Is my OSA/sleep apnea diagnosis a scam?

[Richard McVicker]

I just had a sleep apnea test and there is no way a person could pass this test. I am not saying I don't have Apnea but the sleep set up creates a apnea condition even if you don'y have Apnea.

[49er]

I just had a sleep apnea test and there is no way a person could pass this test. I am not saying I don't have Apnea but the sleep set up creates a apnea condition even if you don'y have Apnea.

Richard,

Can you elaborate since I am having a hard time following your point?

Thanks!

49er

[Panchali]

I didn't read the 9 pages of posts but I'm sure most of the stories are the same. We all find some benefit if we stick with it.

Quick run down. I have never slept well for years. Shift work, kids, life, stress. Then I developed pain. Had vericose vein treatment because they were sure that was some of my problem. Well that didn't help a bit. 2 more years of 4 hrs a night. I could barely get out of bed if I even got in. It hurt to lay down. The most comfortable place was in front of my computer. My chair is the best. Can't sit on my couch, lounger. Had to put down a big fluffy blanket to lay on in bed just so I could lay down. Sleep study. "Hey you have sleep apnea". I was very much confused as to how this could cause pain, till they explained I didn't get REM sleep. Buy a machine, you'll feel better.

Got trial machine cause I thought it was B*&^. 4 hrs a night with the mask and after 2 weeks the pain was gone. GONE! I was a believer. There were other issues between weeks 2 and 8 that made me want to give in and throw it all out. It's amazing how irrational you can be when you have your sleep taken away from you after you get some, BUT I have a new mask that is INCREDIBLE! I sleep now at least 7 hrs each night. It's been a week. Yesterday I rode my bike 7km with NO PAIN, even this morning. I'm ready to pull the bike out and ride now if it wasn't raining. I haven't been on a bike in years. I mean lets face it I was barely able to move for the last year.

Take your 4 hrs a night and give it time, try a new mask. Find a place that lets you try them for 30 days. If you don't get more than 4 hrs after a week with it - take it back. Get another. Do whatever you have to till you get enough hours that you notice a difference. Make them change the settings on your machine, try different things till you feel comfortable.

Anytime you can sleep with it on is a benefit. Don't beat yourself up because you only get 4 hrs. It's 4 you didn't get before. If you don't think it's working take a few nights off and see how much better or worse you feel.

(And yes I completely agree that sleeping in a strange uncomfortable bed, hooked to every wire possible, with a big wad of plastic stuck to your face blowing air at you in the ugly flannel nighty the sleep clinic gives you is not an ideal way to test if you can't sleep. My technician said "you won't sleep, you'll be uncomfortable, I'm sorry." So I can honestly say "She told me so".

[BlackSpinner]

I just had a sleep apnea test and there is no way a person could pass this test. I am not saying I don't have Apnea but the sleep set up creates a apnea condition even if you don'y have Apnea.

That is asinine. People don't stop breathing in their sleep just because they are uncomfortable.

[SleepDepraved2]

As a medical transcriptionist, I can tell you that people usually do not get sent for a sleep study because they are simply overweight, only because they snore, etc. Believe me, you don't need socialized medicine to keep doctors from ordering unnecessary tests. You only need one insurance company that doesn't want to spend money it doesn't have to. If I've heard it once, I've heard it a thousand times that a patient comes back to a doctor with the prescription they were given and tells the doctor the insurance won't cover that medication. And doctors, by law, no longer get freebies from drug companies. Congress ended that in January of 2009. Now that my husband retired and we are on a different prescription plan, we have had to adjust medication for at least two members of our family because the medication that they were on and that was working for them is not on formulary. You think insurance companies are just going to fork over $960 (national average for sleep study) just because the doctor says an overweight individual needs a sleep study? Nuh uh! You have to have more than that for it to be approved by your insurance company.

I was sent for a sleep study because I snored and yes, I am overweight, but also because I was falling asleep during the day, once while I was typing and the dictation was playing through my headphones. I can remember falling asleep in meetings when I worked in an office, even when I was at my optimum weight. I fought to stay awake at the wheel when driving my kids home from school. My sister said I always snored when I was a kid too. And I wasn't fat then. Chances are I have had this all my life. I must have found some way to compensate for it that stopped working at some point, when I started being exhausted by 9 AM, waking with a headache most mornings, and starting gaining more weight despite the fact that I eat less than I used to and am on a steady dose of thyroid hormone. Come to think of it, I had a lot of headaches when I was a kid too. The doctor took all of these factors into account before ordering my sleep study. No wonder it came up positive.

