Doctor Spreading Dangerous Misinformation in Richmond, VA?

The patient usually is an overweight male who's a loud snorer.....
Sleep apnea has many complications. Sudden death during sleep is not one of them. ....
If your son is overweight, weight loss might be the thing that cures him. ....
http://www2.timesdispatch.com/lifestyle ... ar-748715/

It would be a nice gesture if some of you would post contrary views on the newspaper's website.

Yikes!

So Well wrote:

The patient usually is an overweight male who's a loud snorer.....
Sleep apnea has many complications. Sudden death during sleep is not one of them. ....
If your son is overweight, weight loss might be the thing that cures him. ....
http://www2.timesdispatch.com/lifestyle ... ar-748715/

It would be a nice gesture if some of you would post contrary views on the newspaper's website.

I don't see any misinformation there. On the contrary, it might help some readers.

avi123 wrote:
I don't see any misinformation there. On the contrary, it might help some readers.

Like bloody hell it would - "Sleep apnea has many complications. Sudden death during sleep is not one of them"

The patient usually is an overweight male who's a loud snorer.....

True. That is usually the guy who gets sent to the lab by the primary doc. Underweight females who don't snore often get overlooked, which is a shame. But the statement is still true.

Sleep apnea has many complications. Sudden death during sleep is not one of them. ....

Borderline, but arguably true. Sudden death usually requires interplay of another serious condition. In other words, an otherwise healthy patient with a good heart is likely to live through his apneas, even when his quality of life gets to the point that he wishes otherwise.

If your son is overweight, weight loss might be the thing that cures him. ....

"Might" might well be one of my favorite weasel words. For those with sudden onset of OSA following sudden weight gain, losing weight may well cure the condition.

I agree 100% with you that those sentences can easily give people wrong impressions of the seriousness and pervasiveness of OSA and could be used to perpetuate inaccurate stereotypes. But it is difficult to attack the factualness of them, in my warped opinion.

BlackSpinner wrote:

avi123 wrote:
I don't see any misinformation there. On the contrary, it might help some readers.

Like bloody hell it would - "Sleep apnea has many complications. Sudden death during sleep is not one of them"

Right! And what about sleep apnea affecting mostly overweight males? Seriously??? I'm sure all the thin womrn AND men here would like to correct that one!

I've looked up the number for the paper and am considering calling them. This article makes even me mad.

Lets see: where's that list of professional athletes .... ??? Hmmmm. Reggie White, .....

On the other hand, if you have a patient who tends to anxiety, who is up tight about their OSA Dx or are writing an article or publicly answering a question from the general public ....

The doc said:

. . . Sleep apnea has many complications. Sudden death during sleep is not one of them. But it can lead to a rise in blood pressure. It invites heart attacks and strokes. . . .

If the heart attack or stroke occurs at night (which, as I understand it, is more likely than during the day, for OSA sufferers) and occurs during sleep and results in death, that would fit the definition of "sudden death during sleep." Right? Maybe the editor messed that up.

. . . A mouth guard that pulls the chin slightly forward keeps throat tissues from collapsing. The family doctor or dentist can direct him to a place that sells these devices. . . .

Why'd the doc mention a second-best treatment first? Maybe the editor changed the order on him.

. . . In severe cases, surgical or laser removal of the redundant tissue permanently opens the air passageway. . . .

Severity is not the primary issue, is it? Refusal or inability to use PAP therapy or lack of response to oral appliance is generally the issue (or issues) that leads to surgery, isn't it? And if "permanently" is being used there by the doc to mean "a little bit for a few years," maybe that word is OK. But that's not what "permanent" means to me. Bad word choice, I think, especially if he was talking about UPPP.

. . . Sleep apnea is best diagnosed in sleep labs, where body processes are measured during sleep. . . .

I agree with that, at least. Although aren't centers better than labs?

jnk wrote:

. . . Sleep apnea is best diagnosed in sleep labs, where body processes are measured during sleep. . . .

I agree with that, at least. Although aren't centers better than labs?

For top notch quality, you'd want to go to a centre.

If sudden death isn't a complication of OSA, then why does the VA rate someone on a machine at 50% disabled? We all know the VA doesn't rate inconsequential conditions very high and 50 for the VA is the magic number to get concurrent receipt of disability compensation and military retired pay.

Madalot wrote:And what about sleep apnea affecting mostly overweight males? Seriously???

