Comment by elric

Comment by elric 4 days ago

> They claim it is so they know your air pressure numbers but it is all just regulatory capture

I disagree. In lab titration is not about regulatory capture. It's the best place to get a good ballpark start. The rest should be up to the patient, but informing the patient of that is where things go wrong, alas.

> CPAP machines can auto adjust your pressure and people like to tweak numbers manually to their comfort level anyways.

They cannot. See my rant about APAP in the comments here, or my previous APAP rants in my history. Current generation APAP is awful and it needs to die. PAP machines are awful at detecting events. This could probably be partially mitigate with better software. But there is a reason why a sleep study is very much the gold standard. 12+ channels of valuable information. Versus 1 channel on the PAP device.

blackeyeblitzar 4 days ago

Current generation APAP works great - not sure why you’re calling it awful. And I disagree that more channels are necessary - that’s a statistical implication that not true in general and shouldn’t be assumed blindly here. What needs to die is regulatory capture and bureaucratic barriers that take health care out of patients own hands, which is what the sleep study scam does, at least in the US, where you cannot get a CPAP/APAP device otherwise.

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elric 3 days ago

> Current generation APAP works great - not sure why you’re calling it awful
It doesn't. Your PAP machine doesn't even know whether you're awake or sleeping. It can only ever play catch-up to your breathing getting worse. Properly titrated CPAP (or BiLevel or ASV) is vastly superior both in terms of therapy and comfort.
> What needs to die is regulatory capture and bureaucratic barriers
That I agree with.
> which is what the sleep study scam does
It's not a scam. It provides incredibly useful data. Sleep problems are not just a boolean sleep apnea yes/no. All kinds of shit can go wrong during sleep. Maybe you have central sleep apneas, or complex apneas, maybe you need ASV rather than CPAP. Maybe you have restless leg syndrome (orthogonal to sleep disordered breathing). Maybe you just have positional apnea. Maybe you have REM disorders. Your apple watch won't tell you any of that.
Many people end up getting a sleep study because they're tired. That doesn't have to be apnea. Other people get sleep studies because they snore or because a bedpartner tells them they breathe weird in their sleep. That's more likely to be apnea.

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