The elusive "sleep doctor"

darthlucy · Post by **darthlucy** » Fri Jun 08, 2007 9:42 pm

Is it unusual that I haven't met with any sleep doctor during my OSA evaluation? My primary doc scheduled the sleep study, I only saw the tech at the study. The sleep doc sent the report to my doc with the OSA diagnosis, then I scheduled the titration. Same thing with this study, tech only, no doc. Now they're going to mail the report and Rx, so I assume no meeting now, either. Should I care? Is there any value to meeting this person, or is the report/Rx all I really need from him/her (not even sure which!)? Has anyone else had this type of experience?

kavanaugh1950 · Post by **kavanaugh1950** » Fri Jun 08, 2007 10:32 pm

I never saw mine either. Since I don't have any other respiratory problems other than sleep apnea I don't miss him. Saves me another co-pay. pat

blarg · Post by **blarg** » Sat Jun 09, 2007 5:13 am

I talked with mine, but it was because my GP is my father, so there's a bit of a question about bias, especially if he decided to Rx me sleeping pills or something.

So yeah, I was referred to the sleep doc who listened to me, recommended a study, and here I am.

Hurricane · Post by **Hurricane** » Sat Jun 09, 2007 6:41 am

I was told at my sleep study that I had severe apnea and was told That it was probably the cause of me having an irregular heartbeat, which I had corrected with cardio Version so Being I didn't want to go thru the electric paddle treatment again, I asked after the sleep study how long would I have to wait before I received my machine, they told me about 4 weeks, because the Dr at the hospital would read it, sent copies to my Dr, and cardioligist, so after5 weeks I received my machine, so much for urgency huh?
Ed

jabberwock · Post by **jabberwock** » Sat Jun 09, 2007 7:14 am

I met with the sleepdoc about 5 weeks after my original study in 2003, did the titration study, had the Rx sent to a DME, and haven't seen him since. I finally asked my GP for copies of my sleep studies a couple of weeks ago, and have since scheduled an appt with the sleepdoc. I am going to see him, whether he wants to see me or not

If I were you, I would ask to see my GP after he/she receives the sleep study report, and go over the results with him/her. If you feel you want more info/explanation than your GP can provide, I would ask to see the sleepdoc.

Bonnie

RosemaryB · Post by **RosemaryB** » Sat Jun 09, 2007 7:39 am

I think that the sleep docs often just read the studies and write reports, kind of like they do when I have an MRI or mammogram. I wasn't impressed with the report the sleep doc wrote. I think he wrote it in his sleep! Sloppy report writing, IMO.

However, if I could find a really good sleep doc, I'd set up an appointment.

snoregirl · Post by **snoregirl** » Sat Jun 09, 2007 7:46 am

Rosemary,

I think you said it best.

Never saw the sleep doc, wrote a canned report that any monkey could have written with a bunch of stuff that doesn't even apply to me (don't drink as it could exaccerbate the condition etc...)

Large waste of money paid to this "sleep doc". I will avoid any sleep studies or other uses of a sleep doc in the future. I have my auto cpap and backup machine andn I feel great.

RosemaryB · Post by **RosemaryB** » Sat Jun 09, 2007 8:19 am

snoregirl wrote:Never saw the sleep doc, wrote a canned report that any monkey could have written with a bunch of stuff that doesn't even apply to me (don't drink as it could exaccerbate the condition etc...)

Yes, a top recommendation was to lose weight. My weight, stated right on the report, was smack dab in the middle of average BMI. So maybe I need to become aneorexic?

They also had my age wrong, making me older.

So, tell me I'm older and need to lose weight. . . When I'm already sleep deprived and crabby. Now you've got me riled and are playing with fire

There were other inaccuracies, too.

tillymarigold · Post by **tillymarigold** » Sat Jun 09, 2007 8:20 am

The labs here require you meet with a sleep doctor before they schedule a sleep study. The tech told me that this way, about 90% of the people they suspect have a sleep disorder and refer for studies, actually do.

darthlucy · Post by **darthlucy** » Sat Jun 09, 2007 8:56 am

Thanks for all the replies. I guess my scenario isn't at all unique, and since my OSA is relatively mild, I won't be concerned. The funny thing is that while they did send the report to my primary doc, and she reviewed it with me (and gave me a copy), I was the first patient she had ever even referred for a sleep study. With the research I've done here and elsewhere, I was actually explaining the report to her! Guess there's no pressing need for me to see the sleep doc! Time better spent elsewhere...like sleeping!