Do you disagree that OSA patients are usually overweight males? Cause the Mayo Clinic thinks they are.
I don't see anywhere that the quoted doctor said skinny women aren't also affected. They just aren't the largest demographic.

Two of the quoted assertions are accurate, and the "sudden death" one could have been worded better, but none are "misinformation".

jnk wrote:The doc said:

. . . A mouth guard that pulls the chin slightly forward keeps throat tissues from collapsing. The family doctor or dentist can direct him to a place that sells these devices. . . .

Why'd the doc mention a second-best treatment first? Maybe the editor changed the order on him.

I agree that the article could easily mislead people, but I think the reason this doctor listed a second-best treatment first is that he was listing them in monetary order (i.e. the cheapest methods first). Weight loss could be free, a dental appliance would be "cheap", CPAP therapy would be more costly, and surgery could be considered the most expensive. Unfortunately, these days it seems people often look at the price of treatment over the effectiveness of the treatment. If it's "cheap" and it "might" work, they'll try that first.

LinkC wrote:

Madalot wrote:And what about sleep apnea affecting mostly overweight males? Seriously???

Do you disagree that OSA patients are usually overweight males? Cause the Mayo Clinic thinks they are.
I don't see anywhere that the quoted doctor said skinny women aren't also affected. They just aren't the largest demographic.

Two of the quoted assertions are accurate, and the "sudden death" one could have been worded better, but none are "misinformation".

In truth, I see your point as well as other posters. I guess where *I* am coming from is the initial sense a person will get from reading it. What is the very FIRST thing a person will think when they read it? The way it is worded could easily be interpreted, by some, to mean that a skinny woman most likely does NOT have sleep apnea. So a skinny woman that IS diagnosed with sleep apnea could end up in denial because of things like this article.

The assertions are not inaccurate I agree, but they don't present a completely accurate picture either.

jbn3boys wrote:

jnk wrote:The doc said:

. . . A mouth guard that pulls the chin slightly forward keeps throat tissues from collapsing. The family doctor or dentist can direct him to a place that sells these devices. . . .

Why'd the doc mention a second-best treatment first? Maybe the editor changed the order on him.

I agree that the article could easily mislead people, but I think the reason this doctor listed a second-best treatment first is that he was listing them in monetary order (i.e. the cheapest methods first). Weight loss could be free, a dental appliance would be "cheap", CPAP therapy would be more costly, and surgery could be considered the most expensive. Unfortunately, these days it seems people often look at the price of treatment over the effectiveness of the treatment. If it's "cheap" and it "might" work, they'll try that first.

I agree that may have been the doc's intention. But in my opinion, oral device is MUCH more expensive than PAP therapy. Only about half respond acceptably to it, and some are made worse by it, so it turns out to be a total waste of time and money for too many people. There is no way to know which patients are more likely to respond acceptably. All of the doc and dentist visits to measure, customize, fit, titrate, and tweak the device add up quickly to big bucks. Not to mention that if you continue to prove efficacy, you spend a lot of money on PSG testing, since no oral appliance comes with AHI data. I believe the idea that oral appliance is cheaper is a fallacy, all things considered. Still, that may have been the doc's intention.

For the record, I have an oral appliance I occasionally use in conjunction with PAP therapy, and I am glad the dental and surgical options are there for all the poeple who are unable or unwilling to use PAP.

In my case I am a middle aged male that is overweight but weight-loss when one has untreated sleep apnea is not an easy thing, actually my sleep doctor when he diagnosed me told me to not even try and lose weight; it won't happen. In my case my sleep apnea is severe enough to result in quite low oxygen levels during sleep, with no levels 3 and 4 of sleep which are the regenerative levels, and this has a major impact on the whole metabolism. In my case diet changes, adding exercise did nothing to reduce the weight, I continued to gain and this was one of the symptoms that prompted looking into sleep apnea.

I was told that at the stage I am in the sleep apnea promotes weight gain, which in turn makes the sleep apnea worst, which in turn promotes more weight gain and on and on and on. My sleep doctor told me that right now my metabolism is such that weight loss in VERY unlikely until I start CPAP treatment, for which I am still waiting but growing more and more impatient. He said that once I start treatment and when I start to have actually more daytime energy that will be when I can start to make other changes to try and lose some of the weight. At this stage I am exhausted pretty much all the time.

While I do think the article could have elaborated on a few details more I can not say it is actually false, misleading maybe.