[quote="Sleepless_in_LM"]As I see it, the most important thing everyone on this forum can do is be an open advocate for OSA diagnosis and treatment. Since learning I had OSA, I have talked openly about it at work and found three other individuals within our organization (about 70 people) who also are being treated for OSA. Nobody knew it bacause they never talked about it. Now it is pretty much common knowledge. I have had numerous people in my office to talk to me about it. In the last year I know of two people here that have had sleep studies and several spouses, I think due in large part to my encouragment and openess about it.
There are also some wonderful organizations out there trying to do what we are talking about. In Milwaukee, The SleepWellness Institute has partnered with the widow of Reggie White to form a foundation:
http://www.sleepwell.org/images/reggieWhite.pdf
As for doctors, I am guessing the new ones have some knowledge. My Doc has students in all the time shadowing him (he is just a local small town clinic, but allows UW students to come in.) I think he likes to send them in to see me because he knows I will be very open and honest about it. To date, every student has told me they have some knowledge of OSA, but are full of questions about my treatment and its results. Even the PA students are getting some training in OSA. I think the old time doctors will be harder a nut to crack.
What lies ahead? And what to do about it.
Just Look at the Stats!
This is an especially relevant topic since OSA must be one of the most significant (and least understood and diagnosed) public health problems that exists in the United States (and maybe the world). These stats should get the media's attention:
Based on the National Sleep Foundation "Sleep in America" 2005 poll, a full 26% of all adult Americans (over 18) are at "high risk" for OSA.
By gender, 31% of ALL men and 21% of ALL women met the Berlin questionnaire criteria for "high risk" for OSA. The risks trend up with age, up to 65.
The Berlin questionnaire has been demonstrated to be highly predictive of OSA diagnosed through traditional methods (sleep study).
Previous estimates of OSA put the range at between 5% and 10% of the US adult population. An aging US population and increasing obesity rates are cited for the increase.
Hidestand, DM et al., "Prevalence of Symptoms and Risk of Sleep Apnea in the US Population"; Chest 2006;130-780-786.
This study is available online at http://www.chestjournal.org.
Not only that but a number of studies show that OSA victims consume significantly more healthcare services in the years prior to diagnosis than any control group. We're talking about hundreds of millions of dollars. The media, insurers, workers, employers--everyone--should pull their heads out and see OSA diagnosis and treatment as a way of saving serious money in the process rather than treating us like ugly step children!
Based on the National Sleep Foundation "Sleep in America" 2005 poll, a full 26% of all adult Americans (over 18) are at "high risk" for OSA.
By gender, 31% of ALL men and 21% of ALL women met the Berlin questionnaire criteria for "high risk" for OSA. The risks trend up with age, up to 65.
The Berlin questionnaire has been demonstrated to be highly predictive of OSA diagnosed through traditional methods (sleep study).
Previous estimates of OSA put the range at between 5% and 10% of the US adult population. An aging US population and increasing obesity rates are cited for the increase.
Hidestand, DM et al., "Prevalence of Symptoms and Risk of Sleep Apnea in the US Population"; Chest 2006;130-780-786.
This study is available online at http://www.chestjournal.org.
Not only that but a number of studies show that OSA victims consume significantly more healthcare services in the years prior to diagnosis than any control group. We're talking about hundreds of millions of dollars. The media, insurers, workers, employers--everyone--should pull their heads out and see OSA diagnosis and treatment as a way of saving serious money in the process rather than treating us like ugly step children!
Last edited by SleepGuy on Wed Jan 17, 2007 10:42 pm, edited 1 time in total.
Re: Just Look at the Stats!
Thanks for pointing this out SleepGuy. It is incredibly short sighted to address this problem in the current manner. The money that would be spent upfront in getting this mess under control would be paid back ten-fold in savings.SleepGuy wrote:This is an especially relevant topic since OSA must be one of the most significant (and least understood and diagnosed) public health problems that exists in the United States (and maybe the world).
Not only that but a number of studies show that OSA victims consume significantly more healthcare services in the years prior to diagnosis than any control group. We're talking about hundreds of millions of dollars. The media, insurers, workers, employers--everyone--should pull their heads out and see OSA diagnosis and treatment as a way of saving serious money in the process rather than treating us like ugly step children!
Nationally, care for people with chronic conditions consumes these astonishing numbers:
83% of health care spending,
81% of hospital admissions,
76% of all physician visits, and
91% of prescriptions written
Good Lord, nobody get's out alive anyway, so you would think that money would be better spent on vaccines and preventative measures, such as screening for OSA, etc.
Dead Tired? Maybe you're sleeping with the Enemy.
Know Your Snore Score.
Know Your Snore Score.
It makes NO sense to me that insurers fight so hard when it comes to providing coverage for OSA treatment. I read an article where on state medicaid actually dropped all benefits for OSA treatment! They should be pushing to have as many people as possible, who have other risk factors, to be screened and treated. Just read the posts on this site--all of the people who are off their hyptertension meds (or at significantly reduced dosages), diabetics with much improved blood glucose management, heart problems solved, depression resolved, over and over. And there are empirical medical studies to prove that effective OSA therapy significantly improves other chronic conditions in many people.
