Demystifying Medicine One Month at a Time

Snor’n’ in the USA

I’m not a drum-banger for the latest “epidemics” to come to media attention, whether it’s H1N1, Vitamin D, or getting your kids CAT-scanned routinely.

But there comes a time in every blogger’s life when he must comment on something that does bubble up into consciousness a tad, shall we say, often.

Sleeping with (or with someone with) the CPAP monster. Note the pictured restfulness.

I’m talking here about an epidemic that we are learning more about each passing day. Something that you or someone you know or sleep with may be diagnosed with, and ultimately treated for (an interesting national problem in its own right): Obstructive Sleep Apnea (OSA).

What is it, you ask?

A new national scourge? Stop the presses! Can I catch it?

Well, the main thing you should know is that the rise in prevalence of OSA is directly proportional to two main factors:

  1. We now have a treatment that works, thus making us look to diagnose the condition more.
  2. Probably the key factor: OSA is most often (note not always, for there are variants) correlated with being overweight or obese. As we are a nation of expanding waistlines, you can see the correlation.

Do you snore? Is your sleep fitful, and are you tired a lot of the time? Ever fallen asleep at the wheel? Has a bed partner ever commented that even through your snoring, you sometimes stop breathing?

A yes to any of those (even basic old snoring) can be suggestive of sleep apnea.

To get tested, of course: “Talk to your doctor or health care professional.”

You’ll spend the night in a sleep lab, hooked to a polysomnogram (poly=many, somno=sleep, gram=tracing or recording): a device that records your pulse, heart rhythm, blood oxygenation, breathing, muscular contraction and brain wave activity while you sleep. If you stop breathing or “under breathe,” resulting in a loss of blood oxygen, you test positive.

How can we treat it? Lose weight! Exercise!

What do we really do?

Welcome to CPAP-land. CPAP stands for Continuous Positive Airway Pressure. In a nutshell, you use a machine that blows air into your nose or mouth, keeping your airway open.

Volia. No more snoring. No more apnea (stopping breathing). Better sleep. Less fatigue. More energy.

Since this is now a well-recognized medical problem, health insurers pay for this equipment. Hello another billion dollar medical industry.

So classically American: Using technology to work around the underlying problem–our inability to lead less sedentary, gluttonous lives.

Less jello, please.

I’m scared we’re evolving into the blobby people portrayed in the film Wall-e. [See the space station captain at right.]

What is the endpoint of all this? Are we destined, as a people, to hook ourselves to machines all night so that we can sleep better? If you’re an insomniac, it’d be a worthy tradeoff.

Can the day be not too distant when we hook machines to us all the time (I don’t just mean iPads.)? Will we be able to implant electrodes in our head so that we can e-learn without having to crack the books?

What other bodily functions can be augmented by hook-on machines that work while we sleep?

All right, then. Sleep tight!


  1. MC

    Sad to say, I’m sure conditions are diagnosed more often when someone is making $ from the cure

  2. Bredgette

    This challenge has been keeping the establishment a secret for two years until the first batch of wine was ready. and this is my site where i have few more articles that might help in this subject.” ..

  3. maryp

    Please don’t oversimplify. Yes, obesity is a BIG problem (pun intended) and sleep studies/dx of sleep apnea seem to be rising. However all behavior is multifactorial, and studies are clear how hard it is to get the weight off once you gain it. If you look at recent studies about the food and activity choices of people who are chronically tired/sleep deprived/feeling sad mood much of the time – guess what? Being sleep deprived increases your likelihood of NOT making healthy diet choices, not dealing well with stress, not incorporating regular exercise into your day, etc. Structural deformities that are a factor in sleep apnea might be alleviated by require oral surgery, head/neck surgery, dental treatment, etc. These interventions can be expensive, painful, have risk of complications, and no guarantee of success. If you can adapt readily to CPAP, it can be a very effective solution with not a lot of downside. (I’m married to a man with sleep apnea – yes, he is obese, but he had sleep apnea all his life, and a carotid artery dissection/CVA at age 38 – when he was at a normal weight. His CPAP machine makes life sleep and health better for both of us.)

  4. student

    i’m honestly surprised that this post came from someone who teaches ethics. you’re essentially recommending withholding effective treatment in favor of the same advice these people have been given multiple times a day, every day of their lives. you even say in this article that CPAP gives people less fatigue and more energy–that makes it easier to exercise, and maybe even (gasp) lose weight. sometimes when they lose weight, they stop needing the CPAP. but instead, you think people who aren’t breathing while they sleep should just try harder to exercise?

  5. scott

    I believe the author is concerned that by being a society that caters to obesity with aggressive intervention as the first-lone approach, we are becoming a society that enables obesity.

    i propose an approach that facilitates self-accountability while avoiding the potentially inhumane action of denying healthcare to those in need despite their own culpability: In the setting of disease caused by obesity; hypertension, sleep apnea, type 2 diabetes, etc, we provide third-party coverage for the first 12-18 months, then all additional expenses are out-of-pocket. this allows the obese patient a chance to benefit from CPAP, oral hypoglycemic therapy, etc, while getting is weight under control. If the obese patient then fails to return to a more natural weight, then they can pay for their lifestyle choice, providing an undeniable incentive to practice healthier lifestyle choices.

  6. Seahawk

    Hmm, I am thin and have been diagnosed with apnea. Actually, I think my sinusitus is causing apnea events but that is another issue.

    Anyway, while I definitely share your concerns about apnea being way over diagnosed, please do not stereotype who the typical patient is. Someone’s life may depend on it.

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