Slinky · Post by **Slinky** » Sat Jun 09, 2007 9:10 am

If ever there was an explanation of what is wrong w/the sleep profession - here's the proof!!! The sleep "doctor" never sees the patient, relies on information gleaned by machine and technician; makes a life or death Dx and writes the order WHICH is sent to the family or referring doctor who has little to most likely NO experience w/sleep apnea and other sleep disorders.

Then the patient is sent to a local DME supplier. A profession or industry if you will that has a VERY POOR record for service, information or assistance to the patient.

Most likely the patient is given a bare bones, compliance data only CPAP at an inflated cost and NO ONE has the ABILITY "or" the INTEREST to monitor that patient's response to therapy.

THIS thread would be an excellent thread for BrianRT to read and address in his book!!!!!!

christinequilts · Post by **christinequilts** » Sat Jun 09, 2007 9:10 am

In my experience, yes, its unusual to not be seen by the sleep doctor. It sounds like there are two types of sleep labs out there- 'drive through' & 'full service'. To bad there isn't an easy way to judge ahead of time, like with restaurants

The sleep lab I use and other family members use, you are evaluated by the sleep doctor before any sleep studies are ordered. Sometimes other things need to be addressed first or other test need to be order, like thyroid testing or such. My medical issues are more complex, so a full nights sleep study was ordered; in comparison, my Mom had more clear cut OSA, so a split night was ordered by the same sleep doc (though in the end, hers ended up being two separate studies because she didn't have enough events early on). My results were even more unusual then expected, so I another visit with sleep doctor before my titration, but it still only took 10 days between studies. Mom's results were given to here over the phone by the Nurse Practitioner and her titration was scheduled.

Reports were far from being canned, and in fact when Mom was seen by the NP to review her titration results and receive copies of both her studies for her to keep, they accidentally had printed the draft copy of her first study, which was different then the doctors final report. Yes, we have a sleep doctor who actually reviews all the raw data himself and will rescore events, using his years of clinical expertise instead of relying on a scoring techs judgment completely. And no, her AHI wasn't tweaked to be DXed with OSA, it actually went down, putting her in the 5-10 AHI range, which can make it more difficult to get xPAP covered in some cases.

My PCP is only involved in that he made the referral and receives the progress reports from the sleep doctor following every visit. Sleep doctor took over scripting any sleep related medications or treatments, just as any other specialist would. In my Mom's case, she needs to have her iron levels monitored, so that is coordinated with her PCP ordering her yearly blood work. There was no pressure to use their attached DME either, before the first study you were provided a fairly comprehensive list of area DME providers so that you could contact your insurance to see which were covered or identify a different one, if need be. At your study, you let them know which DME you wanted the order sent to, if xPAP was indicated, so there was no confusion later. There DME staff was willing to help anyway they could, even if you were not going to be using them personally. At my sleep doctors request, they lent me a BiPAP ST for a free one months trial to see if it helped, since my titration study had showed less then clear results. It was an older model, but since one months rent on a BiPAP ST is over $600, I wasn't complaining in the least. They were involved with my doctor and my chosen DME, when my insurance provided VPAP II STA didn't work as well for me as other brands to arrange a trial on a Respironics Synchrony BiPAP ST.

I would be pretty frustrated if I had been sent to a 'drive through' sleep lab too. I know friends and family members in other areas of the country have been, and the number of them who have not followed through on their therapy is alarming. Drive through is good for a quick meal, but not sleep medicine.

Guest · Post by **Guest** » Sat Jun 09, 2007 10:40 am

Is your report and prescription being sent to you, to your primary doctor or is it being sent directly to their DME, so that you cannot choose your own DME? Ask.

darthlucy · Post by **darthlucy** » Sat Jun 09, 2007 10:42 am

After some back and forth (posted under the thread Why Must Everything Take So Long?), it is going to be sent to me. I have this board to thank for that knowledge!

sybert1ger · Post by **sybert1ger** » Sat Jun 09, 2007 11:31 am

While my meetings with my sleep doctor have bee fairly short and to the point I do feel he's contributing a lot. I've been on CPAP for 6 months. My AHI is under 22 but I still feel tired all the time. I told him this. He told me a few things to try and scheduled another sleep study to see if they missed anything the first time.

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