Friend: "Doc refused to prescribe sleep study.."

[Big Guy]

Just for fun, here's an interesting example of one result of a driver falling asleep at the wheel.  Chicago O'Hare Airport, March 24, 2014.  No deaths, 30-some injuries, $9 million in damage.

I remember that! Was it ever verified that it was because of sleep apnea though? 

[Fats Drywaller]

https://journal.chestnet.org/article/S00...6/fulltext

Patients with obstructive sleep apnea are at increased risk for auto crashes.  Controlled studies in both the United States and Canada have recently shown that patients with obstructive sleep apnea are involved in auto crashes approximately two and one half times more frequently than other licensed drivers.  In a letter to the editor, George and colleagues showed that a group of 27 Canadian patients with the clinical diagnosis of sleep apnea had an automobile accident rate more than two times greater than a control group of subjects.  My colleagues and I showed that the automobile crash rate of patients with sleep apnea was 2.6 times the crash rate of all licensed drivers in the state of Virginia.  In addition, approximately one third of patients with apnea were involved in an auto crash over a five-year period.  Finally, 24 percent of patients with sleep apnea reported falling asleep at least once per week while driving.  These findings suggest that auto crashes may be an important source of morbidity in patients with sleep apnea and that many of these patients may be putting others at risk when they drive.

And so on.  There are dozens of related papers & popular articles Out There in webland for anyone who wants to search using the obvious terms. Just one more example, from Medical Daily, March 11, 2015:

New evidence adds to the already compelling case that driving a car while not properly rested produces similar risks as driving drunk.

The recent study was published in the journal Sleep and found people with obstructive sleep apnea were 2.5 times more likely to be the driver in an accident than people without the sleep disorder. Fortunately, the study also found continuous positive airway pressure, or CPAP, therapy was effective at reducing the rates by up to 70 percent if the person used the technique for an average of four hours every night.

(Why stop at four hours? Go for eight hours and reduce the rate by more than 70%!)

[Fats Drywaller]

Was it ever verified that it was because of sleep apnea though? 

What practical difference does it make? Falling asleep is falling asleep, and the effects are the same if someone happens to be driving. Suppose the motorman (female in this case; they're all called motormen) didn't have sleep apnea. So what? Does that make it OK? "All right, no sleep apnea, so you're excused and exonerated! Keep on drivin' them trains, and try not to fall asleep from now on! We're gettin' tired of payin' these nine-million-dollar bills and having to settle thirty lawsuits every time you crash a train!"

[Walla Walla]

Was it ever verified that it was because of sleep apnea though? 

What practical difference does it make?  Falling asleep is falling asleep, and the effects are the same if someone happens to be driving.  Suppose the motorman (female in this case; they're all called motormen) didn't have sleep apnea.  So what?  Does that make it OK?  "All right, no sleep apnea, so you're excused and exonerated!  Keep on drivin' them trains, and try not to fall asleep from now on!  We're gettin' tired of payin' these nine-million-dollar bills and having to settle thirty lawsuits every time you crash a train!"

Well just maybe it might be a difference because this is a site about sleep apnea?  

[Big Guy]

Was it ever verified that it was because of sleep apnea though? 

What practical difference does it make?  Falling asleep is falling asleep, and the effects are the same if someone happens to be driving.  Suppose the motorman (female in this case; they're all called motormen) didn't have sleep apnea.  So what?  Does that make it OK?  "All right, no sleep apnea, so you're excused and exonerated!  Keep on drivin' them trains, and try not to fall asleep from now on!  We're gettin' tired of payin' these nine-million-dollar bills and having to settle thirty lawsuits every time you crash a train!"

No need to get testy. There is a big difference between falling asleep naturally and falling asleep because of a medical condition. 

I don't know if someone could be hired as a motormen, if that individual stated that they had sleep apnea on an application form. 

And yes, I would like to know if the female in question, did indeed, have some kind of sleep apnea. I have it, but yet I am not susceptible to nodding off unexpectedly. 

