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Problem with Sleep Lab in Virginia
from user:
I just joined and have just taken a sleep study test in Gainesville, virgina at Commonwealth Sleep Center. I stayed overnight, the only one at the sleep "lab" and was monitored by a wonderful technician named George. Two nights later,I stayed overnight again and was given a nose insert mask to try out all night. Again, I was the only one at the sleep "lab.
I was given a 3 page polysomnograph report with a neurologist's name of Yash Mehndiratta, MD (neurologist) on the bottom (who neither dated or signed the report), another copy of which is to go to my regular family physician. (She's wonderful, but has no sleep disorder background.) The report was generated the next day after my sleep study. It said I have severe sleep apnea with moderate oxygen desaturations. I never saw or was told to see a doctor to review the study with me. It was the tech's job to do this. His name is George and he interpreted the 2 paragraph summary on the top of pg one of the report, reading it to me. The bottom of pg one simply gave simple common sense recommendations to sleep better.
1. I'm not sure this center is accredited and can't find info on the web to substantiate this. Can anyone help me?
2. Shouldn't I have been asked to see some kind of sleep dr affilitated with the sleep "lab" to review the severe apnea test results with me?
3. It seems like my family dr will also be given the name of a cpap machine and mask to sign off on, which I believe she will do. I'm not sure I even want to buy the nostril insert mask, since I've always been a mouth breather.
I have Medicare & am concerned about their coverage/2nd opinion.
HELP!
Views: 1317
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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It is very common for PAPeople to not see a sleep doc during this process. Most labs will not schedule a consult unless they or the PAPerson has a need.
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Permalink Reply by John Krainik on
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It varies from Sleep Center to Sleep Center as to visits with the sleep doc. In our center, the patient sees the Sleep Doc at the very least before he has a sleep study, and before he gets his CPAP machine, and usually in between too. Unfortunately, I get similar comments from the patients because they don't understand what is going on. Either the doc doesn't do a good enough job explaining, or they failed to ask the doc to explain further. In my opinion, both share the blame. I, as a tech, end up getting the chart and clarifying things for the patient.
Generally, (and unfortunately) the doctor only takes the time he feels he needs to to explain the issues to the patient, and the patient, not wanting to look silly, won't ask the doctor to explain further. My advice to everyone I see, is to ask the doc until you understand what is going on. If he won't take the time, you have the wrong doc.
As far as the Sleep Lab is concerned, you can look at the AASM's website to determine if the lab is accredited.
Your concern of being a mouth breather and the choice of the proper interface is understandable. Many mouth breathers when they sleep without CPAP, will close their mouth when CPAP is applied and the pressure controls the obstructions in the airways.
You should have a frank discussion with your primary care doc (it sounds like you have a good rapport with her) and work towards getting your sleep questions answered. Your treatment for your sleep disordered breathing will be much easier when you know what is going on.
John Krainik,CRT,RPSGT
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Thank you, John. I'm going to talk with my family dr tomorrow.
Do you think a mouth breather should wear a nose "mask" or a full face mask?
Also, do you know how I can get a copy of my computer data to give to a sleep doctor to review? (The technician told me he didn't think so, since it would be about 750 pages.)The doctor listed on the bottom of my brief sleep report is a neurologist, AASM diplomate, but who is listed on the web as having 30 primary addresses throughout Virginia and Maryland. (I'm from Virginia.) I took my sleep test this past Sat. night (Memorial Day Wkend). I was given a copy of my sleep report on Sunday by the technician. Doesn't this seem awfully fast? Especially given my test was on Sat. night of Memorial Day wkend? I just don't understand.
Barb
John Krainik said:It varies from Sleep Center to Sleep Center as to visits with the sleep doc. In our center, the patient sees the Sleep Doc at the very least before he has a sleep study, and before he gets his CPAP machine, and usually in between too. Unfortunately, I get similar comments from the patients because they don't understand what is going on. Either the doc doesn't do a good enough job explaining, or they failed to ask the doc to explain further. In my opinion, both share the blame. I, as a tech, end up getting the chart and clarifying things for the patient.
Generally, (and unfortunately) the doctor only takes the time he feels he needs to to explain the issues to the patient, and the patient, not wanting to look silly, won't ask the doctor to explain further. My advice to everyone I see, is to ask the doc until you understand what is going on. If he won't take the time, you have the wrong doc.
As far as the Sleep Lab is concerned, you can look at the AASM's website to determine if the lab is accredited.
Your concern of being a mouth breather and the choice of the proper interface is understandable. Many mouth breathers when they sleep without CPAP, will close their mouth when CPAP is applied and the pressure controls the obstructions in the airways.
