You have been diagnosed with X, Y or Z but is this the correct diagnosis?
A missed (or incorrect) diagnosis represents a missed opportunity to provide the appropriate care.
Missed or incorrect diagnosis?
I’ve had patients referred to me for everything from narcolepsy to epilepsy when in fact they had obstructive sleep apnea (OSA). When I was taught at dental or medical school I was always told, “common things occur commonly”. As we’ve seen – SDB is common.
A missed or mistaken diagnosis?
Are you being treated for something else without the necessary SDB diagnosis? Here I’m referring to anything frequently linked to SDB like stroke, heart attack, atrial fibrillation and diabetes.
Could OSA be a factor in your disease?
If you have had a stroke, heart attack, diabetes, depression, anxiety, insomnia or excessive fatigue or tiredness during the daytime – you need to have the possibility of a sleep disorder considered.
The problem of medical missed and incorrect diagnosis.
Sleep disorders are common in all sections of the population and are either the main clinical complaint or a frequent complication of many conditions for which we see patients in both primary care or specialist services.
However, the subject is poorly covered in medical education.
A major consequence is that the manifestations of the many sleep disorders now identified are likely to be misinterpreted as other clinical conditions of a physical or psychological nature, especially neurological or psychiatric disorders.
These are important relationships and clearly not normal, yet the problem is that when something happens frequently enough – it either becomes considered “normal” or we tend to overlook or ignore it – it might be annoying but if it’s not causing any immediate problems – it becomes less important.
We can go over the different management approaches and the “truth” that’s often not told for these, but unfortunately it may simply be due to a physician’s reluctance to see the possibility that they may not be correct in either their knowledge, diagnosis or therefore their management or treatment.
More than one sleep disorder?
It is important for a healthcare professional to acknowledge that a patient may have a combination of sleep disorders and other conditions of a different nature (and, indeed, more than one type of sleep disorder of which there are over a hundred), especially in the elderly.
Therefore, it is all the more important that each complaint and its cause, including the possibility of sleep disorder, is assessed thoroughly.
Without this, there is a serious risk that the wrong conclusion will be reached, perhaps causing unnecessary concern and also denying the patient the correct treatment for the sleep disorder which, if properly implemented, was otherwise likely to be successful.
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Dr. Stephen Bray 2019