Disillusioned with our sleep doctor today.
I went in armed with questioned from this thread and received some crazy responses. To be blunt he said he changed pressure from 11 to 12, EPR left at 2 (he says EPR has no effect on Apnea). Also neck collars have no effect. Even though i got my mum to not use the collar last night to see if it was helping
Night with collar
https://imgur.com/a/tj9IQ
Night before Appt (no collar)
https://imgur.com/a/wW01h
He asked if I had a Health Degree as I seemed to knowledgeable. (Thank you forum).
He downloaded from the SD card but seemed incompetent in the Resmed software he had no clue how to do detailed daily graphs. He highlighted weekly events without looking at daily graphs. I asked him if he could look into daily graph and work out why the events are clustered. He tried but was obviously unable to work out how to check each days events.
The furthest he went into was into summary events and statistics never looking at 1 daily event even though I asked multiple times to review why the clusters appeared at specific times.
He was more shocked that my Mum used the machine as he said most stop using it after prescribed.
Questions I asked
1) Huge cluster of obstructive needs further investigation, suspect higher pressure needed but this may cause more Centrals.
Reply Yes maybe
2) Auto ASV changes pressure to resolve Obstructive and provides breath by breath support to eliminate Centrals and periodic breathing
Reply Yes maybe
3) Current machine settings will not provide improvement and consistency, will this be lacking?
Reply Maybe
4) EPR is set at 2 should this be reduced to 1 or none if staying with this machine.
Reply it is irrelevant and if I wished I could change this but it has no help in events just discomfort for my mum.
5) Sleep study showed predominately Centrals why was this machine advised with having to go off morphine which she needs to have any chance at a normal life
Reply He never thought with her reports she could go off morphine and he was treating her as if she still required it.
If I am 100% honest with my limited knowledge gathered here I could have seen his next patients and be more capable of giving better advise.