Ethical dilemma: Should Fred lie to get a sleep study?
Discussion
It is bloody obvious to anyone with a brain my friend, Fred, has sleep apnea that at absolute best is moderate and as far as Fred is concerned is serious. For example Fred was in hospital for a while until yesterday for unrelated reasons and the nurses had to keep Fred watched cause Fred's sats were going down to 70s and one of them saw 60s once they think, this was purely cause of apnea, the moment woken up back to 96/97 again within seconds like a normal person. Basically Fred hasevery symptom of it and need a sleep study so Fred can get a CPAP machine.
HOWEVER, to be referred by your GP (Fred has tried!) to get a sleep study you have to do something called the "Epworth Sleepiness Scale" and get a certain score.
I have no doubt whatsoever that the scores you get on this scale are strongly statistically linked to sleep apnea in the sense that someone who scores high has apnea, but that doesn't mean that someone who has apnea will score highly in the test.
This is particularly because they are all the bloody same question basically "How likely are you to fall asleep while doing activity X" (seriously, google it!). Thus, someone like Fred who for a variety of reasons is very unlikely to fall asleep with any kind of mental stimulation at all is basically screwed as Fred can't truthfully say he will fall asleep in any of these situations. Despite obviously having the apnea.
What do you advise Fred to do? My inclination is just to lie on the bloody test and get a sleep lab. But then would Fred's medical notes be ruined by having him down as someone who just makes stuff up to get things? Should Fred see his M(S|E)P instead? How about start a campaign of domestic terrorism against clinical guideline writers who don't understand that (A=>B)!=>(B=>A)? Or maybe just wait to die of a heart attack?
HOWEVER, to be referred by your GP (Fred has tried!) to get a sleep study you have to do something called the "Epworth Sleepiness Scale" and get a certain score.
I have no doubt whatsoever that the scores you get on this scale are strongly statistically linked to sleep apnea in the sense that someone who scores high has apnea, but that doesn't mean that someone who has apnea will score highly in the test.
This is particularly because they are all the bloody same question basically "How likely are you to fall asleep while doing activity X" (seriously, google it!). Thus, someone like Fred who for a variety of reasons is very unlikely to fall asleep with any kind of mental stimulation at all is basically screwed as Fred can't truthfully say he will fall asleep in any of these situations. Despite obviously having the apnea.
What do you advise Fred to do? My inclination is just to lie on the bloody test and get a sleep lab. But then would Fred's medical notes be ruined by having him down as someone who just makes stuff up to get things? Should Fred see his M(S|E)P instead? How about start a campaign of domestic terrorism against clinical guideline writers who don't understand that (A=>B)!=>(B=>A)? Or maybe just wait to die of a heart attack?
Somewhatfoolish said:
This is particularly because they are all the bloody same question basically "How likely are you to fall asleep while doing activity X" (seriously, google it!). Thus, someone like Fred who for a variety of reasons is very unlikely to fall asleep with any kind of mental stimulation at all is basically screwed as Fred can't truthfully say he will fall asleep in any of these situations. Despite obviously having the apnea.
I don't think sleep apnoea is anything to do with falling asleep, but what you do when you ARE asleep. 
Are you sure the test you refer to is not about sleep narcolepsy??
King Herald said:
I don't think sleep apnoea is anything to do with falling asleep, but what you do when you ARE asleep.
Are you sure the test you refer to is not about sleep narcolepsy??
It's more complicated than that. Sleep apnoea does occur while sleeping, but it makes people partially wake up many times in the night. That makes the sleep very low quality, meaning the sufferer is likely to fall asleep during the day. Are you sure the test you refer to is not about sleep narcolepsy??
You need a recording pulse oximeter. You can get one of these on Amazon for £75.
http://www.amazon.co.uk/Contec-Full-Colour-Oximete...
You wear it for the night and then hook it up to your pc by USB and you can then print out your blood oxygen levels for the night.
Should be pretty irrefutable even if it's probably not the most accurate machine in the world. (I have one btw).
http://www.amazon.co.uk/Contec-Full-Colour-Oximete...
You wear it for the night and then hook it up to your pc by USB and you can then print out your blood oxygen levels for the night.
Should be pretty irrefutable even if it's probably not the most accurate machine in the world. (I have one btw).
davepoth said:
It's more complicated than that. Sleep apnoea does occur while sleeping, but it makes people partially wake up many times in the night. That makes the sleep very low quality, meaning the sufferer is likely to fall asleep during the day.
That clears it up a bit more, thanks. Gassing Station | Health Matters | Top of Page | What's New | My Stuff