Bus drivers and truck drivers nod off as well. Who knows if it was just from being being too tired, or, if they had a medical condition? There is a practical difference.

[Walla Walla]

Was it ever verified that it was because of sleep apnea though? 

What practical difference does it make?  Falling asleep is falling asleep, and the effects are the same if someone happens to be driving.  Suppose the motorman (female in this case; they're all called motormen) didn't have sleep apnea.  So what?  Does that make it OK?  "All right, no sleep apnea, so you're excused and exonerated!  Keep on drivin' them trains, and try not to fall asleep from now on!  We're gettin' tired of payin' these nine-million-dollar bills and having to settle thirty lawsuits every time you crash a train!"

No need to get testy. There is a big difference between falling asleep naturally and falling asleep because of a medical condition. 

I don't know if someone could be hired as a motormen, if that individual stated that they had sleep apnea on an application form. 

And yes, I would like to know if the female in question, did indeed, have some kind of sleep apnea. I have it, but yet I am not susceptible to nodding off unexpectedly. 

Bus drivers and truck drivers nod off as well. Who knows if it was just from being being too tired, or, if they had a medical condition? There is a practical difference.

Valid questions. Not every incident of lack of rest is due to sleep apnea. There are many medical conditions that could lead to a lack of sleep. Pain being a big one.

Also being a new parent. I remember holding my sons all night while they were cutting teeth.

[Fats Drywaller]

The example that I used is relevant anyway, as one cautionary tale among zillions that can be found Out There, for the possible benefit of the friend of the OP among others: "Here's what can happen if you fall asleep at the wheel. Untreated sleep apnea is one common cause of falling asleep at the wheel; in fact, studies have shown that you're 2.5 times more likely to crash & burn if you drive with untreated sleep apnea. It's practically equivalent to driving while drunk. If you think you might have sleep apnea, then have a sleep study done to find out, and take it from there."

(end of today's public-service announcement)

By the way, this thread has provided more indications of why subjective responses, like those to the Epworth questions, are useless for most purposes. Considering the question "How likely are you to doze off while driving?", low-number responses to that can't be trusted if the patient has untreated sleep apnea, because they're obviously biased, for the reasons mentioned earlier among others. It's analogous to a patient saying "Yes, it's true that I drink a bottle of whiskey every day, but I would never become violent and I never have! I don't care what the statistics say; they don't apply to me because I'm completely different! I wouldn't harm a fly!" Uh-huh, sure.

With the driving-while-sleepy thing, the only way to determine the truth of the matter would be to have objective evidence, which means cameras in the vehicles recording each driver's alertness, responses, reaction times, ability to drive without weaving, tendency (or the lack thereof) to nod off, and so on. By comparison, answers on a questionnaire are 100% worthless.

Anyone who wants to learn more about the general phenomenon could do a web search for:

"special pleading" intitle:fallacies

[Mosquitobait]

The Epworth Scale is simply a tool. I rated 3 on the Epworth scale. The fact that I needed 2 - 2 hour naps daily after 9 hours of sleep was an indicator something was very wrong. In my case, it wasn't sleep apnea, but did confirm slow heart rate all night (resulting in low oxygen all night).

I agree with others. Get a second opinion or buy a sleep test from an online supplier.

[Big Guy]

I was diagnosed with A-Fib this past summer. It was treated successfully, and I still don't feel one bit differently, as in better. You'd think that if your heart isn't beating correctly, you'd know it. I didn't have a clue. 
I'm hoping that my sleep apnea treatment doesn't turn out the same. 

[Hydrangea]

I've been working with someone to help get their sleep issues remedied, and their dr has refused to refer for a sleep study, has had no clue about the questionnaire, and has been a brick wall. We finally got a sleep study Rxed (due to me feeding the key words to mention, and to keep advocating), and they'd only do an at-home study... which came back with "normal" results. Ugh. Now we're working on pursuing an in-lab sleep study.

I think it has to do with 1) cost, and 2) the doctor's lack of awareness.