Why are people in denial?

[amenite]

I think that there are still too many doctors that think sleep apnea is just a consequence of overweight and loosing weight cures the sleep apnea.

Another thing is that too many people think that sleep apnea is just a comfort issue.

My doctor really had nothing to do with me getting a diagnosis and getting the treatment I needed. I diagnosed myself and brought it to her attention. I was referred to a specialist for a sleep study and the rest is history.

The takeaway is that despite having some of the risk factors, I had been through many annual physicals with this same medical group and even the same specific physician, and never once did the subject come up until I brought it up. This doctor freaked out when she noticed my fasting blood glucose was a few points over 100 on one of my prior year exams, and it was not an issue at all - a minor anomaly on one lab result one time, never repeated.

Until there is some basic screening incorporated into that process of the basic physical exam many will continue to go undiagnosed and untreated. They will suffer all the ill effects, many will have shortened life spans and some of them might even take out others in the process when they drive off the road after falling asleep at the wheel.

[zoocrewphoto]

I appreciate the stories concerning why it's difficult to treat sleep apnea. I hope that awareness can be brought about soon.

I will say that the people I have spoken to admit they have sleep apnea or that they strongly believe they have it based on strong indicators. Yet, they don't have any real motivation to treat it. I would think that spending time around a person with Vascular Dementia, strokes, heart disease, would get one's attention. A little research online lets you know the dangers, even if you don't believe your own doctor.

I'm confused about health coverage. With Healthcare.gov, I'm not sure why everyone in the U.S. doesn't have health insurance coverage. It took me about 5 phone calls, but I located a place to do my sleep study with only $20.00 up front. The rest was my deductible and I could pay over time.

Sounds nice, but that is not what most people have access to. A couple years ago, as the program was starting, my job contract was in negotiations, and the main issue was health insurance. My employer was trying to drop our plan. So, I did some looking at the government website to see what my options would be. My monthly premiums would have been over $200 (that was after the subsidies). (My current premiums are $36 a month). I live paycheck to paycheck already, so $200 a month would be a huge increase for somebody like me. I am borderline on the edge of qualifying for assistance. I did the online test thing, and it said I would qualify for $16 a month in food stamps. So, while the assistance wouldn't be much, I am clearly not considered rich either.

Okay, onto the plan. $2000 deductible. My current plan has a $500 HRA account (basically, I get all my premium back in the form of a medical bank account that gets used before the deductible starts). Then I have a $250 deductible. Only then do I start paying for doctor bills or equipment. With the government plan, I would have to be in the hospital or diagnosed with a new disease to ever get close to finishing the deductible. To use the government plan, I would need to pay over $2400 in premiums and $2000 deductible before getting any use of it. Why bother? I would be better off putting $50 a month into a new bank account and stay off the insurance.

I met a lady awhile back with the government plan, and she had a prescription for a monthly asthma inhaler. Even with insurance, the cost was almost $200. Per month. So, no inhaler for her. I get the same inhaler, and my copay through my employer based plan is $22.

Both my brother are sister are self employed. Neither one qualifies for subsidies. Neither one can afford the premiums for a basically useless plan. Both go without insurance and pay out of pocket when needed. I have a good friend in the same situation. Also self-employed. Income is based on the business income, so they look better than they really are day to day. So, they don't get a good deal.

If everybody could get decent plans like the employer based plans, then yes, it would be awesome. But the government plans can only stay afloat if more people pay in than receive. So, the rates are higher, and people sign up because they think they have to, not because it is what they wanted.

My contract will be up for negotiation again next summer. Not looking forward to it. I suspect I will be joining the uninsured. I was really hoping the healthcare plan would be fixed up a bit by now, but it's not looking like that will happen anytime soon.

I am glad that it is helping some people. But clearly, those with medicaid or the VA system are struggling with long delays and limited choices. They may be getting assistance, but it isn't great. And those who are borderline aren't getting much help from it either. If you want good health insurance, you need to be rich or have a good employer based plan.

