I need to vent about sleep apnea

XianC

So I get depressed a lot. I am constantly unmotivated, lethargic (not sleepy, just lethargic) and can't focus on things. I've been tested twice in the past for my testosterone levels which, both times, were very low. Reading on the benefits of testosterone treatments, I became encouraged that perhaps this would help me in so many areas of my life. Energy, weight issues, depression, etc. I talked to my doctor about it and his first response was "let's get a sleep study done first".

Now, I get that sleep apnea is a real thing. But I have this impression that every doctor tries to push sleep studies like they're the gateway to the chic diagnosis of sleep apnea. Almost like there were millions of CPAP machines made in excess due to a paperwork issue and now the medical profession needs to unload them.

So I go to a sleep doc today. In the paperwork, I'm asked several questions such as "do you snore", "do you wake up several times a night", "do you kick in your sleep", etc. The only thing I checked yes on is snoring. So one yes and about 12 no's. The specialist comes in and after about 2 minutes of talking (mostly about my shirt and my 3rd shift work schedule), he says "well, you probably have sleep apnea. If diagnosing is that easy, I could be a doctor too.

So now they want to do the sleep study. Then they want me to come in for another office visit to discuss the results. In other words, try to bleed me for as much money as they can while I'm a patient. I told them they could just give the results to my doc since he's the one who wants them, not me.

I left frustrated and angry that I'd essentially been diagnosed before a study was even done. I'm generally disheartened by the fact that my PCP won't even address my low testosterone unless I go through this whole process (it's going to be about a month before the study and then I'm sure he'll want me to get treatment for a period of time after that). I feel like the answer is staring me right in the face yet I can't access it.

To be fair, his concern is the increased risk of prostate cancer when receiving testosterone treatments but ... I'm a smoker. If I'm going to get cancer, I'm going to get it. And frankly, I'd rather live the next 10 or 15 years as happy as possible than the next 25 or 30 being miserable.

So yeah, this post was basically a rant but if anyone has any experiences that are similar to this, especially with a doctor's reluctance to testosterone treatments or the ease by which they diagnose sleep apnea, please reply and tell me your story.

lblert

I just had a sleep study done two nights ago because I'm constantly fatigued and get sleepy during the day no matter how many hours I sleep. I don't have sleep apnea, which I was pretty sure of before I ever had the test done. But they try to rule out sleep apnea first because that's the easiest sleep disorder to treat. The disorders involving your sleep cycles are harder to diagnose and treat.

Going by what you wrote, have you been diagnosed with depression? Your symptoms are very typical of depression. You might try going on an anti depressant and see if it helps.

lilbearzmom

I have a feeling you're not going to like what I am going to say, but oh well. I take it you are obese. You say you snore. You say you are lethargic. Any ONE of those symptoms warrants a sleep study, much less put all together. It seems like doctors are over-prescribing sleep studies and CPAP machines because of demographics. If 60% of the population is overweight or obese, then a good percentage of those will probably have varying degrees of OSA. It just goes along with the fattening of society, much like the dramatic rise in Type 2 diabetes. OSA is VERY serious. It kills, Silently. I'm not talking about stopping breathing suddenly during the night. I'm talking like years of painful slow dying from heart problems due to OSA. I really hope you do go through with the study, but it kind of seems like maybe you would prefer the slow painful death, maybe of lung cancer. I realize this sounds very harsh, but I think you needed a wake up call. I do wholeheartedly hope you can turn your health around. Good luck.

XianC

I do have depression but it's situational. I work in the mental health field and while I don't pretend that I can self-diagnose, I am very aware of where my depression comes from and how I am when those factors are not present. I've tried a couple anti-depressants but the side effects made me give up on them.


and lilbearzmom, I don't have a problem with anything you said (except for presuming to know what kind of death I would prefer). You make a lot of good points and you're right. I do need to go through with the study and I do plan to. The way it all happened today just left me frustrated. Being new here to MFP is my re-entry into pursuing that healthy (or at least healthier) lifestyle. I appreciate the kick in the *kitten*.

Kyndness

I had a sleep study several months ago to rule out sleep apnea as a potential cause of my frequent tension headaches. While I agree that sleep studies are probably over-prescribed (this article raises that concern: http://www.kaiserhealthnews.org/Stories/2012/January/16/Sleep-studies.aspx?p=1), lilbearzmom has an excellent point that the demographics match the demand. Lethargy, depression, and the other symptoms you mentioned are definitely symptoms of sleep apnea, so IMO it's absolutely worth getting checked out. I know they're pricey and you're probably not too thrilled with having to spend hundreds (more, if you're uninsured) to diagnose a condition you doubt you have, but 1) the expense is worth it to know if you're putting yourself at an increased risk of cardiovascular problems, and 2) you can take funny pictures of yourself with the monitors and wires glued to your head - they make great conversation starters!

