Doctors reactions to male vs. female complaints

[Patrick A]

I take issue with the premise.

Gynecologists won't even let me make an appointment, let alone give me the time of day!

Same here. Good one.

[roster]

[sonyat]

Hello everyone, this is my first post, and it seemed like a good thread to introduce myself.

You see, I've been wondering if women have different sleep apnea symptoms than men. I have been talking to doctors about my sleep problems for over a decade, and I just had my full overnight sleep study last month. The first time I went, they simply referred me to a psychiatrist. I never scored high on the daytime sleepiness scale -- I don't fall asleep during meetings, while driving, watching TV or a movie, etc. In fact, I had a pretty bad insomnia because I'd figure it was better to stay up late and get stuff done than to drag myself out of bed more tired than ever the next morning. My symptoms (in addition to the most horrible sleep, snoring, and sleep talking) were anxiety and depression and I must have been diagnosed with "inattentive-type Attention Deficit Disorder" at least ten times because I was constantly losing and forgetting things, and not able to pay attention for more than a few minutes at a time. However, all medications for ADD, including Wellbutrin, made me more anxious.

I had a home sleep study with just the pulse oximeter about five years ago and it showed little to no hypoxia, so they didn't diagnose apnea.

I've never had a job where I had to be in before 10 am -- it would have just been impossible. However, I was recently told I need to be in at 9am, so I went to a sleep clinic hoping to get a doctor's note for Delayed Sleep Phase Disorder saying I couldn't do that. Instead, they asked me to do a full overnight sleep study with EEGs and so on, and found that while my oxygen levels rarely become hypoxic, each apneic event creates a severe disturbance in my sleep cycle. So in fact I have "mild" apnea on an oyxgen level but "severe" sleep apnea looking at my EEGs.

I had to wonder if this was just my brain "overreacting" again, because hey, I've been told all this time I'm really just a psych case. Well, since using the CPAP I feel completely different. No anxiety. It's only been a week, but a week without anxiety is a pretty rare week in my life. We'll see how it goes.

[roster]

All of the symptoms you reported in your post are common with sleep-disordered breathing (SDB). Doctors need to learn this.

I had to wonder if this was just my brain "overreacting" again, because hey, I've been told all this time I'm really just a psych case. Well, since using the CPAP I feel completely different. No anxiety. It's only been a week, but a week without anxiety is a pretty rare week in my life. We'll see how it goes.

From that comment I would say SDB may well have been the underlying cause of all of your problems.

Hypoxia is not necessary for SDB to wreck a human. By itself, hundreds of respiratory-related arousals (RERAs) per night for years can do great damage to mind and body.

Information from Dr. Steven Park:

However, there's a variation of sleep apnea called upper airway resistance syndrome (UARS), where you'll stop breathing while sleeping, but not long enough to be called obstructive sleep apnea.

These multiple arousals lead to a chronic low-grade physiologic stress response which heightens the nervous system (and immune system). During times of stress, blood is shunted away from low-priority organs like the GI system, reproductive organs, the distant extremities and the skin. Chronic lack of blood flow can lead to a number detrimental effects, including hair loss.

It's also been shown that chronic physiologic stress also raises your cortisol levels, lowers your thyroid levels, and alters your estrogen/progesterone/testosterone balance.

Source: http://doctorstevenpark.com/index.php?s=uars

[katamoran]

I haven't necessarily had the male vs. female doctor experiences that some of you have, but I've definitely had experiences with doctors who are completely incapable of relating to another human being. For example, they never look you in the eye, keep their heads buried in your chart, treat you like a number on a very long list for that day, etc. Their gender, and mine, didn't seem to play a part.

Another factor that might be considered in all this is your insurance carrier. I can't substantiate it, but I've heard talk in the past that doctors can be essentially gagged by your insurer because said insurer doesn't want to pay for expensive procedures and treatments. Given the importance of greed over care in business, I can completely believe this. In the mean time, we get sicker and end up costing them more in the long run (unless we die prematurely), which they can't see. Has anybody come across evidence of this?

[grandmma]

Rooster, thanks again for being so informative (is that the right form of the word?!).

Hello everyone, this is my first post, and it seemed like a good thread to introduce myself.

Hi Sonya, welcome to the forum. So glad you've found peace at last, and that CPAP is working for you. Continue to post any issues you have, as there are a lot of well informed and experienced folk here who can smooth the way if needed.

[elena88]

so many interesting stories!
Oh new person! hi there!
" " Hello everyone, this is my first post, and it seemed like a good thread to introduce myself.
"I never scored high on the daytime sleepiness scale -- I don't fall asleep during meetings, while driving, watching TV or a movie, etc. In fact, I had a pretty bad insomnia "

I know, I always scored a zero on the epworth sleepiness scale, and thought that was the most useless test on the planet.. they should have
another test for people who are hyper all the time who have sleep apnea.. I know a lot of people fall thru the cracks, but I took that test three
times, scored a zero on it. Still do! Fell thu the cracks with the oximeter too, HELLO, insomniacs dont sleep with little things attached to their
fingers.

Yes, its a whole different ball game if youre an insomniac.. and youre a woman trying to tell a doctor you dont sleep..

but no more of that!

guess what? Im NOT an insomniac anymore.. month four with apap, I log in nine hours, and dont get up ONE time many nights.. OMG!

This is the first time I can remember not having this insomonia problem since I was about thirteen years old!

[DoriC]

Welcome Sonya, so glad your first week is going well and hope that Rooster's post gave you the knowledge that you're on the right track. Keep us updated and good luck..

[Gondring]

My symptoms (in addition to the most horrible sleep, snoring, and sleep talking) were anxiety and depression and I must have been diagnosed with "inattentive-type Attention Deficit Disorder" at least ten times because I was constantly losing and forgetting things, and not able to pay attention for more than a few minutes at a time. However, all medications for ADD, including Wellbutrin, made me more anxious.

Hi there, sonyat.

Several experts with whom I have spoken (and I'm talking world-renown types) have agreed when I asked whether there might be a close relationship between ADD and sleep. In fact, the best way I have found to describe to someone what severe inattentive-type ADD is like is to suggest the person stay awake for several days and then try to function while people tell him, "you just need to focus!"

[sonyat]

Rooster, thanks for that information! It sounds like the upper airway resistance is exactly what I have going on, and it runs in my family. My mother had her tonsils and adenoids out when she was in kindergarten -- for snoring so bad she scared my grandparents. It worked, but then just recently she started snoring again and got a CPAP. My brother has had sinus surgery, UPPP surgery, lost weight, and still needs his CPAP, which he got about 8 years ago. The surgeon said he had the smallest sinuses he'd ever worked with. With apnea in the family you'd think I (or the docs) would have gotten this figured out a long time ago. My doctors have suggested sinus surgery several times just for my repeated sinus infections, but my insurance has a explicit exclusion for it. We might be able to petition them based on it being "sleep surgery."

Until then, I really don't mind the CPAP. Before I finally received it, but just had my diagnosis, I was actually fantasizing about what I'd do with my extra energy. Yeah, I'm overweight, do people think I don't want to work out and burn it off? Come on, just give me enough energy to do it!

Thanks for welcome, everyone!

Sonya