In my experience doctors don’t always have the time or sometimes the desire to justify testing costs to insurance companies. In the real world when a screening tool shows a patient as having a barely intermediate risk, many docs won’t order a test that can cost thousands.Rubicon wrote: ↑Fri Oct 21, 2022 10:52 am
OK then what do you suggest as an alternative?
Let's take a look at you guys' sleep studies. If you scored intermediate on STOPBANG and had AHI of like 6 them IMO STOPBANG did it's job.
Also if you said yes on "O" then you don't need STIOPBANG, you need NPSG.
I would first suggest that the Mallampati score is to underutilized of a tool in screening for OSA.
Perhaps a modified STOPBANG type questioner that puts more weight into actual observable symptoms such as snoring, gasping, and witnessed apneas. I would like to see being male as a criteria done away with, I suspect that because of that many woman with OSA are likely missed. While obesity and a large neck put a person at higher risk for OSA, doctors need to be better educated to the fact that many with OSA are not obese.
As for my son and my sleep studies. My son was 16 when he was finally diagnosed. A neurologist he was seeing suspected OSA, but his PCP refused to refer him to a pediatric sleep doc or refer for a him sleep study (both would require referrals to the nearest Children’s Hospital 7 hours away). My son’s PCP at that time believed all teenagers are tired and only obese older men have sleep apnea. I finally got desperate and got my son in at Mayo in Minnesota where he finally got his first PSG along a host of other tests. He’s actually had 5 PSGs over the years and has been diagnosed with hypoxia, moderate OSA, REM behavior disorder, nightmare disorder, and delayed phase circadian rhythm disorder. He uses an APAP with O2 bleed, light therapy, and takes a med for the REM disorder and nightmares.
I told my PCP the story about a sleep tech suspecting my OSA, but she thought it unlikely that a healthy 110 pound woman could have OSA. Fortunately after dealing with my son’s struggles I knew a bit about OSA was able to talk her into overnight oximetry, which got me a referral to a sleep sleep doc. The oximetry showed that my O2 was <88% for 4.5 hours but I remember the Pulmonologist asking me to rethink my answers to the Epworth questions saying that because my STOPBANG score was low my insurance would likely want to see a really high Epworth score to pay for a PSG. After a home PSG I was diagnosed with moderate OSA, the low O2 was most concerning me.
As I said I believe STOPBANG feeds the misconception held by to many docs that OSA patients are all obsese, and most are male and elderly.