If you want to get your testosterone tested before your sleep study appointment, you can ask another doctor to test it (your psychiatrist will, if you have one prescribing any psych meds), go to a free-standing lab and pay out of pocket (this would probably cost you more than the sleep study would), or share the concerns you mentioned here with your PCP, and tell him you'd feel more comfortable having it tested now. Men with low testosterone *may* have a slightly higher risk of developing or dying from heart disease, so that sort of cancels out the increased risk of prostate cancer.

Good luck to you!

geturgoat

I work for an ENT Physician and I send the sleep study orders off for my clinic. We do not willy nilly order sleep studies unless the patient is over weight, has a large neck, or snores, etc.

Maybe this particular Dr. was looking at your weight and neck size along with the fact that you snore. That would be three indicators of sleep apnea.

But, when we send the orders over to some sleep medicine offices most of them are very pushy and "car salesman" like so I understand your frustration. When you are put on a CPAP machine you will typically get new supplies for it every 6 months, so this creates a revolving charge for the sleep specialist's office. I am not saying all of them operate this way.

Good luck.

amiclvrt

I went through a sleep study and I do have sleep apnea. It seems like it is being diagnosed more often because, I believe, the increased awareness. I thought I was depressed. I went to counseling and tried anti-depressants with no improvement. I knew I was snoring and my husband was out of his mind with annoyance. I spent 2 years sleeping in a different room, which took a huge toll on my marriage. My CPAP is the best thing that ever happened to me. My husband says that I have my personality back. It has made a huge difference in my life.

Depression is often misdiagnosed with someone who actually has sleep apnea because the symptoms of sleep apnea mask as depression. IMHO depression is over-diagnosed.

And weight gain is a major symptom of sleep apnea. I went through the same screening and they haven't actually "diagnosed" you, they more or less did a screening to see if you are likely to have sleep apnea to make sure the sleep test is medically appropriate. When you do the sleep study, you will have to meet certain markers before you are officially diagnosed with sleep apnea and it will be mapped out on a graph. That is the only way to be officially diagnosed. But, since the sleep study is expensive they want people to meet screening criteria before they will actually do the sleep study. They told me as well during screening that it sounded like I had it. It was until I did the sleep study that they were able to see it on paper and then treat as appropriate.

I would suggest you do the sleep study....hope this helps!

vanzeem

I used to work for a place that did sleep disorder testing. You could find out if your place does apnealinks. It's a pre-screening we would use if the doctor wanted a sleep study, but the patient didn't have many symptoms. It was something the patient would take home, use over night, and bring back the next day. We could then download the information to the computer and get a report. I was tired a lot but chalked it up to having two very young kids. I did the apnealink and it was positive so I had the sleep study and got the cpap. I would honestly rather lose weight than wear the cpap just because my kids get up a lot during the night and it's a pain to keep putting the mask on. Good luck.

mamawithtwins

Sleep apnea may be the buzz of the moment, but when it is real it can be serious. If your insurance will pay for the test you should just go have it done.

My dad has severe sleep apnea, that caused problems with his BP and put him at serious risk for a stroke.

It sounds like you may want to avoid the need for a CPAP, and I don't blame you - it can't be easy to sleep comfortably with a mask and tube attached to your face. My dad hated his and stopped using it within the week.

If you are diagnosed and don't want the CPAP, maybe try some OTC solutions?

My dad uses a chinstrap now and he swears by it. It repositions his jaw during sleep to stop the collapse that causes the snoring. The repositioning stops the collapse that causes the airway blockage that creates the snore. He got his off a BOGO free from www.good-bye-snore.com.

My mom happily reports that the snoring is gone

I'm not a doctor, and I'm sure the CPAP is a much better solution, but it can't do you any good if you aren't willing to wear it. If the OTC helps I figure it must be better than nothing.

alexandriax03

I have a feeling you're not going to like what I am going to say, but oh well. I take it you are obese. You say you snore. You say you are lethargic. Any ONE of those symptoms warrants a sleep study, much less put all together. It seems like doctors are over-prescribing sleep studies and CPAP machines because of demographics. If 60% of the population is overweight or obese, then a good percentage of those will probably have varying degrees of OSA. It just goes along with the fattening of society, much like the dramatic rise in Type 2 diabetes. OSA is VERY serious. It kills, Silently. I'm not talking about stopping breathing suddenly during the night. I'm talking like years of painful slow dying from heart problems due to OSA. I really hope you do go through with the study, but it kind of seems like maybe you would prefer the slow painful death, maybe of lung cancer. I realize this sounds very harsh, but I think you needed a wake up call. I do wholeheartedly hope you can turn your health around. Good luck.

Agreed.