Does a sleep lab have to diagnose someone with sleep apnea for them to get a CPAP machine?

This question was asked in Indianapolis, Indiana on 09/06/2012.
I have all the symptoms of sleep apnea & have had them since I were a teenager. I get 7 1/2 hours of sleep on the average & wake up exhausted. I usually only last for 2 maybe 3 hours before I’m dosing off. My brain always feels sluggish and my memory only seems to retain information long enough to get a task done and even then I still struggle so hard to remember the details. I wake up out of my sleep every night to use the restroom. My coordination is off even attempting to walk or drive without veering into another lane. I forget commonly used words everyday (literally) & my train of thought which discourages me from being interactive. I’ve gotten blood work done 2 tims in the past year which checked my thyroid, red and white blood cells, kidney & liver & they both came back normal. I don’t drink, smoke, nor do drugs. I literally take vitamins daily & I exercise. I’m of a slender build of 5'6 & 145 lbs. so I’m not overweight. I literally feel as though the middle section of my brain lacks oxygen and have felt that way well before I knew what sleep apnea was. It feels as if it thirst or thrives for oxygen but isn’t getting its sufficient supply. I just completed my 1st sleep study where the therapist told me she wouldn't recommend me to be on CPAP. This made me feel as though she had my fate in her hands. She let me try a full face mask prior to the study & the oxygen literally felt like it were going to the portion of my brain that felt oxygen deprived. She told me the way I’d know if I had sleep apnea would be if after the study they gave me CPAP treatment. So after the study she lays a mask on my bed and when I returned from the restroom it was gone. I don’t understand. Does the sleep lab have to diagnose a person with sleep apnea for a sleep doctor to prescribe CPAP or can the doctor prescribe it without the labs suggestions? If not. Are there any other options out there for me to receive a CPAP machine? Please respond, I need guidance.

Doctors Answers (5)

Farhad Sigari, MD, FACS
Answered on: 9/13/2012

Please see a sleep specialist. Despite minimal findings (low AHI or RDI) of the daytime symptoms are significant like yours, I usually recommend a therapy. It would also be very worthwhile for you to be checked for nasal obstruction. An ENT would be a great first step.

Richard J. Schumann Jr., MD
Answered on: 9/10/2012

If you had a sleep study at a lab you should discuss the results with your primary doctor or a sleep specialist. They are the ones who should go over the study interpretation NOT THE TECHNICIAN. That's not their role! If you haven't seen a specialist and you are convinced you have a problem with sleep disordered breathing then get a referral to sleep specialist and discuss the problem with them. if you can get a copy of your sleep study interpretation then that would be helpful as well.

Gary K. Zammit, Ph.D.
Answered on: 9/10/2012

In general, yes, a sleep evaluation (not necessarily done in a sleep laboratory) is essential to the diagnosis of sleep apnea. At present, overnight sleep testing can be obtained in traditional laboratory environments, or through home sleep testing services. The results of such testing are needed to determine if sleep apnea is present, and how severe it is. A treatment plan that may involve a CPAP titration night (a second test night during which CPAP is tried) may lead to the prescription for the use of CPAP at home. It is not clear from your description, but it sounds like you may have completed the diagnostic night of testing, and that your doctor wants you to complete a second night for CPAP titration before she makes a final recommendation. Yes... The diagnostic and treatment work-up are essential for a doctor to prescribe CPAP treatment. If your sleep doctor determines that CPAP is not the ideal treatment for you don't lose heart. There are many other treatments available to you. You already are on the right track, given that you do not drink, smoke, or use drugs, and that you exercise. This will no doubt be to your benefit as you follow your doctor's recommendations for treating sleep apnea.

J. Douglas Hudson, MD, DABSM
Answered on: 9/10/2012

In general, yes, a sleep study is required to diagnose sleep apnea. The studies done in a sleep lab are more reliable than those done unattended at home. A common symptom of sleep apnea is daytime fatigue and sleepiness which you certainly have. Memory failure and night time urination are also commonly associated with obstructive sleep apnea. Being overweight aggravates many medical disorders but is not a requirement for sleep apnea. Half the patients we see with sleep apnea are like you, of normal weight. The problem lies in the anatomy of the throat which often runs in the family. It is not the sleep technician?s job to decide or tell you if you should or should not use a CPAP. Even patients with a mild case of sleep apnea often do exceedingly well with CPAP. You should report what the technician did to your doctor or even call the lab director. Yes, a doctor needs to order CPAP for you. As stated above, snoring and a mild degree of apnea can cause all the symptoms you have and CPAP therapy is your best choice. There are other treatments such as avoiding sleeping on your back and dental devices which help somewhat for some patients.

Terry M. Himes, DO
Answered on: 9/10/2012

Yes, the CPAP machine requires a prescription from a Physician. The compliance of use should also be monitored by a Physician or assistant of the Sleep Specialist.