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Is Polysomnogram Foolproof? And....
#21
I have been the CPAP, BI-PAP dental orthotic path throughout all this. I sleep best without any device or machine. My last polysomnogram in which was recorded 62 min. of sleep the interpreting doctor was claiming an AHI of 60. My very first polysomnogram if it had been interpreted correctly would have showed AHI of 15 with no symptoms. AASM guidelines for treatment of sleep disorders recommends that a polysomnogram result of AHI 15 or more with absence of symptoms is needed to even diagnose as a sleep disorder. Their recommendations.
I'm supposed to believe on my last one that every minute I slept I had an event lasting 10 or more seconds? Really?
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#22
(10-23-2016, 11:57 AM)Prometheus Wrote: My last polysomnogram in which was recorded 62 min. of sleep the interpreting doctor was claiming an AHI of 60.
...
I'm supposed to believe on my last one that every minute I slept I had an event lasting 10 or more seconds? Really?
Ask for the full report including all the summary graphs and the summary data.

AHIs in the neighborhood of 60 are NOT rare. They're not extremely common, but they are NOT rare. And yes, there are folks with an AHI > 60 who are actually asymptomatic in terms of daytime symptoms.
Questions about SleepyHead?
See my Guide to SleepyHead
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#23
Yes I would not be surprised at that. But the post question was " Is polysomnogram foolproof". I think what all that has occurred to me is fairly good proof that it's not foolproof.
The doctor who did interpretation of my first polysomnogram was board certified in pulmonology medicine but was not in sleep medicine. AASM accreditation guidelines allow this as long as the interpreting doctor is supervised and reviewed by a board certified sleep physician. Now the doctor I was referred to who works in the same location as original was board certified in sleep medicine. But it would seem he couldn't have been overseeing the other doctor since the error made wasn't discovered by him. Now the third doctor involved was board certified as a diplomat in sleep medicine and was the supervisor of sleep center where testing was done, works with the two other doctors and also does interpretations of sleep studies himself while running his own practice at another location. He also seems to have not been overseeing the original doctor as he also didn't discover the error made.
Now how the error was discovered is that I went to a second sleep testing center where the third doctor is the supervisor and also does test interpretation and was asking about the results of my polysomnogram. He called on phone and had first sleep center fax over the respiratory technician who scored sleep study report of the sleep study. (this is the report that goes to the doctor to interpret sleep study). Now what was interesting was the conversation he was having with another doctor in back room while waiting for fax about the summary and interpretation I had given him when asking about results. I heard first doctors name mentioned and some very subdued comments I couldn't hear clearly.
He came out and gave me an explanation about how there are two different rules on scoring because of Medicare requirements etc, etc. Very odd he made no note of the obvious error the first doctor made in his report of stating my tested AHI was 35.3. Now when I filed my complaint with the AASM accreditation department and they investigated the third doctor who gave me the lame explanation acknowledged to the AASM that the sleep report was in fact incorrect on it's report of the results. Now the result of this was that the doctor assured the AASM that the error was corrected and that the individuals involved were being trained on the correct procedures and I would be contacted to discuss results.
I was contacted by the third doctors nurse and offered a" free" consultation to discuss my test. I was working out of state and the few dates she stated the doctor was available wouldn't work for me. Same results the next couple of calls. It's been over a year since the error was discovered.
Now there is a lot going on with this. But I think one could say the first doctor who caused all this could be called a fool. He made a diagnosis on a medical condition he obviously has little experience and knowledge in it seems as it applies to this situation. (Maybe he just had a bad day). The second doctor could maybe fall into the being a fool as he obviously never oversaw the first doctor and never confirmed whether there were any issues about the testing. He just said CPAP see ya in a year etc.
Now the third doctor most likely can't be called a fool. He realized that there was an error as proven by admitting such to the AASM. But he did nothing about it until officially forced to by an overseeing organization. Now after my attempts at CPAP failed (with no attempts at changing pressure after seeing doctor couple times about my difficulties, dental orthotic attempts, being told to use sleeping pills by respiratory technicians from DME, etc.). I went to an ENT seeking a surgical solution. On the basis of that first test showing severe obstructive sleep apnea he did the septum, UVVP, tonsil surgery. Can't say he's a fool I guess?
The state I reside in has a medical society with an official code of ethics for physicians to abide by. One part states that if a doctor discovers a doctor deficient in character or competence should report such to appropriate entities. It also states the same if fraud or deception occurs. Under state code it states that grounds for medical negligence would be a misdiagnosis of test results. Argument may be that test did diagnose obstructive sleep apnea, but it missed badly on clearly stating the severity. Plus another part of state code relates to unnecessary surgery. The reason I had surgery and that the ENT who did the surgery did it was because both of us had been led to believe I had severe level of sleep apnea which medically allows surgery to be an option.
Back to the original post question. After all that's happened to me (documented and confirmed). Can someone, anyone state that polysomnography is fool proof? No it is not. And everyone here has the chance of the same happening to them because obviously, as small a percentage as it may be, there are doctors out there treating sleep disorders who are fools. Or worse.......
My apologies for the length of this post, but I did fully want to show my example. Thanks.

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#24
No wait. I guess the third doctor is a fool. After our discussion he gave me the copy of the polysomnography technicians report (which is never given to a patient who asks for a copy of polysomnogram results typically only the doctors interpretation report or results report is given to patient). Which after some research and checking numbers allowed me to discover the error. I never have understood this and the only explanation I come up with is the doctor thought a regular "lay" person wouldn't have the knowledge or intelligence of understanding it.
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