[News] Sleep apnea is massively undertreated and costs billions in health problems

[JoeyWallaby]

https://aasm.org/resources/pdf/sleep-apn...crisis.pdf

Frost & Sullivan analysis of only the most well-understood comorbidities linked to OSA indicated that costs among the undiagnosed OSA population were approximately $30 billion in the United States in 2015

[OpalRose]

Thanks JoeyW,
Very interesting!  The thing that stands out most to me is the difference between the diagnosed (5.9m) compared to the undiagnosed (23.5m).

Even though the study is a few years old, we can only hope that doctors are getting better at diagnosing SA sooner than later and send folk for testing.  I know my doctor didn’t recognize my symptoms of SA even after various complaints over a 10yr period.  

A lot of negative things happen to your body when you go that long undiagnosed.

[DeepBreathing]

While it's probably true that doctors aren't recognising apnea sufficiently, I think there is also a huge amount of denial among patients. I know in my own case I kept putting off any consideration that I might have apnea (despite the obvious signs) until my cardiologist twisted my arm to have a sleep test.

[harrywr2]

While it's probably true that doctors aren't recognising apnea sufficiently



/rant on

My cardiology notes specifically state that I didn't appear to have sleep apnea and a referral for a sleep study was unnecessary. 
Afib and sleep apnea go together like a horse and carriage and cardiology should have known this.
I was also advised to continue managing my 'pre diabetes' with diet by my primary care physician despite good A1C numbers. 
It wasn't until I fell asleep in the Dentists chair while the Dental hygienist was doing her thing that someone decided I might have a sleep problem and should be referred for a sleep study. Only scored 17 on the ESS and the sleep study yielded an AHI of 27. 

Apparently they don't teach basic auto mechanics in Medical School...too much fuel(diabetes) will present similar symptoms as too little air(sleep apnea/copd/etc).

Two months into CPAP therapy and all those 'pre-diabetes' symptoms(frequent nocturnal urination, tiredness after meals etc) I have been suffering for 30 years are gone. 

No fewer than 5 primary care physicians ,an endocrinologist and a cardiologist over 30 years went with some form of 'pre-diabetes/insulin resistance' theory rather then consider sleep apnea. The Epworth Sleepiness Scale questionnaire takes 5 minutes and costs nothing to administer.

High blood pressure, diabetes, Afib, High cholesterol etc are all nice little earners for Doctors. Lot's of testing and follow up care to be billed out. Sleep Apnea is nice for the DME but not so profitable for the Doctor.

/rant off

[Geer1]

I saw 6 doctors this past year and 7 other health related people, had numerous appointments, tons of blood tests, a bunch of different prescriptions, ct, mri and more in trying to figure out what was wrong. It took nearly a year of doctoring before one of them finally proposed a sleep study. Only things to come back positive were the sleep study and ENT visit which were two of the last things checked.

I still sort of question that everything is just SDB but I think it is definitely a part of it and I can only imagine what it cost having to have all these useless appointments and blood tests and I was probably one of the lucky ones to get things sorted out in under a year...

[Sleepster]

It seems that almost everyone who is referred for a sleep study ends up getting a CPAP machine. The doctor who sent me for my sleep study did so because I went to him with the specific complaints of snoring and insomnia. After I was diagnosed with a AHI of 23 he told me I didn't "look" like someone with sleep apnea.

[Grandpapa-G]

I think that our reluctance to consider the possibility of needing to use a cpap machine is the biggest barrier for most patients.  It is very easy to dismiss our family doctors suggestion that we should consider a sleep test.  It is only when the apnea becomes severe enough that our spouse becomes concerned with the number of times each night that we stop breathing and struggle to regain our breath that we are convinced to seek help.

[JoeyWallaby]

Opposite for me... sleep doctor said to not worry about sleep study results... then I treat the sleep apnea and my nocturnal bruxism is cured  

[car54]

I think in my case it took at least 2 years to get treated. I initially talked to my doctor about my energy level being reduced and my testosterone was checked. Then over a year or so I started to get tired throughout the day. My initial thought was that I was just getting old. Then I was getting very tired on a daily basis and I was going to talk to my doctor on my next visit about it. The visit was moved up when my wife heard me gasping for air at night.  I do not blame my doctor but my lack of knowledge about the subject. I knew about sleep apnea but not very much. It turns out that my brother had been on cpap for 2 years and he never told me. I think that if I knew about his sleep apnea, I might have understood my situation earlier. Because of that I do not hide my sleep apnea but I try to educate people. Another reason that possibly delayed my diagnosis was the myth of what a typical sufferer looks like. I do not fit into that category.

Car54

[SarcasticDave94]

I credit my initial sleep study and apnea diagnosis to my first primary care physician that had been our family doc since the early '70's. A visit to him about extreme tiredness and racing heart upon waking led him to refer me to the pulmonary doc, where a sleep study was scheduled. Then a long bumpy road, several masks and wrong machines to get an ASV. Next stop?

I'd thank that PCP for the referral and apnea diagnosis, but he passed away at 80 before I could do so. He was one of the best docs one could hope for.