What type of doctor should monitor my treatments

[SleepingBearDoNtWake]

Hello,
I have been diagnosis for several years with sleep apnea, but only started using it the last few months.
My question is that I'm using my ACPAP every night but the numbers are not good. I have tried to change the settings around and sometimes I get improvements for a day or 2 before the numbers start going back up again.
So my Primary Care Doctor sent me to a ENT Specialist, who looked at me and sent me for a sleep study. Then I was given the resmed auto ii for my cpap. Does a ENT specialist really know how to treat this, or is it beyond there scope. Do I need another kind of doctor and what title would I look for. I feel that I really need to get in touch with a doctor who can monitor my sleep data at least for a few weeks to make sure that I am getting the right treatment.
I problably wouldn't mind not having one if I didn't have other very disabilitating illness that my be cause in part by poor sleep. So it is my utmost importance that I get some real answers and real fixes to make sure I doing everything right.

Also Resmed S8 autoset got my new resmed s8 autoset II I am really thinking of trying to sell these back to the DME and getting credit for a S9. Has anyone ever done this. Do they allow you to do these things. If not any idea on alternative.

Thanks,

Mike

[archangle]

Unfortunately, no particular specialty necessarily knows how to treat apnea. Even if you get a "sleep doctor," far too often, they simply collect enough data to meet insurance requirements and are not willing or able to spend the time to do it "right." Even if they do look at the data you get, they often simply look at getting the AHI numbers "good" or try to solve "serious" problems. They also far to often leave the details to the DMEs. Too often, the DME is just a used car salesman type.

Yes, a good doctor (of any type) could really help fine tune your treatment. Unfortunately, CPAP medicine in the USA is in the "battlefield triage" stage. They stop the bleeding and ship you out. Far too often, there's no good followup care.

It seems most of us need to learn to monitor and manage the fine tuning of our treatment ourselves.

[Jay Aitchsee]

Mike, I think Archangle summed it up pretty good. I would look for a "sleep certified" doctor but that's no guarantee. Your ENT might not be certified but he might be good. You have to decide. Most sleep doctors are pulmonologists, which is fine if your sleep disturbance is limited to respiratory problems only. Unfortunately, many of us have other problems which might be more properly treated by a neurologist. So, you might want two doctors on your team. You have to interview the Dr and decide if they are going to work with you in solving your problems or just give you a "try this and come back in 6 months" approach. You must become an expert in your own treatment. You must learn what data is available from your machine, how to get it and what in means. You must be able to make adjustments to your treatment yourself (hopefully with the consent of the good Dr you've found). You must have patience, make changes to your treatment with purpose and wait for you body to adjust. Your doctor must look at the data you collect and present (don't count on your DME to provide much more than compliance data) discuss it with you, and the two of you decide on a course of treatment. If that doesn't happen, you need a different Dr.
As far as the S8 auto II goes, I think it to be a very capable machine. The only problem with the S8 is obtaining a card reader to download the data. They are available but the technology is confusing. See some of my other posts for more info.
As for trading machines, your insurance plays a big part in what you can do. If you are willing to pay out of pocket, you can do anything you want, as long as you have a script and nearly any Dr can write a script for you - it doesn't have to be your "sleep doctor". Your DME probably will not be interested in buying your machine back but you can ask.
Mike, you can find answers to most of your questions regarding your treatment, how to get your data, adjust your machine, etc, right here on this site; just remember, though, most of us are lay people and you still need a good Dr or two on your team.
Good luck to you,
Jay

[nanwilson]

The best doctor to monitor your treatments is Doctor SleepingBeardoNTWake...in other words YOU. Do some reading on this site and you will see that most of us have taken charge of our own therapy and doing a better job than most doctors. With the S9 you will be able to monitor your therapy on a daily basis and tweek what you need to tweek as you go along. If you have any questions, just ask, there are folks here that have been on cpap for 10+ years and do know what they are talking about. I've only been at this for 16 months and haven't heard or seen from the sleep doctor..not even a "how are you doing" call. I have basically done this by myself with the help of the wonderful folks here at cpaptalk.

[xenablue]

IMHO, Dr. SleepingBearDoNotWake is probably going to be your best best for a caring, dedicated monitor of your treatments.

It helps to have a good medical person to keep an eye on things, but from what I've learned here from these good folk is YOU are THE ONE.

Cheers,
xena

[BlackSpinner]

I agree with the above.

However if you need more testing and you want someone to look over your results it depends on what was found on the sleep study. If it includes a lot of centrals, leg movements or such then a neurologist is the best bet, if not then a pulmonologist is( OSA doesn't really have anything to do with sleep but with breathing).

One thing you can do is get a copy of your sleep study and put it up here for people to look at. Also the charts from your current data. There are people here who can read them and make suggestions.

[2flamingos]

I agree with everyone else - You are the best person, and probably the only one you can really rely upon. But, I will go further to say that ANY dr you have that shows ANY interest in your treatment is a good dr to have. All of my regulars admit to limited knowledge on the subject, and the dr's at the sleep lab seem to only deal with their "active" patients (ones that are in process of testing and titration).