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my husband thinks he has sleep apnea. he has discussed this w/ his regular doctor & he is ready to do a sleep study. (my daughter was diagnosed w/ apnea last yr.) in northern california, do you just go to stanford or ucsf or do local hospitals do sleep studies? i have a friend who goes to kaiser & she says that they gave her a cpap machine & they were able to "calibrate" it based on how she slept for a week w/ the machine. she said that she never had to do an overnight study.

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go to Stanford. i lived in Menlo Park for years and got my sleep study there. they're unsurpassed for quality/ reliability. it's worth making a point to go there over anywhere else. just my $0.02. also, ask for Dr. Pelayo. He's terrific.
I've got to respectfully disagree. Stanford is cutting edge for research, but I have a differing opinion with regards to their sleep center. I worked for them (on a remote basis) for 2 years and some of their scoring practices are a little funky. RERAS aren't scored, or weren't at the time, despite evidence of their existence. There were some other things that turned me off, but I'd prefer to not get into it. The personnel there are great though!!! I'm talking strictly policy. Dr. Kushida is awesome!!!!

That said, any accredited sleep center should be great. I live in Northern California within the Mercy CHW system.

Kaiser just sets people on on Auto Titrating devices like you said and base the diagnosis on that. This isn't really a good way to go at all. You really benefit from a technician observed sleep study.

If you have any further questions, let me know. I'd be happy to answer.
I so agree w/Saz!!! Not about Stanford 'cause I am in Michigan and have no personal knowledge of Stanford - but - about bypassing Kaiser and going for the full in-lab sleep study at an accredited sleep lab. Once you've been evaluated for all the 80+ sleep disorders that can occur and found to have OSA then MAYBE if financies are a consideration an at home auto titration such as Kaiser does. BUT, understand one LARGE problem w/at-home auto titrations if you've never been on CPAP before - it can take weeks to months to find THE RIGHT mask and w/o THE RIGHT mask and acclimation to mask and CPAP pressure that auto PAPs are at a GREAT disadvantage in titrating THE RIGHT pressure for YOU. For your first time on PAP therapy to be a ONE WEEK auto titration is NOT a particularly good idea in my personal opinion. I wouldn't go for it unless it was my only alternative due to finances. APAPs are great for keeping a close eye on TRENDS w/your sleep, and even for "fine tuning" your pressure needs based on an in-lab titration, but NOT for your first experience w/PAP therapy, again, in my not at all humble, but strictly patient opinion. I am no medical professional by a long shot!!!
I totally agree with Judy on this one, Laurie!!

Susan McCord :-)



Judy said:
I so agree w/Saz!!! Not about Stanford 'cause I am in Michigan and have no personal knowledge of Stanford - but - about bypassing Kaiser and going for the full in-lab sleep study at an accredited sleep lab. Once you've been evaluated for all the 80+ sleep disorders that can occur and found to have OSA then MAYBE if financies are a consideration an at home auto titration such as Kaiser does. BUT, understand one LARGE problem w/at-home auto titrations if you've never been on CPAP before - it can take weeks to months to find THE RIGHT mask and w/o THE RIGHT mask and acclimation to mask and CPAP pressure that auto PAPs are at a GREAT disadvantage in titrating THE RIGHT pressure for YOU. For your first time on PAP therapy to be a ONE WEEK auto titration is NOT a particularly good idea in my personal opinion. I wouldn't go for it unless it was my only alternative due to finances. APAPs are great for keeping a close eye on TRENDS w/your sleep, and even for "fine tuning" your pressure needs based on an in-lab titration, but NOT for your first experience w/PAP therapy, again, in my not at all humble, but strictly patient opinion. I am no medical professional by a long shot!!!
The home study and auto-titration is a rough road to go down. This process could add weeks, months, or years to your acclimation to PAP therapy. Get a lab based study.

Jason you suck. I respect your opinion, and to hear you say that Stanford might not be the best place to go. I got to go with ya cause you the man. Just to be able to rub elbows with the best in our field though.
JUDY are you SENDING code TO the SOVIETS?

Judy said:
I so agree w/Saz!!! Not about Stanford 'cause I am in Michigan and have no personal knowledge of Stanford - but - about bypassing Kaiser and going for the full in-lab sleep study at an accredited sleep lab. Once you've been evaluated for all the 80+ sleep disorders that can occur and found to have OSA then MAYBE if financies are a consideration an at home auto titration such as Kaiser does. BUT, understand one LARGE problem w/at-home auto titrations if you've never been on CPAP before - it can take weeks to months to find THE RIGHT mask and w/o THE RIGHT mask and acclimation to mask and CPAP pressure that auto PAPs are at a GREAT disadvantage in titrating THE RIGHT pressure for YOU. For your first time on PAP therapy to be a ONE WEEK auto titration is NOT a particularly good idea in my personal opinion. I wouldn't go for it unless it was my only alternative due to finances. APAPs are great for keeping a close eye on TRENDS w/your sleep, and even for "fine tuning" your pressure needs based on an in-lab titration, but NOT for your first experience w/PAP therapy, again, in my not at all humble, but strictly patient opinion. I am no medical professional by a long shot!!!
Say WHAT, Rock HInkle??? Me??? Little ole gray haired, sweet tempered, mild mannered moi???
LOL, Judy!! You're an unceasing source of amusement for me!!!

