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[Diagnosis] Can I be Misdiagnoised
#1
Angry 
Can I be Misdiagnoised
I went in for my third sleep study, thinking that I would finally get on pap/ASV therapy for my central apnea, and in the morning after getting the titration, I was told I have obstructive apnea. What?? I don't snore, I don't have the morning headache, and I don't wake up with dry mouth. Is it possible that I could have been misdiagnosed with this study? Now I'm being told that I need to be on CPAP with oxygen because my oxygen didn't raise enough even with the CPAP. Im so confused right now. If I really have Central Apnea, can CPAP make it worse? Has this happened to anyone? Huh
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#2
RE: Can I be Misdiagnoised
It is impossible to be misdiagnosed, because doctors never make mistakes.

That being said, why have you had three sleep studies? Do you have complete copies of all three? If not you need to get copies. You need to read them including the graphs until you understand them. You may need to ask questions of your doctors and also here.

Once you have a thorough understanding of the test reports the answer to your question should be obvious. Sometimes after being on APAP for a while (3 years in my case) things can change. I am now on ASV.
Be pro active. Know your test results. Know your therapy results. Make sure any necessary changes are made in a timely manner.
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#3
RE: Can I be Misdiagnoised
Obstructive verses central is a pretty easy call for a sleep study.
You don't have to snore to have obstructive apnea
you don't have to have morning headaches to have any apnea
you don't have to wake up with a dry mouth to have any apnea
CPAP does treat centrals and if not set correctly it can cause some centrals, if set correctly it won't do anything at all with centrals.

Centrals are complicated things. A true central is when the brain stem does not trigger a breath when your CO2 levels are too high and you really need to take a breath. If you have a lot of these then your CO2 levels will climb and you get headaches. You can actually have O2 levels that are just fine and still have CO2 levels that are too high. I am not sure if anybody has zero centrals all the time. A central can happen if you O2/CO2 levels are fine and you really just don't need to take a breath, so you skip one or two.

I am not sure why you are so certain that you need ASV for your centrals. How many centrals do you have an hour? If you don't know this, then you don't know if you need your centrals treated.

"I don't snore, I don't have the morning headache, and I don't wake up with dry mouth" this says you don't understand sleep apnea as this is not how you know you don't have obstructive apnea.
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#4
RE: Can I be Misdiagnoised
(11-01-2015, 01:26 PM)julrez9 Wrote: If I really have Central Apnea, can CPAP make it worse? Has this happened to anyone? Huh
ResMed (S9 Autoset, Airsense 10 AutoSet/AutoSet for Her) and PR (System One Auto and DreamStation Auto) adamant their machines can detect both obstructive apnea and central apnnea, and won't increase pressure in response to central apnea (PR call it clear airway)

Some women don't have the classic symptoms as men do and that may present problem to doctors and can be misdiagnosed
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#5
RE: Can I be Misdiagnoised

Hi julrez9,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you in getting your sleep problems straightened out.
trish6hundred
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#6
RE: Can I be Misdiagnoised
Julrez, you say they diagnosed CA, but what kind of PAP therapy was applied that was deemed insufficient? Did the titration evaluate ASV therapy?
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#7
RE: Can I be Misdiagnoised
Its not hard for a lab to tell central from obstructive. Heck a home study can tell.
Anyone that knows the difference can just watch you sleep and know ine from the other.
I doubt your misdiagnosed if three sleep studies say obstructive. Especially if one was wired up to pick up your brain waves.
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#8
RE: Can I be Misdiagnoised
(11-01-2015, 01:26 PM)julrez9 Wrote: I went in for my third sleep study, thinking that I would finally get on pap/ASV therapy for my central apnea, and in the morning after getting the titration, I was told I have obstructive apnea. What?? I don't snore, I don't have the morning headache, and I don't wake up with dry mouth. Is it possible that I could have been misdiagnosed with this study? Now I'm being told that I need to be on CPAP with oxygen because my oxygen didn't raise enough even with the CPAP. Im so confused right now. If I really have Central Apnea, can CPAP make it worse? Has this happened to anyone? Huh

Julia, who told you the morning after your sleep study that you have obstructive apnea -- the sleep tech?

Who told you that you need to be on CPAP with oxygen?

Do you have a copy of the report from that test and the first one that we could take a look at?


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#9
RE: Can I be Misdiagnoised
When I started the journey was because I couldn't get to sleep or stay asleep. I have really bad insomnia. The doc thought apnea was the reason. The first sleep study I had said I had 19 centrals and 0.8 obstructions per hour. My Oxygen went down to 72. Also 1% REM and No N4. My 2nd study was a bust, I only slept 1.8 hours with no apnea events. Oxygen was 85. No REM, N3 or N4. The third, according to the sleep tech, was no centrals and 17 obstructive with an oxygen of 68. Slept through all sleep phases. The tech put a mask on me part way through the study while I was half asleep. I'm on oxygen therapy now, but the tech ordered a cpap with oxygen. I also woke up with a splitting headache and I didn't feel rested after the cpap. Actually I felt so bad I had to take an old oxy pain med from a surgery and an energy drink just to get through the day. I got a copy from the first study, the graph is small and unreadable and I just got a summery of the results. Didn't bother with the 2nd and the 3rd is still being read by the doc. How the heck can I have two different results like this? At this point, I'm stopping all treatments until my doctors can give one diagnosis. This is now going on a year and still no pap or ASV machine. Dont-know Ahhhh!
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#10
RE: Can I be Misdiagnoised
(11-02-2015, 03:23 AM)julrez9 Wrote: When I started the journey was because I couldn't get to sleep or stay asleep. I have really bad insomnia. The doc thought apnea was the reason. The first sleep study I had said I had 19 centrals and 0.8 obstructions per hour. My Oxygen went down to 72. Also 1% REM and No N4. My 2nd study was a bust, I only slept 1.8 hours with no apnea events. Oxygen was 85. No REM, N3 or N4. The third, according to the sleep tech, was no centrals and 17 obstructive with an oxygen of 68. Slept through all sleep phases. The tech put a mask on me part way through the study while I was half asleep. I'm on oxygen therapy now, but the tech ordered a cpap with oxygen. I also woke up with a splitting headache and I didn't feel rested after the cpap. Actually I felt so bad I had to take an old oxy pain med from a surgery and an energy drink just to get through the day. I got a copy from the first study, the graph is small and unreadable and I just got a summery of the results. Didn't bother with the 2nd and the 3rd is still being read by the doc. How the heck can I have two different results like this? At this point, I'm stopping all treatments until my doctors can give one diagnosis. This is now going on a year and still no pap or ASV machine. Dont-know Ahhhh!

Sleep techs cannot prescribe CPAP or oxygen therapy. And they can't diagnose patients (they really aren't even supposed to discuss test results with you at all, though some do anyway). So let's see what your doctor has to say about the results of the third test. I wouldn't be surprised if the tech gave you a bunch of misinformation.

And I don't know why you felt so miserable and had that awful headache after this sleep study, but if your earlier CSA diagnosis was correct and you were put on a CPAP machine this time, that could certainly explain why you felt so awful.

Were you on different medications (or different doses) at the time of your first sleep study?

When do you expect to hear from your doctor about the results of this third sleep study?
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