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Getting the Undiagnosed to the Sleep Lab
We all know that the vast majority of folks who have Sleep Apnea remain undiagnosed. What is the best way to convince people who don't know they have a problem that they might have one, and to get tested?
Views: 155
Replies to This Discussion
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Permalink Reply by Dave on
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Please clarify: Is the question getting the undiagnosed to go to the sleep lab or getting the undiagnosed tested?
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Permalink Reply by Adrian Karl Zacher on
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Hi Mike, All,
This is something that I have both a personal and professional interest in, and I will follow the responses with great interest.
In my experience I have found that 'suggesting' doesn't work and think that perhaps it's more about education of the whole host of problems that generally afflict the likely OSA sufferer and that you are on their side. Ultimately, I believe they have to have sufficient education and then make their own decision to act.
Look forward to the discussion of this crucial question.
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Permalink Reply by Mary Z on
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Maybe a suggestion for a google of sleep apnea and their symptoms might be enough to pique their interest and plant a seed. I guess some folks will be open to the possibility, depending on the level of their symptoms, but others are in complete denial and I know of no way to convince them they ought to get tested. If you could get them to give their PCP an honest list of symptoms maybe the PCP could convince them. This is a good question, Mike, as it's hard to believe that anyone suffering from AM headaches daily, fatigue, falling asleep at work or at the wheel, and waking up not feeling rested would be resistant to the idea of sleep apnea as the cause.
Get them to read this thread.
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Permalink Reply by Mike on
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not sure what the distinction you're making is, Dave. Isn't getting the undiagnosed to go the sleep lab a necessary part of getting the undiagnosed tested?
Dave said:Please clarify: Is the question getting the undiagnosed to go to the sleep lab or getting the undiagnosed tested?
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Permalink Reply by Amy on
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You can not convince anyone of something they wish to stay ignorant about. That being said. Share the story of how the diagnosis changed your life. I usually emphesize that they will feel better, if it is a man that thier wife will stop elbowing them at night, that they may have less medical issues. Then I talk about how easy the test is and it is worth knowing one way or another.
What amazes me most is that so many people do not know how bad they feel until they feel better.
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Looking back, I had sleep apnea long before I was ever diagnosed. Even when I did the sleep lab I was in denial that I could have sleep apnea. I think people with frequent headaches should be tested. I have used my CPAP for about 8 months now and can not believe that I no longer have chronic migraines and headaches. Sinus problems have all but gone away. I did not realize that headaches are also a sign of sleep apnea. Most of the information I heard was concerning snoring. My husband has severe sleep apnea and snores horribly when he doesnt have his mask on. If I snore.. it is very soft. Not something that would alarm another person in the same room with me.
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Permalink Reply by Gordon Osmond on
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I live in a retirement village. I am sure there are others in my village who suffer from sleep apnoea. I am also the editor of the village newsletter. Would anyone like to send me a short (A4 using Times New Roman size 14 bold) article for my newsletter?
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Permalink Reply by St. Chris on
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When you hear the person talking about telltale symptoms, say "That sounds familiar," and tell your own story. Stick to the reasons it's good for you; stay away from dire warnings. Tell them they can just ask their regular doctor, who might tell them it's nothing to worry about -- but if the doctor thinks it's worth a look, they'll do a sleep study and they'll find out the answer and do something about it if it's a problem.
CPAP probably sounds like a Big Medical Thing to most people, like dialysis or physical therapy, so stay casual and treat it like a pair of running shoes. If you're running with shoes that are wrong for you, it doesn't work well. You might not even notice it because you're used to your old shoes -- the discomfort is so familiar that it seems normal -- but you put unnecessary stress on your body that can cause real damage over time. When you get the right pair of shoes, it always takes a while to get used to the new feel, but after a while it feels natural (and if you try the old shoes again, you really notice how wrong they were), and it just works better, taking the stress off your body.
Some people can run barefoot. I sure can't. I went to a running store, had my gait analyzed, and got a good pair of shoes that keep my feet aligned and absorb stress to the point that I don't even notice the shoes anymore. Running just feels like running.
And that's how sleeping with CPAP feels. Now that I'm used to the fit, sleep just feels like sleep.
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Permalink Reply by J. Medina-Bairan, MD, FCCP, FACP on
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In my clinic I sit with the patient, explain then why I think that they have OSAS, the consequences of it if untreated and most of them agree to go to the lab. I try to educate the PCP to do the same, most of them do, but others are to busy and do not want to use that time in something that they do not want to belief.
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Permalink Reply by Banyon on
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On physical examinations, either routine or in connection with a health complaint, we commonly check body temperature, blood pressure, lipid profile and blood sugar levels. A screening for sleep-disordered breathing (SDB) needs to be added to this list. Afterall, we need to get to the root of health problems.
1. A short screening questionnaire for sleep-disordered breathing should be developed. The questionnaire could use elements of the Berlin questionnaire and the Epworth Sleepiness questionnaire.
2. This questionnaire should be administered and evaluated by a doctor or physician's assistant who is trained to recognize symptoms of SDB and implement the questionnaire.
3. The questionnaire should be used as a screening for sleep-disordered breathing on each initial physical exam. If the patient screens negative, then a screening should be done every three years at the time of a routine physical examination.
4. If between examinations, the patient complains about any symptom of sleep apnea, then he should be given the full questionnaire again.
5. If the patient screens positive for SDB, he should be prescribed a portable home study.
6. If the patient refuses the home study, the doctor should say something like, "Look, we don't just want to treat the symptoms of your health problem, we want to treat the root cause. I can prescribe drugs or surgery for your ________ (fill in the blank - hypertension, heart disease, depression, anxiety, diabetes, etc.) but you will still be unhealthy, lead a poor quality of life, and die prematurely. You may also spend a great deal of money treating the symptoms."
7. The doctor should also spend a little time educating the patient about the effects of SDB.
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Permalink Reply by Jeffrey Donaldson on
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Well, I usually ask them about certain things that I used to have that they most likely would notice. When they say yes I have experienced that, I tell them that I did too before C-Pap and now its gone. After a few of those questions, it usually gets their attention. I have also had success with explaining all of the bad things that undiagnosed sleep apnea can have on you.
I am pretty good at getting things across to people. It's all in how you go about it. I find that most people are a bit shy about spending the night in a sleep lab under observation. I give them as much info as I can about the whole experience. I tell them that if you go to the lab I did, that it is just like a bedroom and it won't look, or feel like a lab. The whole experience is totally painless and somewhat entertaining. One of mine was close to comical at one point. I tell them that the sleep techs have about the best bedside manner as anyone. My last study I had a tech that was a former Marine who had just come back from Iraq six months before. Now how cool is that.
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Mike,
I am new to looking at this market, but I guess that from my perspective, ever since CMS and most of the major payors approved unattended Home Sleep Tests for diagnosis of sleep apnea (provided that results are read by a boad certified sleep physician), that diagnosis does not necessarily have to involve spending a night at a sleep lab. Since there is a significant cost savings and the model is not prone to bottleneck at the sleep labs, I would think that making greater use of home sleep tests would be a significant factor in reaching the underserved population. That was the only distinction I was trying to make.
Mike said:not sure what the distinction you're making is, Dave. Isn't getting the undiagnosed to go the sleep lab a necessary part of getting the undiagnosed tested?
Dave said:Please clarify: Is the question getting the undiagnosed to go to the sleep lab or getting the undiagnosed tested?
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