You should have a frank discussion with your primary care doc (it sounds like you have a good rapport with her) and work towards getting your sleep questions answered. Your treatment for your sleep disordered breathing will be much easier when you know what is going on.
John Krainik,CRT,RPSGT
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Can you please tell me what PA People means? Also, can you tell me what DME means? (I'm reading some discussions here that mention, "your DME...."
Barb
RockRpsgt said:It is very common for PAPeople to not see a sleep doc during this process. Most labs will not schedule a consult unless they or the PAPerson has a need.
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PAPeople and PAPerson is something that I made up. I don't like calling people patients.
DME=Durable Medical Equipment provider. This is the company that provide you with the equipment
Barb Van Siclen said:Can you please tell me what PA People means? Also, can you tell me what DME means? (I'm reading some discussions here that mention, "your DME...."
Barb
RockRpsgt said:It is very common for PAPeople to not see a sleep doc during this process. Most labs will not schedule a consult unless they or the PAPerson has a need.
-
-
Barb,
You should use the mask that works the best and easiest for you. As i mentioned in my previous reply, many people that are mouth breathers without CPAP, can use the nasal interfaces because the obstructed breathing is corrected with the CPAP. In many cases, the only reason the mouth is open when the obstructed breathing is untreated, is that the body realizes that it is not getting enough air. The mouth opens in an attempt to get more air. However, because of the obstruction, there still is not enough air and the mouth remains open. Fixing the obstruction with CPAP, allows the body to breathe normally and the mouth, in many cases, closes. The sleep lab titrated you with the nasal interface, so I would suspect that it works for you. If it didn't, they would have used the full mask.
As far as the sleep study is concerned, I believe that it is rare for a sleep center to give out a copy of the raw data. First off, it is computerized, it would be given to you on a DVD. Second, there are many different manufacturers of the equipment, and most won't read another. You mentioned that the doc frrom the Sleep lab is an AASM diplomat. if that is the case you can be relatively sure that you are ok from that standpoint. You alredy have a copy of the report. That is really all you need. Your primary care doc can get more information from the sleep doc if necessary. You should have a final copy, not a preliminary copy. Final copy has the interpretation. It doesn't surprise me that the report was ready as quick as it was. In some centers, the techs score the study as they acquire it. (that means it is scored as they record it) Some sleep centers have scoring techs that score even on holiday weekends. Once scored, the docs can read the report remotely and add their comments to the report, as well as sign it electronically.
Everything sounds like it is on the up and up. I would suggest that you get a good explaination of sleep apnea and it's treament. Then get your questions answered as they pertain to you. You will do well as it sounds like you want to know what is going on. Unfortunately, you have found yourself in a situation and you don't know the what fors and whys. Ask those questions and don't stop until you get your answers.
If you are like most of my patients, once you know what is going on, and why, you will deal with this fairly easily.
John
Barb Van Siclen said:Thank you, John. I'm going to talk with my family dr tomorrow.
Do you think a mouth breather should wear a nose "mask" or a full face mask?
Also, do you know how I can get a copy of my computer data to give to a sleep doctor to review? (The technician told me he didn't think so, since it would be about 750 pages.)The doctor listed on the bottom of my brief sleep report is a neurologist, AASM diplomate, but who is listed on the web as having 30 primary addresses throughout Virginia and Maryland. (I'm from Virginia.) I took my sleep test this past Sat. night (Memorial Day Wkend). I was given a copy of my sleep report on Sunday by the technician. Doesn't this seem awfully fast? Especially given my test was on Sat. night of Memorial Day wkend? I just don't understand.
Barb
John Krainik said:It varies from Sleep Center to Sleep Center as to visits with the sleep doc. In our center, the patient sees the Sleep Doc at the very least before he has a sleep study, and before he gets his CPAP machine, and usually in between too. Unfortunately, I get similar comments from the patients because they don't understand what is going on. Either the doc doesn't do a good enough job explaining, or they failed to ask the doc to explain further. In my opinion, both share the blame. I, as a tech, end up getting the chart and clarifying things for the patient.
Generally, (and unfortunately) the doctor only takes the time he feels he needs to to explain the issues to the patient, and the patient, not wanting to look silly, won't ask the doctor to explain further. My advice to everyone I see, is to ask the doc until you understand what is going on. If he won't take the time, you have the wrong doc.
As far as the Sleep Lab is concerned, you can look at the AASM's website to determine if the lab is accredited.
Your concern of being a mouth breather and the choice of the proper interface is understandable. Many mouth breathers when they sleep without CPAP, will close their mouth when CPAP is applied and the pressure controls the obstructions in the airways.