Even if I suspected I was wrongly diagnosed, the positive benefits of good sleep have more than convinced me that I was not. I remember fighting sleepiness to stay up longer, probably because somewhere deep down I realized that the way I slept was dangerous to me. I would stay up until I was staggering with exhaustion before I would let myself go to bed. Now I go to bed when I am tired and I wake up feeling great. The machine is benefiting my body. I am losing weight, staying awake all day, and having fewer headaches. Yes, I guess I'm addicted to my hose crack. Since not using it will probably kill me in one way, shape, or form, I guess I'm hooked for life. At least I will have a life. My doctor saved my life twice. Once by finding thyroid cancer no one else bothered to look for. And once by sending me for a sleep study.

[JohnBFisher]

I just had a sleep apnea test and there is no way a person could pass this test. I am not saying I don't have Apnea but the sleep set up creates a apnea condition even if you don'y have Apnea.

[ .. Enable Sarcasm Mode ..]

Oh, yes. My permanent kidney damage exists just because some doctor thought he ought to line his pocket and have me use an xPAP device.

Sure. I stopped breathing so long at night that it created uncontrolled high blood pressure. That was just a scam of the test. Sure. I've got a great bridge I can sell you too.

[ .. Disable Sarcasm Mode ..]

Of course the sleep study is uncomfortable. But they are not measuring if you are comfortable. They are measuring your respiration, they are measuring your heart rate. They are measuring your brain waves. And they are measuring your breathing effort. If you don't have sleep apnea, it will show in the results. If you have sleep apnea, it shows. It has NOTHING to do with how comfortable you feel. NOTHING at all.

I'll be the first to admit that my nights a sleep center labs are by in large some of the worst that I've had. (Except for two exceptions). But who cares, if they can find out what's wrong with my sleep. And they do. But if my wife went in for a sleep study they would tell her that sleep apnea is not a problem - because it is not. She might also find the sleep lab experience uncomfortable, but they would KNOW if sleep apnea was a problem for her.

[SleepDepraved2]

The thing that makes me chuckle is the bit about the "lazy diaphragm". This person has never been on a CPAP, obviously. Wouldn't know that what the machine blows in, we have to blow back out. Against pressure. My diaphragm has never been less lazy. Why else do many people find their GERD clears up after being put on CPAP? Mine hasn't yet, probably because I am on BiPAP, but I figure I'm still breathing out against pressure, so it will just take longer, that's all.

[chunkyfrog]

As too many of us already know; the scamming begins AFTER the sleep study.

[Wonderbeastlett]

There are a lot of other diseases that overlap OSA symptoms. So although they might send you for a sleep study you could also have other illnesses. The test results do not lie! If your results are showing apneas, but you feel your symptoms don't match OSA, then I don't know what to tell you. If your still tired after cpap and you tried to fix the other issues like mask leaks etc, then I'd get checked for other illnesses.

If your certain OSA is a scam or maybe you just don't have it, then don't get a cpap. Don't use it or even worry about! It's your body and however you want to take care of yourself is your business.

[themonk]

I want to be clear right up front - I DON'T think apnea is a scam. I think it exists and I think it is deadly serious.

However, they do stack the deck against you in the lab. You are under terrible stress, forced to sleep in one position, unable to even more your head without serious effort, and are on a very thin pillow. All or most of these could force you into positions you wouldn't normally be in for longer than you would normally be in them, and possibly bring out a severity of apnea that you wouldn't have under normal conditions.

I also think there is more art than science in interpreting the data, specifically for RERAs and hypopneas. Likely won't change the diagnosis for most people, but could in some cases.

Again, I don't think it is a scam. Let me be clear. No scam.

[chunkyfrog]

If anything, adverse conditions in a sleep lab work AGAINST a positive diagnosis:
Comfort leads to deeper sleep, specifically REM, where many apneas occur.
Most labs encourage the patient to bring their own pillow, etc. in order to have as comfortable a night as possible.
Failure to check out the location beforehand might be considered negligence on the part of the patient;
especially if you are already aware of problems getting to sleep.