And I haven't even mentioned the collateral costs (traffic accidents, work accidents, loss of worker productivity, etc.) of untreated OSA.
Given that fully one third of all men, and one fifth of all women in the US are at "high risk" for OSA (that must be around 50 or 60 million people), you'd think that given what's at stake--and the hundreds of millions that are being spent to treat other conditions--someone--anyone (news media, politicians, Medicare, Medicaid, GAO, public health organizations, worker health and safety organizations, public highway safety people, insurance companies, the medical profession--some Washington Think Tank) would be willing to take up the cause here.
Meanwhile I guess we'll go on our merry way as the step children, fighting for insurance benefits and trying to find the most comfortable mask....
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CPAPopedia Keywords Contained In This Post (Click For Definition): medicare
And I haven't even mentioned the collateral costs (traffic accidents, work accidents, loss of worker productivity, etc.) of untreated OSA.
Given that fully one third of all men, and one fifth of all women in the US are at "high risk" for OSA (that must be around 50 or 60 million people), you'd think that given what's at stake--and the hundreds of millions that are being spent to treat other conditions--someone--anyone (news media, politicians, Medicare, Medicaid, GAO, public health organizations, worker health and safety organizations, public highway safety people, insurance companies, the medical profession--some Washington Think Tank) would be willing to take up the cause here.
Meanwhile I guess we'll go on our merry way as the step children, fighting for insurance benefits and trying to find the most comfortable mask....
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CPAPopedia Keywords Contained In This Post (Click For Definition): medicare
[quote="SleepGuy"]It makes NO sense to me that insurers fight so hard when it comes to providing coverage for OSA treatment. I read an article where on state medicaid actually dropped all benefits for OSA treatment! They should be pushing to have as many people as possible, who have other risk factors, to be screened and treated. Just read the posts on this site--all of the people who are off their hyptertension meds (or at significantly reduced dosages), diabetics with much improved blood glucose management, heart problems solved, depression resolved, over and over. And there are empirical medical studies to prove that effective OSA therapy significantly improves other chronic conditions in many people.
And I haven't even mentioned the collateral costs (traffic accidents, work accidents, loss of worker productivity, etc.) of untreated OSA.
Given that fully one third of all men, and one fifth of all women in the US are at "high risk" for OSA (that must be around 50 or 60 million people), you'd think that given what's at stake--and the hundreds of millions that are being spent to treat other conditions--someone--anyone (news media, politicians, Medicare, Medicaid, GAO, public health organizations, worker health and safety organizations, public highway safety people, insurance companies, the medical profession--some Washington Think Tank) would be willing to take up the cause here.
Meanwhile I guess we'll go on our merry way as the step children, fighting for insurance benefits and trying to find the most comfortable mask....
And I haven't even mentioned the collateral costs (traffic accidents, work accidents, loss of worker productivity, etc.) of untreated OSA.
Given that fully one third of all men, and one fifth of all women in the US are at "high risk" for OSA (that must be around 50 or 60 million people), you'd think that given what's at stake--and the hundreds of millions that are being spent to treat other conditions--someone--anyone (news media, politicians, Medicare, Medicaid, GAO, public health organizations, worker health and safety organizations, public highway safety people, insurance companies, the medical profession--some Washington Think Tank) would be willing to take up the cause here.
Meanwhile I guess we'll go on our merry way as the step children, fighting for insurance benefits and trying to find the most comfortable mask....
Dead Tired? Maybe you're sleeping with the Enemy.
Know Your Snore Score.
Know Your Snore Score.
Ok, I just found out something that I think it very relevant and fairly shocking to our "situation".
I am going to think of a creative way to introduce it though. Watch this post for further details!
P.S. There's $$$ in it for you!
I am going to think of a creative way to introduce it though. Watch this post for further details!
P.S. There's $$$ in it for you!
Dead Tired? Maybe you're sleeping with the Enemy.
Know Your Snore Score.
Know Your Snore Score.
Doc, I had my sleep study done in a teaching hospital. Having no insurance, I saw a student Doc. It was amazing what he didn't know about sleep apnea. I have dealt with student docs before, and most at least give the impression they know what they are doing, but this poor guy didn't have clue.
This was back in '99 or '00, so hopefully things have changed a little since then.
This was back in '99 or '00, so hopefully things have changed a little since then.
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Sleepless_in_LM
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Isn't this just like a typical Doc. "Yeah, I have your test results and diagnosis. Let's make an appointment in three weeks so I can tell you."drbandage wrote:Ok, I just found out something that I think it very relevant and fairly shocking to our "situation".
I am going to think of a creative way to introduce it though. Watch this post for further details!
P.S. There's $$$ in it for you!
The suspense is killing me!
