% of patients who do sleep studies NOT diagnosed with apnea

KarenK wrote:I don't know that many people with apnea, but I have never met anyone who had a sleep study who did not get diagnosed with apnea. Comments?? [Lots of my friends think it's a giant health industry scam]

I think you need to find a more intelligent class of "friends". Maybe some that will bother to do some research on the subject.
I don't worry about a few users who MAY have been diagnosed with Sleep Apnea when they didn't actually have it. I worry more about the millions of people out there who have it and have NOT been diagnosed or have been diagnosed and are NOT using their equipment. There are way too many sleep-deprived people driving on the roads who need to be using this therapy. There could be one heading at you any time you're on the highways.

You may not have met the people who use this therapy because they're afraid of being ridiculed by people like your "friends".
Not every XPAP therapy user goes around wearing a sign that announces it or really wishes to talk about it. It's a privacy thing to many of them. Just like many people with Diabetes don't go around telling everybody that they have it either. By the way, many people who have OSA also have Diabetes. The lack of oxygen when we sleep can screw up out body's metabolism.


Merry Christmas.

Den

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Correcting typo.
Should have been: The lack of oxygen when we sleep can screw up our body's metabolism.


Den

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My first few tests showed NO sleep apnea, although I had been symptomatic for years and two different doctors had been certain I would be diagnosed when they sent me for sleep studies. A lack of meeting the criteria for diagnosis during a study does not always mean the person does not have sleep apnea. It just means the criteria wasn't met during the study. Could be due to not enough sleep or not enough of the right stages and/or positions. Or that another sleep disorder masked the OSA. With me, my limb movements were so prominent I didn't sleep enough for the apneas to be able to show up. Once the legs were a bit controlled the OSA showed up. In the end, the doctors' hunches were right on target.

A good friend had a sleep study due to major snoring, no Apnea. My oldest son had a sleep study because of insomnia, no apnea. I had a sleep study as I was not regaining my energy after cancer treatments, yes apnea. That is 66% no apnea diagnosis in my limited sample.

I dealt with a terrible situation. started my journey back in October. Scheduled a sleep study which was cancelled, because insurance demanded a home study, which was negative. I knew I had apnea. Doctor said nothing else for him to do, but I said there has to be a problem (I was falling asleep driving home an hr commute). He ordered a sleep study and a day study. I was diagnosed with moderate to severe osa, mild periodic limb movement, and excessive day sleepiness. Fight through an insurance error for about a week finally last Friday I got my CPAP. Still waking up tired, the mask slides sometimes at night till I wake with leaks, I get extreme dry mouth after about four hrs. I am a mouth sleeper. But my story is for a different post.

Guest wrote:I dealt with a terrible situation. started my journey back in October. Scheduled a sleep study which was cancelled, because insurance demanded a home study, which was negative. I knew I had apnea. Doctor said nothing else for him to do, but I said there has to be a problem (I was falling asleep driving home an hr commute). He ordered a sleep study and a day study. I was diagnosed with moderate to severe osa, mild periodic limb movement, and excessive day sleepiness. Fight through an insurance error for about a week finally last Friday I got my CPAP. Still waking up tired, the mask slides sometimes at night till I wake with leaks, I get extreme dry mouth after about four hrs. I am a mouth sleeper. But my story is for a different post.

This is my post forgive me for I am a newbie

There are definitely scams in operation, but false positives are probably the least likely.
Insurance companies (and HMO's) may skew toward false negatives more often.
But the biggest malpractice is the system, which permits and encourages sub-optimal equipment at egregiously inflated prices.

bavinck wrote:My point was more along the lines that medical professionals are legally obligated to be honest

Just want to make sure that "I" understand this.

If they are "LEGALLY" obligated to be honest, there is no way that they would be anything but honest?

StuUnderPressure wrote:

bavinck wrote:My point was more along the lines that medical professionals are legally obligated to be honest

Just want to make sure that "I" understand this.

If they are "LEGALLY" obligated to be honest, there is no way that they would be anything but honest?