[SleepDepraved2]

At the sleep lab I went to, I was allowed as many pillows as I wanted, so I pulled them off the hospital bed in the room and added them to the double bed I slept in. I routinely used to sleep with a feather pillow on top of a fiberfill pillow plus a body pillow. The sleep tech told me to replicate my sleeping environment as closely as I could so they could get the best results. No, it's still not easy to sleep, but I did manage to sleep long enough for them to get good numbers.

it IS possible to have a sleep study done at home, so not all apnea is diagnosed in a sleep lab.

[Xney]

I've been through 4 sleep studies. I bring my own pillow!

Insurance companies SAVE money diagnosing sleep apnea. So do doctors. The health complications from it being untreated are very, very serious and costly.

I'm sure there's scamming going around and misdiagnosis, but it's a very common disease.

In my personal case, I was extremely fatigued, not overweight, and didn't snore. The diagnosis came almost 8 years later because they didn't connect the dots. Which really, really sucks - 8 years of excessive misery.

[Wonderbeastlett]

Honestly I don't see a problem if they were putting you in optimum settings. There are already tons of health tests that put your body in settings to checks for things. Whether its not eating for 24 hours or drinking a nasty liquid! I want to know the level of severity and if sleeping on my back flat will show that, great! I've known some doctors who don't care and never will but most do. In this time of google and self diagnosis, you gotta give some props to the crap these guys go through! lol

[patrissimo]

I really liked how balanced this response was. Many, many people have some degree SDB, so when you select for "people who get a sleep study", most of them will have some degree of it. That doesn't mean there aren't companies, doctors, etc who over-diagnose.

I'd really like to see a paper giving a baseline AHI & RDI for a random population sample. I feel like many studies are missing that baseline. ie Barry Krakow finds that 90% of insomniacs with PTSD have sleep apnea, well, what percentage of non-insomniacs with PTSD have sleep apnea? What about age-matched controls?

Hey there, I'm a registered sleep disorders technician.

This skepticism isn't anything new in the field. It's true that most people sent in for a sleep study are set up with a CPAP machine. Why?

Because the screening before they are sent in for the study is very straightforward. High blood pressure, witnessed snoring, witnessed apnea, tired during the day, overweight, small airway, difficulty concentrating, memory problems....etc.

This stuff isn't real hard to screen for in the doctors office. They are all big red flags for sleep apnea.

I can understand the frustration when some of the symptoms don't seem to fit. Our sleep is very personal to us. The original post said that he has memory and concentration problems, but never remembers waking up. Classic apnea. Memory and concentration problems speak directly to REM deprivations. (yes, there are studies for this too). Many people never remember waking up from apnea because they only last roughly three seconds. Here is an example: http://www.freecpapadvice.com/Obstructi ... Apnea.html It's no surprise that these awakenings aren't remembered. That doesn't mean that they aren't happening though.

People who set you up on CPAP, some of my fellow Registered Sleep Technologists, and even doctors can bring about these feelings of it being a Scam.

There are some unscrupulous folks out there who are just trying to make a buck.

Apria is a home health care company that has their business set up to herd people in and out as quickly as possible. You're given no choice in mask and no instruction on how to use it or your machine. In my opinion, that's criminal.

Some doctors who have no business reading sleep studies do so because they have deals set up where they get reading fees. If they're not Board Certified in Sleep Medicine, then they are very likely sketchy as hell.

Some of my fellow registered sleep techs are incompetent as well, or the sleep center is set up poorly. Labs try to get people tested, and that's it. They just give you any old mask to get the pressure right, not caring or knowing that this is probably the mask you'll be expected to sleep with. Some doctors and labs don't recognize RERAs( even medicare doesn't....idiot) as being disruptive to sleep. These wake you up, but often aren't titrated for. Many people using CPAP are at too low a pressure, so it doesn't work and they get frustrated. Sometimes the mask sucks, so it doesn't work and they get frustrated. Often it's both.....

It's a somewhat new field. There is so much lack of information and misinformation out there. I have a website where I try to get people to the point where they know what questions they need to ask of their sleep center and sleep doctor.

I can certainly appreciate that people think it's a Scam of some sort. Just know that it is very real, and in the hands of a good sleep lab, sleep doctor, sleep technologist, and home health care company, you can manage your sleep apnea very effectively.