Should I tell my sleep doctor I'm using CPAP?

[isuckatsleeping]

I have a follow-up with my sleep doctor next week after a botched sleep test late last month. I only slept ~3 hrs and the sleep doctor told me he didn't see any apneas in that time. At the time I was convinced I had sleep apnea due to my symptoms along with reports of me holding my breath by girlfriends going back to when I was 18 and my quality of life had been declining steadily due to the constant fatigue and brain fog. So, I went out and got a Resmed S10 Autoset. I've been using it for the last week or so, and the improvement in my quality of life has been significant on the days following good CPAP therapy. When I have a good CPAP night, I wake up feeling like I slept better than I ever have over the last 10 years.

• What should my game plan be for the follow-up with the sleep doctor next week? 
  
• Should I bring my SD card with the Sleepyhead data? 
  
• Based on the data is it pretty clear CPAP therapy is right for me? 
  
• If he asks me to take another sleep study, should I? I already reached my deductible so there's no downside really.
  

Added a few nights of data from my CPAP for reference.

[Walla Walla]

I would show them the results and ask for another test. It will make it easier for insurance purposes in the future to get it documented.

[sheepless]

there's no nice way to say this: many providers are clear they want us to have no part in our treatment decisions and most of us comply, at least in the beginning. it's borderline intimidation. but you've already made the decision to be proactive. there's absolutely nothing to be gained by being secretive or creating a situation where you and your providers are working blind or at odds with each other. much better to have an open working relationship with them. some will balk, in which case it's time to find new providers that'll work with you. many providers will, once they realize you're determined and have a reasonable level of knowledge and your suggestions are defensible. they may even welcome it because it makes their job easier. they may also disagree with you. hopefully they know more than us so that should be a good thing. just be sure they explain themselves to your satisfaction. it's our health we're talking about; if we want to be involved, it's only right that they accommodate us. so my advice is to talk openly with them. let them know you have a machine and show them the data. tell them your expectations of them and how much involvement you want. they may set some ground rules for their needs and that's fine. when I argued with my doc that it's perfectly legal and appropriate, the first thing he said was it was within his rights to refuse to treat me. I told him that served no one, that I wanted to work with him. when I brought my laptop to appointments and used sleepyhead to explain my view of things (in the 5 minutes he gave me he listened but never actually looked at anything), he told me to do as I saw fit but asked me to set the machine back to his settings for the next appointment. then he gave me a new rx for the settings I wanted. it's ridiculous to wait 1 - 6 months to make adjustments because they're too busy for us to get an appointment. after 2 years I'm still fine tuning my settings, sometimes weekly. at any rate, he didn't disagree with me; he just wanted to do things according to hoyle for insurance and whatever other things govern his actions. btw, do take your sd card and take your machine but don't expect them to look at any data, especially sleepyhead data, that you aren't prepared to show them on paper or on your laptop. they only look at compliance unless you put the info directly in front of them. my doc didn't even have the capability of reading the cards. they took compliance data directly from the machine.

[Mosquitobait]

I'd give the doc the benefit of the doubt. You have data. That says something. Except in the case of using illegal substances, I wouldn't keep what I'm doing secret, especially if it is helping.

Before anybody knocks me about the illegal substance thing, there's a reason why doctors and patients have been asking for pot to be legalized for medical use. Admitting that you used it potentially resulted in loss of benefits. Your medical record is not secret.

[mesenteria]

On balance, I'd take the data and ask that he/she at least review it.  Clearly, with pressure changes, you have events of different kinds.  It appears that you are using the device properly as far as fit and duration.  What is by no means clear is what is the optimal range of pressure and mode of delivery.  You have measured events, and the machine even records at least one large leak...a good sign that it is functioning properly, even if not dispensed by a DME or other 'trusted agent'.

There is one huge up-side to your revealing all of this: you can argue that you are now more comfortable and experienced with wearing a mask of a given type, even if it won't be the one eventually prescribed, that there seems to be recordable events of a kind or two, and that a new session is likely to yield a much higher quality assessment as a result.  Both of you should anticipate a much more valid diagnosis this time.

[Sleeprider]

I think the data is fine, but I don't even know why you're returning to the doctor. I would be straight-forward and tell him

"I disagree with the conclusion you reached based on a limited sleep study. I disagree to the extent I spent my own money to get relief trom the symptoms we discussed prior to the test. The CPAP I bought documents that my sleep apnea is controlled with the machine, and more importantly, I feel better. I'd still like to have this problem covered by my insurance. If you're not the guy to help me out, just say so and I'll move along. If you can help me solve this problem I hope we can work together.

[Matt00926]

My game plan would be to call and cancel the appointment, and then continue on with my life. Your treated results look pretty good, and you did that all by yourself.

[isuckatsleeping]

I had my appointment this morning and the doc was great. He plugged my SD card in and talked with me about the data and the changes I could expect to see over the next 6 months as my sleep and health improves. He wants me to try some CBT for insomnia which I’m down to take a look at. Overall though I am really happy with how he reacted. He wants to see me in 6 weeks to look at more data.

[sonicboom]

Overall though I am really happy with how he reacted. He wants to see me in 6 weeks to look at more data.

That puts him in a rare class.  Most, including mine, have no interest in looking at data or even seeing me unless I call in with a particular problem or issue.  Follow up? hahahahahaha.  The DME was actually more helpful in my case.  They followed up routinely until they realized I didn't need their help.  Your data looks good.  The best barometer of the efficacy of treatment is how you feel the next day.  You should notice continuing improvements over time as your body acclimates from years of apnea assaults.

[SarcasticDave94]

I had my appointment this morning and the doc was great. He plugged my SD card in and talked with me about the data and the changes I could expect to see over the next 6 months as my sleep and health improves. He wants me to try some CBT for insomnia which I’m down to take a look at. Overall though I am really happy with how he reacted. He wants to see me in 6 weeks to look at more data.

Congrats on having a rare Doc that will actually support your actions after the fact. Keep up the good communication with him, as this will help in the event you'd want insurance to pay something towards apnea treatment including paying for future machines and/or supplies.