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Carol, that was an amazing explanation of the importance of a sleep study. Thank you for sharing that! Unfortunately, the earliest Vanderbilt can get me seen for a sleep study consult (not even the actual sleep study) is September 28th – which is 5 1/2 months from now. And that is via Telehealth! It seems to me a rather long time to wait to even discuss a sleep study. In addition to the MG breathing difficulties, I also happen to have Variegate Porphyria , which can cause breathing paralysis if I happen to be in a state of porphyrin overload. Thankfully, my VP is under control with no major porphyria attacks in a few years. However, Vanderbilt hasn’t addressed my sleeping/breathing in regards to this issue either. It feels like I have 2 strikes against me and no one cares enough to pay attention to the ballgame. Because of my extensive experience in the “rare disease” world, I completely agree about the importance of educating ourselves so that we can then educate our medical team. Sadly, some don’t appreciate an educated patient. And you are 100% correct about the importance of CLINICAL SKILLS, not just test skills or book knowledge. But, all I can do at this point is press on. It has become clear from the replies on this forum, that I will be in better hands by searching out a new neuromuscular specialist. Thank you for your reply and all the best to you on your journey.