Surely you can have a dishonest doctor. An oath is only as good as one's principle toward it. Better than no oath though, and serious consequences of violation.

This has been my past experience and would be my guess overall. I would speculate that more people are sent to sleep studies and if they score "mild OSA" their insurance company denies treatment and the sleep doctor tells the patient, "nope, you dont have OSA." Or "yeah, you did have some mild OSA but I dont think its severe enough to treat. I think you can get rid of it with lifestyle changes, such as losing fifty pounds. Im putting you on a diet and want you to go to the gym five times a week to do mild cardio."

It might be different in other countries, but in my experiences false negatives (lying to OSA patients and withholding CPAP therapy to them) is probably more the norm than the false positive.

Eric

chunkyfrog wrote:There are definitely scams in operation, but false positives are probably the least likely.
Insurance companies (and HMO's) may skew toward false negatives more often.
But the biggest malpractice is the system, which permits and encourages sub-optimal equipment at egregiously inflated prices.

neallo wrote:

Guest wrote:I dealt with a terrible situation. started my journey back in October. Scheduled a sleep study which was cancelled, because insurance demanded a home study, which was negative. I knew I had apnea. Doctor said nothing else for him to do, but I said there has to be a problem (I was falling asleep driving home an hr commute). He ordered a sleep study and a day study. I was diagnosed with moderate to severe osa, mild periodic limb movement, and excessive day sleepiness. Fight through an insurance error for about a week finally last Friday I got my CPAP. Still waking up tired, the mask slides sometimes at night till I wake with leaks, I get extreme dry mouth after about four hrs. I am a mouth sleeper. But my story is for a different post.

This is my post forgive me for I am a newbie

Since you mention limb movements, be sure to read my post a little ways up in this thread.

EDIT: Sorry, I meant my post in the thread linked below,,,
viewtopic.php?f=1&t=94589&p=874505#p874505

Blaifarm wrote:I had a home sleep study done in September of this year. It was a pulse oximetry test and I was diagnosed with mild apnea. I've read and been told on a couple of these forums that this was not the correct way to be diagnosed with sleep apnea. The doctor had to guess and assume in order to do so. Would all of you accept this? I didn't and am now scheduled for an in lab study and will accept the diagnoses from that test.

By the way, my pcp had been asking me for a couple of years to have a sleep test done and I finally gave in a stated that I would do so. That is why I agreed to a sleep study.

The pulseox may give a pretty conclusive result that you do have apnea. However, you can have pretty bad apnea and it might not show up on a pulseox test. It's probably worth doing the pulseox test if it's cheap and you don't have a real strong indication the patient has apnea.

i.e. you probably do have apnea. If the doctor is good, he can probably monitor and treat it with a good, modern CPAP machine if he monitors the results and adjusts it based on the result. The standard approach would be to have a formal in-lab sleep test with a "titration" to find the right pressure. You can even do a "split night" study and do both in one night.

Be sure you get the doctor to give you a sleeping pill in case you can't sleep in the lab. Otherwise, you end up with an expensive sleepless night with no data from the sleep test.

Read the links in my signature line to keep from getting screwed by the DME (CPAP salesman) with a bad CPAP machine.

To amplify a little...

The pulseox study looks at two things, your pulse rate and oxygen levels.

If your airway becomes blocked, your oxygen saturation will drop until you start breathing again. This is reasonably obvious.

What can be more subtle is changes in your pulse rate. A doctor that is good at reading pulse data can form an educated guess from the pulse rate changes and order some follow up tests (like a sleep study where they add EEG data) to try to add definition to the guess. Unfortunately, pulse data fluctuates and unless you are fluent in reading it the fluctuations can simply look like noise. Furthermore, many of the fluctuations in pulse rate are noise.

The point is that your doctor may have seen something in the pulse rate data along with some minor desaturations that are leading to further study.

In my first sleep study no one bothered to mention I could adjust the firmness of my bed. It was set to max firmness, and not being able to sleep on a stiff bed it was not surprising that I tossed and turned all night.

Be aware of the PANOPLY of variables in unrestful sleep

I did the sleep study, and said I did not have it.