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Sleep Medicine Doctors in the U.S?
Sleep Medicine Doctors in the U.S?
I have been to two doctors who specialize in sleep medicine in the past few months. Both were board certified in sleep medicine. But both doctors seem to be going off of a formula and seem very rigid in their approach. They don't seem to be able, or interested, in taking into account an individuals specific circumstances. Its almost like they are going off of a script. So I was wondering is this approach widespread throughout the sleep medicine profession? 

Over the years I have seen many specialists for various conditions and most of them seem to have been pretty fluid in their approach and seemed much more open minded about things in comparison. 

What has your experience been with sleep medicine physicians in the United states?
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RE: Sleep Medicine Doctors in the U.S?
all I'll say is after 7 sleep studies in more than 30 years since diagnosis, no doctor, sleep medicine specialist, pulmonologist, neurologist, dentist, orthodontist, dme provider, respiratory technician or insurer has helped my apnea one bit. in fact, I'd say they pretty well missed the boat at every port. & it has cost me a bundle of money in addition to lost health. my fault for not persevering but that's why. much better progress on my own with help from forum members.
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RE: Sleep Medicine Doctors in the U.S?
My experience has been limited. I started SA Therapy in Sept. of 2018. I took two in-lab sleep studies from a local facility. The sleep lab doctor has been okay......from what I can tell. Then again, what would I know? 

Anyways, he's busy, as well as the lab he manages. I'm still a long ways off from being as SA educated as I would like. But, I'm learning as time goes by and picking up a lot of information from this forum and it's members. 

I honestly don't know where all this SA Therapy will take me. I'm going to give it two years to see if I improve any. So far, I feel the same as before I started. 

I have no desire to seek out a different sleep doctor. The one I have seems to be competent. I'm doing my best to remain compliant and stead-fast with the therapy. 

There are times though, when I do tend to question all of this, and just how legit it might be. Time will tell I suppose.
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RE: Sleep Medicine Doctors in the U.S?
My sleep doctor seems to be interested only in compliance, not results. He has been willing to go along with the changes I have made in my settings since they resulted in AHI below 5, but really doesn’t care that I still only sleep maybe 5 hours on a good night, and even that is badly fragmented.

Overall, based on my experience, the entire industry sucks.
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RE: Sleep Medicine Doctors in the U.S?
Took the Epworth Sleepiness questionnaire in the waiting room, scored more than 10, got to see the doctor, doctor asked me some questions about things that might be neurological,glanced in my mouth, tech came in with the home sleep test gizmo, explained how to use it. My parking receipt shows 40 minutes total time.

I dropped the test next day. Got an email that a DME would be contacting me. DME contacted me, went to the CPAP familiarization class, got a lesson on how to turn the machine on and the importance of replacing perfectly good over priced mask parts every 2 weeks. I've had one follow up phone call. $600 for the Doctor, $350 for the DME(The machine itself in on loan). Nice business model for them.
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RE: Sleep Medicine Doctors in the U.S?
I'm fairly recently diagnosed with UARS/mild OSA, so my data points are limited.

I had two meetings with my sleep doc.

First was great; not the "script"-based approach noted by OP. She listened, was responsive, etc.

Second meeting, where I informed her I believed I was failing the CPAP trial, was pretty much the opposite. She was fairly dismissive and seemed only concerned about my AHI. I had to be pretty assertive to insist on a titration study that included bilevel.

In the end I was right, and I got the prescription, but I was unhappy enough with the experience I talked it over with my primary care doc, who is fantastic.

For now, I'll continue with the sleep doc, mostly for insurance reasons. But I've dramatically lowered my expectations of what I can expect out of her.
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RE: Sleep Medicine Doctors in the U.S?
I don't think that it is limited to the U.S. Sleep disorders can be extremely complex and for those who do not fit into a defined box, it is difficult to diagnose, especially since the primary medical treatment that is recommended is blowing air into the patient's face. It would be difficult to find a more primitive medical procedure. Yet that is what it is.

Also medicine has become a commodity and most doctors are more like auto mechanics than researchers driven to discover a cure. In some ways, it is no different than taking your car in and the mechanic who gets a code, replaces the part(s), and a week later the car won't run. If you really want to know what is going on, you go online and find a forum and if you are lucky someone else has had the same issue and you find out how to really fix the odd quirk. If your mechanic is not involved online, he will never know and a wall full of certifications won't help.

Recently a poster indicated still being tired after a year of CPAP and mentioned a doctor's name. It was Dr. Guilleminault. I didn't know this doctor, yet I was curious since typically doctors are not named in posts. Here is a snippet of his biography...

Dr. Christian Guilleminault was a physician and researcher in the field of sleep medicine who played a central role in the early discovery of obstructive sleep apnea and has made seminal discoveries in many other areas of sleep medicine.

I agree that most sleep doctors do not really care enough to help patients who really want to improve their quality of sleep. But the above really struck me as the defining statement on just how complex the subject of sleep really is. If possibly one of the foremost authorities was not able to help his patient and that patient came to an online forum for help, then God help us because it really is just us.

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RE: Sleep Medicine Doctors in the U.S?
My experience with "sleep doctors" is that they probably used to be car salesmen, but realized there was more money in pedaling sleep apnea one-liners (script) and the machines.

I'm grateful my sleep "doctor" [albeit reluctantly] diagnosed me with sleep apnea. I'm grateful because having a xPAP has Changed.My.Life. But beyond that, my sleep "doctor" was a slimy sleaze bag that only cared about getting paid his fat check from my insurance, and he did not care about me one iota.

So, yeah, that has been my experience with sleep medicine.
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RE: Sleep Medicine Doctors in the U.S?
My sleep doctor was responsive in that he listened to what I wanted as far as machine and mask. Even before I was diagnosed. (We were pretty certain, based on history and exam that I had SA and I had researched before going in. I was very familiar since hubby has been on CPAP for 12+ years).

Anyway, that's as far as it went. Followup was with his PA, who looked at the compliance report and said all was well. I told her I still was not sleeping well, multiple wake ups per night (6+), awake for hours every night, still exhausted. At the time, I had not found a mask I could tolerate. She said, "But your numbers look great! Your apnea is well treated." And that was the end of that!

Fifteen months later, I STILL don't sleep well, have multiple wake ups per night, am awake 1-2 hours a couple of nights a week, and thanks to the Bleep finally have a mask I can tolerate. Still tired, but progress. Thank goodness for the forums! Without them I would still be back where I was almost 2 years ago! It's pretty sad.
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RE: Sleep Medicine Doctors in the U.S?

My experience pretty much mirrors yours. My sleep doc is board-certified, but both she and her nurse-practitioner are concerned with compliance/usage, treatment with AHI<5, and my reporting generally positive benefits while under treatment. I discovered years ago they were not interested at looking at anything beyond that. As they schedule patients for no more than 15-minute visits, they are not inclined to discuss much else.

For what it's worth, the doc and I could do this remotely. It's strictly to meet a Medicare requirement and generate a fresh script for supplies.
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