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Adventures in Sleep

RLS and PLMs

Published January 12, 2010 2:05 PM by Amy Reavis
Patients are becoming better educated, but there are some days I think all this information or half-information can really cause us headaches in the sleep lab. Take the TV commercials and sound bites about restless legs syndrome. You know the ones with the moth floating around at night or the two-minute talk the expert gives on the 6 p.m. news.

We have to educate (and re-educate) those who come into the lab. The big issue is some people mistake their arousals for RLS. They think the twitch and wake they have during the night is just like what they see on TV. As a result, they may have missed an excellent opportunity to discuss the real issue with their doctor and come into our office with a preconceived idea of what's wrong with them. I have even had some patients get upset because we didn't see the RLS and they couldn't get a pill. Instead, they have to wear that mask thingy.

It's a hard situation to be in. I'm trying to schedule the second sleep study, and they're arguing that I messed up and all they need is a pill. That's when I send them to their ordering doctor for follow-up. About half these people return for their second study. (Probably a good 10 percent think we're quacks just trying to rip them off.)

I believe if there was better education many of these people would be more open-minded to care. It's tough to challenge the information age, still care for your patients, and keep from going crazy.

posted by Amy Reavis

2 comments

Goshes. I don't try to Dx my sleep disorders but I sure as the devil do appreciate an explanation of some of my data rather than being told that data from a fully data capable xPAP is "useless".  

I sure as the devil don't have anywhere near the confidence in the xPAP data as I do an in-lab PSG's data - but I "do" think the long-term trend data from a fully data capable xPAP is superior to a one night in-lab PSG and worth paying attention to and addressing any issues that the data trends might suggest!

What I would REALLY like to see is the sleep labs or the sleep specialist doctors having an experienced, knowledge PA, NP, RRT or RPSGT on staff who "could" spend the time w/us to explain and address what the sleep doctor doesn't have the time for.

It is a TERRIBLE MISTAKE for sleep specialists to be satisfied w/letting RRTs and RRT underlings at the local DME providers be the ones answering the questions, providing the support and advice to patients!!!

Judy January 21, 2010 3:53 PM

I could not have said it better!  People simply don't understand the physiological complexities involved with sleep disorders, and self-diagnosing and having a preconceived idea of what their problem is really makes re-educating so much harder.  

From a personal perspective, I have sleep apnea, and I have that twitch or leg movement just before arousal that you mention.  I do not have RLS, which has other symptoms involved.  Rather, I kick/twitch when I have an apnea.  Also,  after a 3rd sleep study, I have learned that I also have a REM behavior disorder.

I personally am much relieved to know I don't have to take a pill!  I love my CPAP and knowing why I move during the night is enough.  I only wish more patients followed my line of thinking!

Thank you for your post!

Melinda Hertel, Sleep Equipment Retail - Operations Manager, EZ CPAP, LLC January 19, 2010 2:56 PM
Scottsdale AZ

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    Adventures in Sleep
    Occupation: Sleep technicians
    Setting: Various sleep facilities
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