THE MEDICAL PROFESSION has mounted an ongoing effort to market a treatment for a sleep disorder a majority of adults have never heard of, and that most likely don't have.
The condition is obstructive sleep apnea, an energy-sapping malady that five years ago was virtually unknown by the general public, or for that matter insomniacs and restless sleepers. Today apnea is the darling of the medical profession, a mother lode for new patients and new income. Almost every hospital has climbed aboard the bandwagon and opened a sleep center with a staff of pulmonologists to sell the concept, as well as to diagnose and treat it.
Estimates are that some 18 million Americans could be suffering from sleep apnea, but 75% to 90% of all apnea cases remain undiagnosed. While most apnea sufferers haven't as yet gotten a wake-up call about it, specialist doctors are busy ballyhooing the ailment and signing up prospective patients for expensive sleep studies.
Sleep apnea is defined as a condition in which the tongue flops back during sleep and repeatedly blocks the airway, temporarily choking off oxygen to the lungs and heart dozens or hundreds of times a night. This means the heart is forced to pump harder to get oxygen, putting stress on the cardiovascular system. The most serious consequence is atrial fibrillation, a rapid erratic quivering of the heart's upper chamber.
Another apnea definition claims it refers to periods lasting at least 10 seconds and often as much as 30 seconds when the back of the throat narrows or actually closes during sleep. This can happen 400 times a night, they say, and is most likely to occur in overweight males with a 17-inch or larger neck who snore, are hypertensive, or suffer from daytime fatigue.
Sleep apnea is not an ailment like diabetes, asthma, or high cholesterol that you are likely to consult your family doctor about. Some patients afflicted with chronic insomnia learn about apnea when they seek a prescription for one of the new, highly effective sleeping pills that have come on the market in recent years.
Rather than a bottle of prescription sleep aids, however, many individuals wind up being referred to a pulmonologist or a sleep specialist who will suggest their problem is most likely apnea, a diagnosis that can be confirmed only by a costly sleep study, and treated by a specialist in abnormal sleep patterns.
I am one of those who has been grist for the sleep disorders mill. Like many older Americans, I had been sleeping poorly at times, routinely getting up several times at night. A major cause of this was the fact my cardiologist had me on a diuretic and it was necessary for me to empty my bladder frequently.
However, when a lung specialist last November suggested I ought to have a sleep study done, I made an appointment for a mid-February consultation with Gaylord Hospital Sleep Services to learn about their program. Before I could keep the appointment, however, I wound up in Norwalk Hospital for other reasons. My wife, however, mentioned to the Norwalk staff that she had to cancel my Gaylord appointment, and they took that as authorization to put me in their sleep disorders program. Without any testing, technicians began strapping masks and other apparatus on my head at night, none of which seemed to fit properly or to help me sleep.
When I was discharged after eight days of poking and probing, I agreed to a sleep study (known as a polysomnogram) later in the month. This involved showing up at the hospital about 7 p.m. one evening and being given a bed in a motel-style room so tiny I could only get into or out of the bed on one side. A technician then placed two dozen or more electrodes on my body, attached by wires to a remote monitoring station, which made it impossible to get out of bed to use the adjacent bathroom. Not the best possible arrangement for one taking diuretics.
The sensors monitored my brain waves, muscle movements, eye movements, breathing through the mouth and nose, snoring, heart rate, leg movements, and blood oxygen level.
Although a sleep study has been described as being somewhat like spending a night in a hotel bed, frankly I have had a better night's rest stacked up like cordwood with other GI's in a troop ship or barracks. Mostly I just tossed and turned, as one is apt to do when in a strange bed for the first time.
I was rousted out of bed about 5:45 a.m. and told my wife had been called to come and get me. About 10 days later I met with one of the sleep doctors who told me that I had a major case of apnea. Although I had only slept for about 30 minutes, during that time I had stopped breathing for milliseconds 50 or so times. He billed my insurance carrier $80 for passing this info along, and made an appointment for me to come back and be fitted with a mask that fits over the mouth and nose and a CPAP (Continuous Positive Airway Pressure) device, a plug-in bedside unit that pumps air through the mask.
This appointment was later canceled by me because of the weather and has not been rescheduled as I seem to be sleeping reasonably well and have had other health problems to attend to, such as a urinary tract infection, a hemorrhage in the right eye, and peripheral arterial problems in both legs. I considered all of those more important than a sleep disorder.
While I was in Norwalk Hospital, their sleep specialist billed my insurance carrier $425 for an evaluation and $295 for two beside visits, which I believe were attempts to force a breathing mask on me. The polysomnography study was $2,001, and a doctor billed my insurance $424 for reading sensor outputs.
My original intention was simply to have a physician assess my sleep problems and then determine whether or not I wanted to proceed with a fullblown study. Instead I was shanghai'd into a competitive hospital program and my insurance provider was billed $3,225 to "prove" that I actually had sleep apnea.
When I inquired how much the face mask and CPAP were going to cost, I was told by the doctor not to worry about it; it would be largely covered by insurance. (I have found over the years that when you ask a doctor how much he is going to charge for surgery or an office visit, he claims he doesn't have the faintest idea. The billing is handled by some mysterious group in the back office and he has nothing to do with it. If you believe that, you probably still believe in the tooth fairy.)
I have inquired of others with sleep problems what they think of apnea programs. A long-time friend who has twice been tested for apnea believes the medical profession is trying to make everyone with sleeping problems march to the beat of the same drummer. He says he gets his best sleep from sunrise to noon, but sleep clinics never measure that time period, instead sending patients home when the sun rises.
A middle-aged executive told me he has solved his snoring problem by having his tonsils, adenoids, and uvula, a fleshly lobe at the back of the throat, surgically removed. On the other hand, his father, with similar symptoms, opted for the face mask and CPAP, and says they have improved his sleep 100%.
The bottom line seems to be that before you make any major medical decision you are unsure of, it is always best to get a second opinion.
© 2006 Barks Publications Provided by ProQuest LLC. All Rights Reserved.
Source: Electrical Apparatus