I'm changing sleep doctors

[Mammal]

From the knowledge that I've gained on this forum, I have decided to change sleep specialists. What I have wanted for some time is a sleep specialist who is prepared to work with me, reviewing my results, looking at my graphs, from my software. My current one doesn't seem to want to do that. His attitude seems to be:

1. Is your AHI under 5? Yes, (I'm averaging 2.2),
2. Do you feel better? Yes,

then I'll see you in 12 months time !

I think the reason for his attitude is that he is basically a sole practitioner, and just doesn't have the time to go the extra mile. Having previously run my own business for 15 years, I can relate to that, but it doesn't do me any favours, as its my health that I'm talking about. What really pissed me off, was what happended at my 3 monthly review, 1 month ago. The appointment was supposed to be for half an hour. It started 10 mins late. Thats no big deal, however after 20 mins I heard a buzzer go off, and his demeanour changed and he couldn't get me out of there quick enough, and I still had unanswered questions to be addressed. So I have searched the net and I found a clinic in Melbourne that:

1. Specializes in sleep disorders,
2. Has a number of sleep specialists, not just one.

I rang them up and asked them if they are prepared to work with me, reviewing my results, etc, and they said they will. So I made a appointment for Nov 23.

[FoxNewsFan]

I thought ResScan 3.7 was for the S8?

You want 3.11

Ed

[LSAT]

I'm curious...You've got an S9 Autoset which gives you your data...your AHI is 2.3...You say you feel better....
WHY THE HELL DO YOU NEED A SLEEP DOCTOR???

[DoriC]

Ditto! Sounds like you're doing fine and almost any question you have can be answered here. It's been 2 years and we saw a "sleep specialist" once for a 1 month followup. I was not impressed. Good luck.

[Mammal]

I'm actually using Rescan 3.10, but it doesn't appear in the drop down menu of the equipment profile.

Should I just accept an average of 2.2? Mind you some nites I have 3's and 4's, which I think is due to back sleeping. I have actually ordered a positional shirt online today, to try and help with that.

There are just some issues I would like a second opinion on, such as central apneas, pressures, length of apneas etc. I also wake up with my eyes somewhat bloodshot every morning, so I would like some advice on that.

Its going to cost me $100 out of pocket for the session, so cost doesn't unduly concern me.

[elena88]

well, I do understand you are new at this, and although things are going well, you still have some questions, and plus

wont it be nice to have a doc in your pocket if things go south in the future?

If it only cost me a hundred bucks, I probably would have gone in for that second opinion my sleep doctor wanted me to have..

[Mammal]

Yes Elena, it will be good to strike up a rapport for the future, not just for me, but for the many other people that I know, who I suspect have sleep apnea, and don't even realise it.

[The Guest]

While I believe the doc should answer all your questions I must say I agree with him. An AHI under 5 is normal, especially if you are not having symptoms. If you are getting 8 hours of sleep then the bloodshot eyes might likely be due to a mask leak blowing into your eyes. This can happen when you change positions. If it is not too uncomfortable perhaps try tightening the upper part of the mask just a bit and see if that helps.

[Laurie1041]

I'm curious...You've got an S9 Autoset which gives you your data...your AHI is 2.3...You say you feel better....
WHY THE HELL DO YOU NEED A SLEEP DOCTOR???

I'll tell you straight up why the hell I need a sleep doctor. Because he or she is the one who prescribed treatment and has the fiduciary responsibility to monitor me for any signs or symptoms of possible ineffective treatment and side effects, regardless of what those numbers say on the "smart cards" or how well I feel. Does a diabetic stop going to see his or her doctor just because their blood glucose levels are in range? Absolutely not! Quite clearly, in any chronic disorder, proper monitoring is on-going.

This forum provides an extensive amount of information and there are some very knowledgeable people on it. Having said that, no one on this forum has any business posing the question, "Why the hell do you need a sleep doctor"? To answer your question, I see my sleep doctor as he recommends because I trust his expertise more than I trust my smart card. There is a saying in nursing, "Check the Patient before you Check the Monitors". There is no substitute for a good rapport between patient and doctor. If one does not like their sleep doctor, I highly encourage you to find one who is genuinely interested and motivated in assisting you a attain wellness. L

[jonquiljo]

An AHI under 5 is normal, especially if you are not having symptoms.