_________________
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Ironically, the only research showing the magnitude of medical costs associated with undiagnosed/untreated OSA is from countries with socialized medicine (why is no one in the US even thinking about this?). The two most recent studies are from Canada and Israel:
A study from Canada showed that OSA victims consume 23 to 50% more medical services in the five years prior to diagnosis than control subjects, with OSA victims being at higher risk for hypertension, congestive heart failure, cardiac arrhythmias, cardiovascular disease, chronic obstructive airways disease, and depression. In a recent study from Israel, healthcare utilization was 1.7-fold higher by OSA patients compared to the control group, with the upper 25% of the most costly OSA patients accounting for 70% of the total healthcare expenditures.
The Canadian study can be found at: Smith, R, Ronald, J et al. (2002); What Are Obstructive Sleep Apnea Patients Being Treated for Prior to this Diagnosis?; Chest 2002;121:164-172
The study for Israel is: Tarasiuk, A, Greenberg-Dotan, S, et al. (2005); Determinants Affecting Health-Care Utilization in Obstructive Sleep Apnea Syndrome Patients; Chest 2005;128;1310-1314
In light of these statistics, the cost to the US healthcare and insurance industries of undiagnosed/untreated OSA must be in the hundreds of millions annually.
The worst of it is that not only is the U.S. polulation bearing all of these costs (primarily through taxes that support public health services and employer-provided healthcare insurance) but that perhaps 40 or 50 million hard working, taxpaying adults in the US are suffering from OSA and its common co-morbid conditions and don't even know it because the entire healthcare system remains largely in denial about OSA and the importance of its diagnosis and treatment!
A study from Canada showed that OSA victims consume 23 to 50% more medical services in the five years prior to diagnosis than control subjects, with OSA victims being at higher risk for hypertension, congestive heart failure, cardiac arrhythmias, cardiovascular disease, chronic obstructive airways disease, and depression. In a recent study from Israel, healthcare utilization was 1.7-fold higher by OSA patients compared to the control group, with the upper 25% of the most costly OSA patients accounting for 70% of the total healthcare expenditures.
The Canadian study can be found at: Smith, R, Ronald, J et al. (2002); What Are Obstructive Sleep Apnea Patients Being Treated for Prior to this Diagnosis?; Chest 2002;121:164-172
The study for Israel is: Tarasiuk, A, Greenberg-Dotan, S, et al. (2005); Determinants Affecting Health-Care Utilization in Obstructive Sleep Apnea Syndrome Patients; Chest 2005;128;1310-1314
In light of these statistics, the cost to the US healthcare and insurance industries of undiagnosed/untreated OSA must be in the hundreds of millions annually.
The worst of it is that not only is the U.S. polulation bearing all of these costs (primarily through taxes that support public health services and employer-provided healthcare insurance) but that perhaps 40 or 50 million hard working, taxpaying adults in the US are suffering from OSA and its common co-morbid conditions and don't even know it because the entire healthcare system remains largely in denial about OSA and the importance of its diagnosis and treatment!
Last edited by SleepGuy on Thu Jan 18, 2007 2:21 pm, edited 1 time in total.
Follow the money. It's more profitable to treat the symptoms than the cause.SleepGuy wrote:why is no one in the US even thinking about this?
It could seriously affect a lot of peoples' incomes.
Den
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User since 05/14/05
It's shocking to me that the news media is so willing to devote so much attention to public health Non-issues such as: avian flu (which by the way has killed exactly no one), Mad Cow Disease, smallpox and other hypothetical pandemics, etc.; and valid but largely incidental public health issues such as West Nile Virus, e-coli, while virtually ignoring very important public health issues such as OSA in particular.
Then to add insult to injury, OSA is a topic where public education, awareness, screening, etc. are critical in solving the problem, whereas media attention on hypothetical pandemics and Mad Cow disease really do nothing to solve the problem except make people stressed, worried, and anxious.
Sorry to vent on this so much--but I feel better now and perhaps the good doctor here should consider going into therapy.
Does anyone out there have ideas on how to get the news media to pay attention to these issues? It's beyond me.
Then to add insult to injury, OSA is a topic where public education, awareness, screening, etc. are critical in solving the problem, whereas media attention on hypothetical pandemics and Mad Cow disease really do nothing to solve the problem except make people stressed, worried, and anxious.
Sorry to vent on this so much--but I feel better now and perhaps the good doctor here should consider going into therapy.
Does anyone out there have ideas on how to get the news media to pay attention to these issues? It's beyond me.
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Sleepless_in_LM
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Den,Wulfman wrote:Follow the money. It's more profitable to treat the symptoms than the cause.SleepGuy wrote:why is no one in the US even thinking about this?
It could seriously affect a lot of peoples' incomes.
Den
I agree with you, but there is so much money to be made in treating this disease also. I can't figure out why Resperonics, Resmed, etc. aren't out there promoting this issue? Unless they figure expanding the market would bring in competition and drive the price of thier equipment to a reasonable level...???
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DreamStalker
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Just as Den stated "follow the money". Money will always trump health. Like the tobacco industry, it is quite evident that the commercial and fast food industries are the primary causes of health issues today ... but because there are big bucks to be made, these issue(s) remain hush hush.
President-pretender, J. Biden, said "the DNC has built the largest voter fraud organization in US history". Too bad they didn’t build the smartest voter fraud organization and got caught.