Susan McCord :-p)
LOL!!! ;^)

Stanford isn't terrible. I just wouldn't say that they're worth going out of the way for. If I were equal distance between Stanford and UCSF, I'd go to UCSF.

I would agree that you will rub elbows with some of the best and most innovative sleep specialists in the field. Those aren't the people who will be titrating your CPAP, or keeping your study artifact free, or scoring your sleep study.

I used to pitch in college. I had a serious injury in my elbow that required surgery. "Go see Dr. Jobe...Dr. Jobe is the man...The pioneer of Tommy John surgery" My university training staff (big honchos in the field themselves) and the orthopedic surgeon in the area who trained under Jobe all said, "Frank Jobe Frank Jobe Frank Jobe."

So there I went. And the surgery was performed by......not Frank Jobe, a bunch of med students. The elbow healed to where I could continue pitching long enough to blow out my shoulder, but it still clicks and pops and locks up every now and then. I see Stanford as the same climate. Tons of brilliant people training others that aren't quite ready for prime-time.

Rock Hinkle said:
The home study and auto-titration is a rough road to go down. This process could add weeks, months, or years to your acclimation to PAP therapy. Get a lab based study.

Jason you suck. I respect your opinion, and to hear you say that Stanford might not be the best place to go. I got to go with ya cause you the man. Just to be able to rub elbows with the best in our field though.
I think the Kaiser-bashing is unfair. The clinic was about 5 days. They explained how to use the machine and I-Pod looking diagostic thing you wear around your neck. They let you take it home. I am sure if I didn't sleep the min 7 hrs, they would have let me do it another night. They then refer to a few suppliers for machine/masks, who ALSO sent their own diagnostic machine home to verify my Rx, and if I bought everything there, the $100 for this was included. For those with Kaiser, I don't know why you wouldn't go there, especially if they pay for the equipmt, my insur said no-pay for "durable medical equipment" but I still did the right thing, rather than beat around the bush or wait, procrastinate is no good, this is serious business we're talking about because it's usually gone on a while before we act. My 2cents... Gordon.
Saz, I totally agree that you often want to steer clear of the "head honcho" types in medicine and head instead to the physician who is going to spend the most time and energy giving you care. with the only surgery i ever had, i asked to be operated on by the Chief of Urology of a large teaching hospital. The guy was a total jerk, condescending and arrogant, and now, 15 years later, I'm still dealing with the effects of his crappy work (or whatever underling he found to actually do the procedure when i was on the operating table).

so i hear you. that said, i've personally had good experiences at Stanford. both with Pelayo and some of the up and coming young doctors in the fellowship program there.

Saz RPSGT said:
LOL!!! ;^)
Stanford isn't terrible. I just wouldn't say that they're worth going out of the way for. If I were equal distance between Stanford and UCSF, I'd go to UCSF.
I would agree that you will rub elbows with some of the best and most innovative sleep specialists in the field. Those aren't the people who will be titrating your CPAP, or keeping your study artifact free, or scoring your sleep study.

I used to pitch in college. I had a serious injury in my elbow that required surgery. "Go see Dr. Jobe...Dr. Jobe is the man...The pioneer of Tommy John surgery" My university training staff (big honchos in the field themselves) and the orthopedic surgeon in the area who trained under Jobe all said, "Frank Jobe Frank Jobe Frank Jobe."

So there I went. And the surgery was performed by......not Frank Jobe, a bunch of med students. The elbow healed to where I could continue pitching long enough to blow out my shoulder, but it still clicks and pops and locks up every now and then. I see Stanford as the same climate. Tons of brilliant people training others that aren't quite ready for prime-time.

Rock Hinkle said:
The home study and auto-titration is a rough road to go down. This process could add weeks, months, or years to your acclimation to PAP therapy. Get a lab based study.

Jason you suck. I respect your opinion, and to hear you say that Stanford might not be the best place to go. I got to go with ya cause you the man. Just to be able to rub elbows with the best in our field though.
Really, when it comes down to it your experience there and the treatment that you received after is all that matters. With the other policy "stuff", I think all accredited labs (and they are one) are now on the same page and everything is more standardized.

Even with regards to Kaiser. I know that the one in my area has changed their model. Really it's the results that matter and how the patients life has improved.

My wife's uncle just died. Heart attack. He's 300+ lbs and I'd been on his case for years about getting his OSA treated. He chose not to. Trust me...it's the results that matter.

J


Mike said:
Saz, I totally agree that you often want to steer clear of the "head honcho" types in medicine and head instead to the physician who is going to spend the most time and energy giving you care. with the only surgery i ever had, i asked to be operated on by the Chief of Urology of a large teaching hospital. The guy was a total jerk, condescending and arrogant, and now, 15 years later, I'm still dealing with the effects of his crappy work (or whatever underling he found to actually do the procedure when i was on the operating table).
so i hear you. that said, i've personally had good experiences at Stanford. both with Pelayo and some of the up and coming young doctors in the fellowship program there.

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