Do I need a Sleep Doc?

I have been on PAP therapy since September 2010
The last few visits I have had to a sleep doc, turned out to be with a PA who simply said you are doing great, keep up the good work.
My PCP does provide DME prescriptions any time I ask.
My AHI bounces around between 0.0 and 3.0 with an occasional spike.

How do you feel?

I am more tired than usual the past six months.

I would get hold of the MD and notjust do whatever the PA says....

What is it that you wish a sleep doc would do for you that someone else can't?
Investigate the fatigue issues?

Fatigue is one item.
I am also out of breath after mild exertion, like putting on my shoes and sox.
I am thinking a pulmonologist/sleep doc.

Yes. Next time I will be insisting on an appointment with the MD, not a PA.

Did you bring up the fatigue and shortness of breath with the PA? And still get "you are doing great, keep up the good work"?

The problem with a sleep doc and/or PA in a sleep doc office is that they are focused on your CPAP use. Numbers look good, mission accomplished. It's one thing I hate about modern medicine--bunch of blind men describing an elephant. Very few care providers "see" the whole person" any more. But your PCP SHOULD.

I think your primary care doc should be your next step. "Hey, I'm doing well with CPAP, but I feel like crap". You PCP should be doing some basic tests and making appropriate referrals to more blind men.

bwexler wrote: ↑

Mon Mar 10, 2025 1:40 pm

I am also out of breath after mild exertion, like putting on my shoes and sox.

You need a doctor.
Now.
Don't self-diagnose, don't let people on the internet attempt to diagnose - go to a doctor now.

Janknitz
That incident with the PA was probably 5 years ago.
The exhaustion has only been the past 6 months.

Azij
I am very patiently awaiting my appointment with my PCP next week. I am also researching "blind men" that are in network. I have found 2 pulmonologists/Apnea specialists that are in network, and they share the same office.

I have found 2 Cardiologists in network. I have a mutual agreement with one of them not to see him again.

When I started CPAP, I had an in home sleep study, and only consulted my regular DOC.
That was OK, but I also had suffered from Asthma, and had 2 docs tell me that was COPD.

In 2020, I was hospitalized with Covid, and almost died. In the hospital I was treated by a Pulmonary/Respiratory doc.
I followed up with him after my hospital stay. He did a lot of testing, and the testing determined conclusively that I did not have COPD.
Once that was determined, more testing determined a specific type of Asthma, that has been treated with Xolair injections.
Now, I rarely have any serious Asthma episodes. I had some issues with another brief C-19 episode that required me using my nebulizer. I now have only used that a few times in the last 2 years. I used to take treatments 5 times a day.

This doc also reviews my CPAP data, and so far no major changes needed. My settings were dialed in years ago with help from this board (OSCAR) and another tweak about 2.5 years ago using Sleep HQ.

My point is that getting a good doc can be a real game changer. In my case it was more about the Asthma than the CPAP, but I really like this doc.
Getting a proper diagnosis can make a world of difference. My original PCPs were nice enough, but were not properly able to deal with my Allergies and Asthma. I hope you can get a good doc. I wish you well!