You should have a frank discussion with your primary care doc (it sounds like you have a good rapport with her) and work towards getting your sleep questions answered. Your treatment for your sleep disordered breathing will be much easier when you know what is going on.
John Krainik,CRT,RPSGT
-
-
Thanks!
Barb
RockRpsgt said:PAPeople and PAPerson is something that I made up. I don't like calling people patients.
DME=Durable Medical Equipment provider. This is the company that provide you with the equipment
Barb Van Siclen said:Can you please tell me what PA People means? Also, can you tell me what DME means? (I'm reading some discussions here that mention, "your DME...."
Barb
RockRpsgt said:It is very common for PAPeople to not see a sleep doc during this process. Most labs will not schedule a consult unless they or the PAPerson has a need.
-
-
John,
Got it. Thank you, again.
Barb
John Krainik said:Barb,
You should use the mask that works the best and easiest for you. As i mentioned in my previous reply, many people that are mouth breathers without CPAP, can use the nasal interfaces because the obstructed breathing is corrected with the CPAP. In many cases, the only reason the mouth is open when the obstructed breathing is untreated, is that the body realizes that it is not getting enough air. The mouth opens in an attempt to get more air. However, because of the obstruction, there still is not enough air and the mouth remains open. Fixing the obstruction with CPAP, allows the body to breathe normally and the mouth, in many cases, closes. The sleep lab titrated you with the nasal interface, so I would suspect that it works for you. If it didn't, they would have used the full mask.
As far as the sleep study is concerned, I believe that it is rare for a sleep center to give out a copy of the raw data. First off, it is computerized, it would be given to you on a DVD. Second, there are many different manufacturers of the equipment, and most won't read another. You mentioned that the doc frrom the Sleep lab is an AASM diplomat. if that is the case you can be relatively sure that you are ok from that standpoint. You alredy have a copy of the report. That is really all you need. Your primary care doc can get more information from the sleep doc if necessary. You should have a final copy, not a preliminary copy. Final copy has the interpretation. It doesn't surprise me that the report was ready as quick as it was. In some centers, the techs score the study as they acquire it. (that means it is scored as they record it) Some sleep centers have scoring techs that score even on holiday weekends. Once scored, the docs can read the report remotely and add their comments to the report, as well as sign it electronically.
Everything sounds like it is on the up and up. I would suggest that you get a good explaination of sleep apnea and it's treament. Then get your questions answered as they pertain to you. You will do well as it sounds like you want to know what is going on. Unfortunately, you have found yourself in a situation and you don't know the what fors and whys. Ask those questions and don't stop until you get your answers.
If you are like most of my patients, once you know what is going on, and why, you will deal with this fairly easily.
John
Barb Van Siclen said:Thank you, John. I'm going to talk with my family dr tomorrow.
Do you think a mouth breather should wear a nose "mask" or a full face mask?
Also, do you know how I can get a copy of my computer data to give to a sleep doctor to review? (The technician told me he didn't think so, since it would be about 750 pages.)The doctor listed on the bottom of my brief sleep report is a neurologist, AASM diplomate, but who is listed on the web as having 30 primary addresses throughout Virginia and Maryland. (I'm from Virginia.) I took my sleep test this past Sat. night (Memorial Day Wkend). I was given a copy of my sleep report on Sunday by the technician. Doesn't this seem awfully fast? Especially given my test was on Sat. night of Memorial Day wkend? I just don't understand.
Barb
John Krainik said:It varies from Sleep Center to Sleep Center as to visits with the sleep doc. In our center, the patient sees the Sleep Doc at the very least before he has a sleep study, and before he gets his CPAP machine, and usually in between too. Unfortunately, I get similar comments from the patients because they don't understand what is going on. Either the doc doesn't do a good enough job explaining, or they failed to ask the doc to explain further. In my opinion, both share the blame. I, as a tech, end up getting the chart and clarifying things for the patient.
Generally, (and unfortunately) the doctor only takes the time he feels he needs to to explain the issues to the patient, and the patient, not wanting to look silly, won't ask the doctor to explain further. My advice to everyone I see, is to ask the doc until you understand what is going on. If he won't take the time, you have the wrong doc.
As far as the Sleep Lab is concerned, you can look at the AASM's website to determine if the lab is accredited.
Your concern of being a mouth breather and the choice of the proper interface is understandable. Many mouth breathers when they sleep without CPAP, will close their mouth when CPAP is applied and the pressure controls the obstructions in the airways.
You should have a frank discussion with your primary care doc (it sounds like you have a good rapport with her) and work towards getting your sleep questions answered. Your treatment for your sleep disordered breathing will be much easier when you know what is going on.
John Krainik,CRT,RPSGT
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