[kteague]

Denial seems the easier route. When sleep deprived everything feels like too much effort, and when you add all the other turn-offs to the mix, it's just feels easier to not open Pandora's box. I think most of us pick and choose our denials. While I took my sleep quite serious, I've procrastinated in other health areas. When things cross my mind I dismiss them. Probably will bite me in the butt one day. I can get on my soapbox and preach about OSA, but that just happens to be my soapbox issue.

[zoocrewphoto]

Here are the reasons I waited over 10 years for diagnosis and treatment, despite knowing full well that I had sleep apnea.

1) I did not understand what sleep apnea meant. Why it was dangerous. To me, it was just another form of sleep deprivation, no different than me being a night owl and not spending enough time in bed. I had no idea that it was oxygen deprivation and led to serious issues like high blood pressure, heart attacks, and stroke.

2) I was a night owl, and my mom's sleep studies were always early and done by 5 or 6am, just as I was getting to sleep. Why pay for a sleep study if I won't be asleep?

3) I thought you had to use a nasal mask to use cpap, and as a mouth breather, even during the day, there was no way I could use a nasal mask.

4) my doctor never once mentioned it. Even though she was also my mom's doctor, and she knew my mom had sleep apnea. Even though I had high blood pressure which was not responding well to multiple medications. She never once asked about my sleep or suggested sleep apnea. While I had not volunteered the information, I would not have lied had I been asked. She did warn me for a couple years that I was at a higher risk for stroke. But I didn't understand why, and I was in denial about it. I was in my 30s afterall.

Why did I finally get diagnosed and treated?

1) I learned that cpap has full face masks too, and I could take a sleeping pill for the sleep study.

2) I saw a news report that sleep apnea causes high blood pressure which leads to stroke. All of a sudden, my health issues and doctor's warnings made sense. I confessed to my doctor a couple weeks later, had the test, was diagnosed as severe, and had a great night for my titration. I am a true convert.

I wish I had done this many years ago.

[Sheriff Buford]

Zoocrew: I am so sorry for your health care situation. When the big obama care debate occured in this country, many liberals denied what you just said. I also felt bad for you when you lost your previous insurance that you liked. "You can keep your plan", "insurance will be cheaper", "you can keep your doctor" were all lies. Of course, you don't need me to point that out. You are living it. My heart goes out to you.

Also, OSA is not limited to men, thou I would suspect more men have it than women. My wife has it,along with my mom, and she denies she has it.

Sheriff

[chunkyfrog]

I had the symptoms well over 20 years ago, but the HMO at work --that passed for health insurance--
put me through a fake sleep study, with a clean bill of health; and I suffered for an additional 19 years,
oblivious to the fact that there was a reason I was always so "lazy".
A little over five years ago, My husband's gasping at night finally got to me enough that I talked him into
mentioning it to our doctor. He was diagnosed, and then he talked ME into getting checked out.
--"I don't snore, no, sir, I do not!"

[Janknitz]

I think most people would rather die than sleep with a mask strapped to their face. I used to feel that way until I realized that I was going to die very soon if I didn't take care of this. Not everybody gets the message.

[joeljjk11]

I think many people think it's 'no big deal' or that CPAP won't help them. It is also expensive out of pocket depending on your insurance. I have paid about $700 out of pocket for my CPAP machine and masks.

[yaconsult]

I think most people would rather die than sleep with a mask strapped to their face. I used to feel that way until I realized that I was going to die very soon if I didn't take care of this. Not everybody gets the message.

Many do die, including a dear friend of mine. I diagnosed him and got him to get a sleep study which confirmed severe apnea. He got his machine and I gave him all the support and advice I could, being on the other side of the country. But I couldn't be there to make sure he put the mask on every night and so, most nights, he didn't. He had a stroke as he was about to start his car and is no longer with us.

I wish more people realized how great the risk is when they decide it's "too hard" or "I can't do this".