The OP said he was feeling better not that he wasn't having symptoms. An AHI under 5.0 is not normal if it is causing you to not feel well. Good for the OP finding someone that possibly can help him!

These practitioners that want to see you and send you on your way without a moment's look at what is going on with you are what's wrong with medicine today. "vote with your feet" someone recently said - and I agree. Go to the specialists that will help you and let the lousy ones take out ads in the yellow pages.

[The Guest]

An AHI under 5 is normal, especially if you are not having symptoms.

The OP said he was feeling better not that he wasn't having symptoms. An AHI under 5.0 is not normal if it is causing you to not feel well. Good for the OP finding someone that possibly can help him!

These practitioners that want to see you and send you on your way without a moment's look at what is going on with you are what's wrong with medicine today. "vote with your feet" someone recently said - and I agree. Go to the specialists that will help you and let the lousy ones take out ads in the yellow pages.

You're right, he did say that he is feeling better, not that he is asymptomatic. Thanks for pointing that out to me as I read it too quickly. That being said, AHI points to sleep related breathing disorders such as sleep apnea. If someone consistently has an AHI lower than 5 but still feels tired during the day then the cause is likely not sleep disordered breathing, but one of the over 80 other possible sleep disorders that have nothing to do with sleep apnea. His physician should take the time to satisfy all questions and investigate this further.

[jonquiljo]

If someone consistently has an AHI lower than 5 but still feels tired during the day then the cause is likely not sleep disordered breathing, but one of the over 80 other possible sleep disorders that have nothing to do with sleep apnea. His physician should take the time to satisfy all questions and investigate this further.

I don't know about that. If I woke up 5 times per hour all night - I would feel like crap the next day. Now, that assumes that all the obstructive events are arousals (funny word to use!).

It would be like saying after 8 hours sleep, "I only woke up 40 times last night!" Well, if I wake up more than once to use the bathroom (or let one of my dogs use the yard) then I am going to feel it.

[The Guest]

If someone consistently has an AHI lower than 5 but still feels tired during the day then the cause is likely not sleep disordered breathing, but one of the over 80 other possible sleep disorders that have nothing to do with sleep apnea. His physician should take the time to satisfy all questions and investigate this further.

I don't know about that. If I woke up 5 times per hour all night - I would feel like crap the next day. Now, that assumes that all the obstructive events are arousals (funny word to use!).

It would be like saying after 8 hours sleep, "I only woke up 40 times last night!" Well, if I wake up more than once to use the bathroom (or let one of my dogs use the yard) then I am going to feel it.

You are right that typically there is not going to be an arousal for every one of those 5 events per hour. But it should be noted that normal sleep consists of some apneas throughout the night, up to about 5 per hour. The apneas are generally associated with the transition from wake to sleep and also movement. As for arousals, these are not the 'get up to go to the bathroom' or 'take the dog out' arousals. They are microarousals, lasting only about 3-5 seconds with no recall of the arousal. This is normal sleep and should not make you tired. It is likely that you do wake up much more than you actually are aware of throughout the night, but it does not cause you daytime sleepiness. That would indicate that your sleep apnea is well controlled and you don't have any other sleep disorder making you tired. The OP stated that his AHI is 2.2. That is indication that his breathing is basically normal throughout the night. So if he still feels tired, it would be reasonable to expect that another sleep disorder is present such as PLMD, bruxism, or other sleep disorders that cause more frequent arousals than normal. He needs to follow up with his physician.

[Mammal]

Just for the record, I no longer suffer from tiredness during the day. I spent the whole winter basically asleep like a polar bear, and it was one of the best decisons that I have ever made. It took about 3 months to clear away the sleep deprivation from my system.

What is a OP ?

I love this website, it has been a godsend to me. However, some of the advice on here is contradictory, and causes confusion. For example, some people say if your AHI is under 5, then don't worry. Others say that you need to get it as close to 0.0 as possible. Then others mention that they can feel the difference between a AHI of 1 vs a AHI of 2, and that at a AHI of 2.0 they feel worse. Then others say it is the length of the apneas and/or oxygen desats that is critical. So my attitude is, well, why not go to the so called experts and find out?

Please note that I haven't taken offence at anybody's posts to this thread. I'm sure that some of the replies have been by more experienced people than me, and they were just trying to make their point, as briefly, and as emphatically as possible.

[snnnark]

What is a OP ?

OP = Original Poster i.e. you!