Legal Action? Lawyers Here? Missed Diagnosis

[Phill]

The box I had strapped to my chest for the home sleep test was about the size of a cigar box, with all the wires and a couple of tubes up my nostrils.
I asked how they were expecting to get a representative nights sleep with all this stuff attached, especially as it is impossible to sleep on your stomach, more or less forcing you to sleep on your back.

Then in a previous thread on the subject it was said that an event was more likely if you slept on your back, at which stage you want to give up.

I did refer to the people dealing with me as being "cerebrally incontinent", you can put your own interpretation on that.

[KSMatthew]

For starters I find mattresses intolerable and have been sleeping on a sofa for at least 15 years. I recently switched to a recliner; so very comfortable.

I think there are a lot of issues besides apneas.  

Does the sofa and recliner raise your head vs a mattress?  Maybe that's part of your sleep problems - have you tried using an extra pillow or two?

[K.L.]

Sofas/recliner: It's not about any dysfunction; it's my low back. My low back does not take well to mattresses. A mattress forces a mild extension of the low back. Overnight in this position results in awakening with a sore low back.

The mattress industry wants us to believe that anything other than a mattress is bad for the back or suggestive of a "sleep problem" if one doesn't like mattresses. Kind of like the dog food industry; wants us to believe that the only good food for dogs is the stuff made in a factory. It's all about marketing. Though some people love their mattresses, they are not for everybody.

A sofa has a dip in the middle that aligns with my low back, resulting in a very comfortable lumbar flexion, which prevents the soreness.

The mattress industry hasn't caught onto this. However, the fitness equipment industry has, which is why all the leg curl equipment these days (and for the past 20 years or so), where you lie on your stomach, now has a bend in it to prevent low back extension.

I'm not a side sleeper. I can only tolerate this for an hour before it just gets so uncomfortable. When I travel and must sleep in a hotel bed...it's never pretty, no matter what I do with the pillows.

The home sleep study works fine for me as far as comfort since I'm a back sleeper. 

I have tried every imaginable permutation of pillow arrangements you can think of for sleeping on my back and side.

The sofa won out 15 years ago. Several years ago I propped one end of it up by 12 inches to prevent acid reflux, which has worked. But I was still getting the occasional abrupt awakening gasping for air. Recently I propped an extra pillow to my already two head pillows, increasing my torso angle. The new pillow is memory foam. This seemed to stop the abrupt awakenings, but was forcing neck flexion once I fell asleep -- and I had an abrupt awakening.

Then I bought the recliner and have had zero abrupt awakenings. It has me anywhere from pretty much upright to reclined back 30 degrees from parallel. I've been experimenting with different trunk angles (30 degrees to almost upright) and neck extension. It's super comfortable, and comfort is what you need for a good night's sleep, whether you have SA or not.

If I sleep straight through the next study, I'll know it. So I feel confident there won't be a diluted AHI. If I don't sleep straight through I'll note the time period. It's possible the results are graphed according to time lapse. So if I report that I was awake (in the bed) from 3 am to 4 am, I'm sure they'll be able to correlate the results to this period of time and eliminate them from the analysis.

[SarcasticDave94]

K.L.

I can understand somewhat what you're dealing with on that bad back thing. I myself have several back problems stacked on top of each other. Back sleeping is near torture IMO. I have been a side sleeper for many years, so that's how I get around it for now. Get sleep however you must.



FWIW: I'm about to get the spinal stimulant trial.
 Dave

[HalfAsleep]

I guess I'd be concerned in your sleeping arrangement that your head is tilting forward more than you realize. That can easily happen when you sleep with your torso at a substantial tilt. I struggle with this regularly. The problem is that tilting the head forward can create substantial throat obstruction and exacerbate OSA. That's one factor in why many CPAPpers use cervical collars for sleeping. The other major reason is to minimize mouth breathing, which interferes with CPAP effects and thereby risks increasing OSA...Seeing a pattern here? Head position during sleep really matters.....

[K.L.]

I've been positioning my head so that it's slightly tilted back (slight neck extension) against the recliner. It seems to "hold" that position even after I fall asleep. But the stretch in the front of my neck will take getting used to. 

If I prop myself up by sitting on a pillow, my head will be high enough up against the recliner that my neck will naturally extend as it contours to the cushion, eliminating the need to consciously tilt it back. 

I realize that neck extension opens the airway (anyone who's ever taken a CPR class will know that). What I don't get is that the tilting back puts the tongue in more of a vertical position, making it more vulnerable to falling backwards from gravity. Can anyone explain how tilting the head backwards could reduce events since, at the same time, it puts the tongue at an angle that makes it vulnerable to falling "down" into the airway?

As for cervical collars, I've been very curious about this after reading about a man who claims to have gotten his AHI into the normal range with a cervical collar (he had a sleep test done with one).

As mentioned in a previous post, maybe I'm getting too pre-emptive, but if I'm ultimately diagnosed, I want my ducks already lined up in a neat row. Knowledge is power.

[KSMatthew]

... The next availability for the equipment is Nov. 9....

How did it go?

[K.L.]

Had to cancel it due to family emergency. I am now not in a "mental place" to pursue it until the dust settles--which won't be for a while. Thanks for asking.

[KSMatthew]

OK - Take care of yourself.

[Mark Douglas]

A significant percentage of the membership have the same story. Welcome to the club.

Hear is my take. 

How much is your life worth to you?

Do you want to be angry or do you want to live a better and likely longer life?

IMO quit fighting with ins companies and go buy an APAP, install sleepyhead, and begin your new life.
Antidotal evidence indicates the people here are far and away more knowledgeable than your average sleep doc.
DEFINITELY more knowledgeable than equipment providers. What I learned here changed my life and many many people will tell you the same thing.
Often times you will pay as much in insurance fees as buying a gently used machine outright and no compliance hassles.
Learn here how to discuss the subject with confidence then explain your symptoms to your GP and likely walk out with an Rx so you can legally buy what you need. I of course would never point out Craigslist is full of cpap machines.
With GP Rx I bought a a bipap with a few hours on it for less money than a new, less capable machine, manage my own setting with the help of the good folks here and I'm never looking back.