[manwe]

Interesting topic. I am newly diagnosed (still working on fighting to get my machine), but I guess I was pretty sure I had it for the last 10 years or so at least. Reasons I never forced the issue to get a sleep study until last month (NOTE: I'm not implying they were good reasons):

1. Didn't think it was a big deal.
I "knew" what sleep apnea was. In my head it meant I snored a lot and would occasionally stop breathing which would wake me up. As stupid as this now sounds, that didn't scare me. I figured "Hey, it will just wake me up and make me start breathing again. I'll just be tired a lot."

2. Too "busy".
Work, kids, stuff, etc. I was lucky if I got in for a physical once every 7 or 8 years let alone taking time to schedule and follow up with a sleep study overnight. This was even considering I have always had very good insurance through my job(s) that would have covered everything pretty much.

3. Thought that the way I feel now is normal.
I guess I still don't know what normal means. I feel tired all the time, but I always just wrote it off as working too many hours and not being a "morning person". I assumed that every one dragged their butt out of bed and crawled into the shower every morning using the will power of a Hobbit marching up Mt. Doom. I also thought that slapping myself in the face to stay awake while driving on long trips was normal and I just needed to break up my driving a little more. I'm looking forward to the day when I will feel something different and to be honest that more so than any great fear of long term health problems is really what motivated me to finally force the issue with my PCP.

4. Never had any idea that there were long term health issues involved.
I have been very lucky up to this point in my life to really have no significant health issues so there was nothing really to make me curious about sleep apnea being the root cause of something else I guess. All I had was the tiredness symptoms and a wife that was getting more and more persistent that I get checked out because she didn't like when I stopped breathing at night.

So the combination of realizing that "tired isn't normal" for everyone, and that I was making my wife very scared, made me ask my PCP for a sleep study. Only after the sleep study and the followup sleep lab did I finally start educating myself and realizing that this was a lot more serious than I thought.

[SewTired]

For most people, the treatment is not easy. We deal with many of those problems here every day. But many others, having no support, just give up. That's one of the reasons there are so many machines for sale on craigslist.

All those who gave up will suffer the consequences, eventually. And there are even more people that are undiagnosed and have no idea. Some will pass away due to stroke, heart attack and other major problems caused or aggravated by their apnea.

Most people have no clue as to the long term consequences of untreated sleep apnea. That's the word that needs to get out!

I actually helped someone who had a cpap up for sale on Craiglist (I was considering buying it at the time). He took it off Craigslist and is now using it. It's unfortunate that they don't have cpap classes similar to the diabetes ones. The DME dropped all the Medicare patients when the Competitive Bid thing came through and they weren't grandfathered in.

[chunkyfrog]

Contact medicare. Someone may be lying.

[SunnyBeBe]

I'm certainly learning a lot about where people are coming from, but most of you are now receiving treatment, right? I certainly didn't mean to insult anyone. I think the people who need it the most are the ones who aren't on these boards. lol I guess everyone has their own story and their own reasons for arriving at their current treatment plan.

I noticed this week that my GP and Endocrinologist had Apnea charts with signs and warnings on their exam room doors. I noticed it, but many patients may not. I don't think my doctors would have picked up on it with me, unless I had presented it to them and told them that I thought I had it and why.

I don't know what everyone's experience has been with affordable health care, but I and quite a few people I know obtained coverage from varying prices, zero and up per month and they are entitled to good benefits. There are options for your deductible. Even affordable plans offer durable medical equipment coverage. With so many people not using the cpap, I can understand why the insurance companies confirm compliance before they fork out the money to purchase it for the customer though.

I'm one month in and I really do feel good. I guess it's taken me that long to really start feeling the benefits. My AHI is running between .1 and 1 each night. I hope that my enthusiasm will be contagious. I don't want to bug anyone, but I think I might offer them some material to read. Do you think that would be too pushy?

[Chevie]

Why are people in denial?

The same reasons that 69% of the population consumes so many calories they are overweight and 35% are obese?

http://www.cdc.gov/nchs/fastats/obesity-overweight.htm

How fat are you?

[chunkyfrog]

Everybody probably knows the bride who only asked her fat friends to be bridesmaids . . .