RE: Do Sleep Doctors hate APAP machines?
The question as to whether or not 'sleep doctors' dislike APAP machines over CPAP, IMHO is a matter of 'keeping the money machine working'. If you happen to luck out and find a doctor who appreciates the fact that you are collecting data you are fortunate. Mine said "Geez, you know more than I do about this... you'd make a great internist" and "I'm going to Rx data collecting APAP for all of my patients in future".
Did he resolve my sleep apnea? NO! Not by a long shot. I had to go out and buy my own S9 Auto. I had to learn about OSA and a variety of other afflictions. I had to learn how to titrate my own settings as I am sure that he was just guessing at the pressure. And when I continued to suffer from massive desats during the night (okay during the day) I wound up with a second sleep study and 3 more specialists all doing their own tests, off on a tangent.
Duh? Simple enough to me. My breathing got very shallow during REM/L4 sleep and SpO2 plummeted (and BP skyrocketed and I awoke in a cold sweat often). I asked about supplemental oxygen at night and my sleep doc added ***+O2 to my Rx. That was it. Not much discussion. So I went out and bought (BOUGHT) two oxygen concentrators (My share of the rent was $150 a month... the cost to purchase the TWO units was about $1300 total. Paid for in under a year, right? (I demand redundancy).
I titrated my supplemental O2 infusion into the airline and found that at 4L/M my SpO2 stayed at about 95% all night. Go figure. It did drop but marginally and always above 90%. Slept like a log excepting for arthritis and spinal injury pain and the side-effects of the pain meds taken so I could sleep.... a vicious circle to be sure.
I titrated my own PAP pressure and came up with a good range. I titrated my own O2 infusion rate. I bought my own machines and saved a bundle even with insurance. I learned everything I could about apnea and began supplementing my diet with Magnesium, Potassium, Taurine, CoEnzyme Q10 (UBIQUINOL FORM!) and a host of vitamins including time release vitamin C, D, B's, etc.
We discovered that I had Atrial Fibrillation, which NONE of the doctors seemed to be looking for in terms of low SpO2 at night. And now that I have been blessed by a medication that gives me Normal Sinus Rhythm (and awaiting a catheter ablation) my SpO2 at night seems to be running closer to 100% every night all night long and I am about to educate myself as to the ideal SpO2 during sleep. When I am moving about during the day I am fine. It is somewhat more complex that this, of course, but it also took some time to find a knowledgable cardiologist/electrophysiologist while my first cardiologist tried to kill me dead. What a quack.
My point is that (a) you MUST advocate for yourself through knowledge and willpower if you are looking for the quickest possible resolution; and (b) most doctors hate it when the patient is educated or has more information than they do and have utter disdain for patients asking educated questions. If you have one of these doc's you need to get referred to a more flexible one and fast.
Now, I am not saying that all doctors are quacks or money machines, but am saying that most specialists are just that... specialists. And they may know diddly about what ails you. YOU need to know. And if you spend the time and effort you will know.
In the course of my travels from MD to MD I made a point of requesting a copy of my test results. ALL OF THEM. They are YOURS and you are entitled to them. Some hospitals/clinics will try to charge you an exhorbitant amount of money to have this information but that is strictly BS and the statement "Who is your governing body and may I have their phone number" usually resolves the matter in about ten seconds.
I got good news the other day! Eating healthy, living healthy, supplementing my diet, maintaining healthy levels of hydration, Magnesium, Potassium, Etc. Etc. has helped me. My pulmonologist (one of MANY MD's) demanded that I have another CT scan one year and a half after my last one to see what was happening inside me. Just a shot in the dark as she had nothing good to suggest all along otherwise. I got a copy of that report, of course, and discovered that clean living and healthy diet (NO PREPARED FOODS AT ALL. PERIOD. ALL FRESH AND AS ORGANIC AS POSSIBLE). No salt, no caffeine, no MSG, no chocolate, no........, well - you get the picture. Thus the motto "no prepared foods" as there is hidden salt, hidden MSG, hidden chemicals and genetic engineering and Lord knows what if it comes out of a package. Even the darned frozen fresh chicken breasts we were buying were loaded with crap I am sure... definitely loaded with salt. So I am on a "Paleo - like diet" as best I can. Did the doctors suggest it? Nope. They just wanted me to go to THEIR nutritionists who made up a diet for me that was full of crap. Keep your patients in the dark and feed them crap.
BOTTOM LINE? Most doctors, it is my gut feeling, hate any and all data collected by patients and have a dislike for educated patients. We take too much time. We are not money makers. We are often too much of a challenge for what they learned 40 years ago in med school. So, in answer to your question, "Do Sleep Doctors HATE APAP machines?" - my learned opinion is that your answer is not black and white but rather grey. You can take the aforesaid mini-statement and chew on it. My story is very, very long and sordid and I really should write a white paper or book on it sometime. It would, I have little doubt, be a real eye-opener for most patients seeing doc's for apneas, aFib, internal 'inflammation', etc.
Oh, and the good news from the second CT scan that I demanded a copy of? All of my internal inflammation was gone. No cardiopulmonary effusion, no pleural effusion (nothing in the sac that houses the lungs, or in the sac housing the heart) , etc. It was absolutely normal. And THAT I attribute totally to living healthy and reducing stress on my body.
If you are not using an APAP machine that gathers data right now? I highly recommend that you take a look at the gear I am using and give it some careful consideration. In especially I believe that anyone suffering from apnea or aFib needs a recording pulse oximeter like the Contec CMS-50E or EW (blue tooth) to get a handle on what is going on at night. And deal with it! Advocate for yourself when you go to see the doctor/specialist and do not EVER EVER EVER take "no" or "we need a lot more tests" for an answer. How about, "Here's some empirical data that I have gathered.... I believe that I need to begin X, Y and Z right away and unless you have a strong objection to this, I would like to do this immediately. I have no problem with more tests and visits, but I want to handle my problem starting today unless you can tell me why I should not".... and the answer "We need to do more tests" is insufficient in my opinion.
Whether or not your sleep doc or other specialist hates APAP is moot. YOU want APAP at the very least and YOU want APAP that gathers data so you can take it every day and put it on your hard drive and print out hard copies for your binder.... and when you next see that doctor that hates APAP, you take your binder and a copy of your software and data on a DVD. If they don't look at it, dump the doctor on the spot. I did and have on more than one occasion and I am telling you, for a fact, that I would not be here today enjoying life had I not. I spent three weeks on TOTAL life support exactly three years ago this past week. And I blame the doctors for that fiasco. The lab sent my chest xrays to the docs by mail. I should have DEMANDED same and taken it to the doctors offices marked "URGENT; OPEN AND EXAMINE S-T-A-T"..... I had the worst case of bacterial pneumonia ever seen following H1N1. The last thing I recall is being wheeled into the ambulance and a bag being put over my face. I woke up three weeks later in CRITICAL CARE... after they had asked my wife if they could unplug me. So, you see, on top of apnea and aFib, I now also have only perhaps 60% of my lungs working, yet am able to get above 90% SpO2 all the time and almost 100% at night with supplemental (minor) O2 infused into the air I am breathing at 4L/M.
Nuff said. Short answer.... some do and some don't.
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.