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Sleep Doctors vs. Patients: CPAP Data Monitoring

Posted May 20 2009 11:52am

It’s common knowledge that one important way of increasing effectiveness of CPAP therapy is to constantly monitor the data that the machine records, which includes time used, lead rates, effective AHI, and other variables. Traditionally, this data is somehow taken to or transmitted to the patient’s sleep medicine doctor who analyzes the data to monitor compliance and effectiveness, in light of how the patient is doing. 


There’s been a growing movement amongst CPAP users to analyze their own data, and some people are even changing their own pressure settings. What I’ve noticed is that these are the most committed users, willing to do anything to get a better night’s sleep. In many cases these people know more about their xPAP machines than the DME vendors (durable medical equipment) or even their sleep doctors. Patients will know all about the latest xPAP models and try new mask models, in many cases paying extra beyond what insurance pays for.


There are many vocal arguments for and against this type of self-monitoring, but the issue I want to bring up is a sense that not all, but many sleep doctors are reluctant to have the patient take an active part in monitoring their own therapy. They’re not being told to go elsewhere, but the essential message that patients seem to hear is, "if you do this, you’re on your own." DME vendors are also caught in the middle.


Sleep doctors argue that self monitoring is good, but changing pressures should always be done after consulting the treating physician, since improper pressure can lead to problems such as ineffectiveness or even central sleep apnea. Patients argue that they should be able to manage their own condition for the most part, like what a diabetic does. 


There’s no black or white issue here—there are some patients that are fully capable and responsible enough to do this on their own, and others that are not. An ideal situation is to have a system in place where patients that want to take more responsibility can do so without feeling like they’re being frowned upon. This takes extra effort on the part of the sleep doctor and a trusting relationship with good communication. 


If you’re a CPAP user, where do you lie along this continuum? How much extra effort do you take to maximize your results?


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