the doc.

"Patients with a respiratory disturbance index (RDI) higher than 40 during the first 2 hours of diagnostic PSG should undergo a split-night PSG study. The final portion of the study is used for titrating the continuous positive airway pressure (CPAP) device. Split-night studies may be considered for patients with an RDI of 20-40, as based on clinical observations (eg, prolonged obstructive events, marked oxygen desaturation). A minimum of 3 hours of sleep is preferred to adequately titrate the CPAP device after this treatment is started.

https://www.medscape.com/answers/295807 ... -apnea-osa"

[Miss Emerita]

You might try using a recording oximeter, as others have suggested, though you may have apnea without showing any significant desats. (I was diagnosed with moderate apnea even though my O-sats never dropped below 90 and were mostly around 94-96.)

Do you have a bed partner who has observed you stopping breathing off and on during the night? That is good evidence.

I think doctors listen better when you are specific about subjective symptoms (meaning symptoms they can't observe for themselves). For example: I need a nap every day; I nod out when I'm driving/working/reading; I can't sustain a train of thought, which is affecting my ability to do my work; my mood is unusually gloomy; I struggle to find the word for something; I'm unusually irritable, and my friends have noticed; I feel no energy during the day.

But there are some doctors who for some reason don't want to explore the possibility of a sleep disorder. This may be especially true when the patient doesn't fit the stereotype (= older, male, overweight). If that turns out to be your doctor, I agree with others that you need to find a doctor who is a better listener and diagnostician.

[zonker]

Do you have a bed partner who has observed you stopping breathing off and on during the night? That is good evidence.

could this become a new pickup line?

"say, baby, how'd you like to come home with me and see if i stop breathing during the night?"

[chunkyfrog]

Start nagging the doctor for a sleep test.
Be a pest.
But be a nice pest.
Present the doc with written results of the Epworth, or the better one.
If he is still hesitant, ask for a recommendation for a COMPETENT physician.

***Zonker, that's tooooo funny!