Snoring Can Kill You
By Tom Barrett (01/19/05)
Snoring kills thousands of Americans each year. I found that out the hard way six years ago. Insurance companies also kill Americans. I've know that for a long time, but I got a strong reminder of it this week.
Let's start with snoring, and then we'll discuss health insurance companies.
Six years ago I was involved in a near-fatal car accident. I was diving home when I noticed a road tractor with an orange triangular sign on the back.
Since these signs indicate a slow-moving vehicle, I remember thinking, "I need to slow down." Seconds later I hit the rear of the tractor, never having applied my brakes.
I came to as rescue workers were in the midst of the 45-minute long process of cutting my vehicle apart to extricate me. The trauma helicopter took me to the hospital because I was in such critical condition that I might have died during the 25 minutes it would have taken an ambulance to get me there.
Naturally I was interested to discover why I, a careful driver, could have caused such an accident. For years I had driven emergency vehicles, and had even written and taught a course for emergency vehicle operators. I was always aware of my surroundings, and always had a pre-planned place to go in the event that another vehicle decided to occupy the space where mine was.
How could this have happened?
My doctor sent me to a sleep specialist who told me I probably had sleep apnea, and ordered a sleep study. His conclusion was based on the facts that I snore frequently, and that when the doctor asked my wife if I stopped breathing during the night, she answered that I did.
I knew that I did not sleep well, that I was often tired when I first woke up, and that I was often drowsy during the day. I sometimes fell asleep during the day, and had even dozed off while driving and was awakened by my tires driving over the gravel shoulder of the road. But I never realized that I had a serious, life-threatening condition.
Most people have never heard of sleep apnea. Many of the people reading this article have the condition, and don't have a clue that they do. As you read the signs and symptoms, remember that most cases of sleep apnea are not as severe as mine. You may never have dozed off during the day, but you could still have a milder form of the condition that could take your life, or the life of someone you love.
When I titled this piece, "Snoring Can Kill You," I wasn't thinking about your spouse's threats to murder you if you don't stop snoring. And it's not actually snoring that can kill you. Snoring is just a symptom that is present with almost everyone that has sleep apnea. Not everyone that snores has sleep apnea, but anyone who snores loudly or frequently should consider the possibility, because sleep apnea can kill.
People with sleep apnea have a much higher risk of stroke and heart attack than the general population. They are fifty per cent more likely to suffer from high blood pressure. And they are over 300 per cent more likely to be involved in fatal car accidents.
If you live alone, it is far less likely that your sleep apnea will be discovered. Some danger signs would be snoring that awakens you, or waking up gasping for air. That is because the word "apnea" means you stop breathing, even for a few seconds. If you sleep in the same room with someone, they will undoubtedly complain about your snoring. But they may not notice that you sometimes stop breathing unless you ask them to stay awake and monitor your breathing for a couple of hours after you doze off.
The sleep study my doctor ordered confirmed his preliminary diagnosis of sleep apnea. You see, there is no blood test or other easy way to definitely determine if one has sleep apnea. In the sleep study you go to bed in a comfortable room with numerous monitoring devices. You are also the star on a closed-circuit TV network.
Trained sleep disorder technicians monitor the various instruments and the TV feed. They count how many times you stop breathing and not how long each period is. Then the diagnosis is made and the appropriate treatment is prescribed. There are a number of surgical procedures that have been tried, but the least invasive and most popular treatment is the use of a CPAP machine.
Nasal Continuous Positive Airway Pressure (CPAP) is the most common effective treatment for sleep apnea. When you use one of these machines, you wear a mask over your nose when you go to sleep, and pressure from an air blower forces air through the nasal passages. The air pressure is adjusted to your needs by a respiratory therapist.
It took me a few weeks to get used to wearing the small nasal mask, but the very first night convinced me that it would be worth getting used to. I had the best night's sleep I had had in years. Within a few days I had more energy and felt better than I deserved to! Since that first night I have seldom had a night without my CPAP machine; I even take it with me when I travel.
Other than minor maintenance (which I do), and a yearly check of the settings by a therapist, I have never had a problem with my machine until about a week ago when the motor went out. I made a call to the medical supply company for service, and the Battle with the Insurance Company began.
Health insurance companies are remarkably short-sighted. By and large they refuse to pay for preventative measures that prevent serious, more costly conditions from occurring. (Not all insurance companies are like this, but most are.) Their bureaucratic systems often delay necessary treatments until they become life-threatening.
A case in point is my tailor, Mr. Glickstien. He mentioned to me one day many years ago that he had seen blood in his urine. I was a paramedic at that time, and immediately thought of a half-dozen terrible things that could indicate. I advised him to see a doctor right away. He said that his insurance company told him he had to see a general practitioner first, then wait four to six weeks to see a specialist. I told him to go to the emergency room. He did, and was told that if he had waited another day he probably would have died.
Out of the quarter of a million people who read Conservative Truth each week, there are probably thousands of you with similar stories. Mine began when the medical supply company told me that Blue Cross (my insurance
company) now required a sleep study before supplying a CPAP machine. Not only that, but Blue Cross only pays for rentals now, and the medical supply company (the only one that is authorized by Blue Cross) does not rent, but only sells CPAP machines! Talk about a catch-22!
Assuming (falsely) that I was dealing with reasonable people, I said that I had already had a sleep study. They countered that it had to be within the last twelve months. I told them I was already suffering from lack of sleep, that I needed the machine now, and that it would take four to six weeks to get a sleep study. They said, "Sorry."
Assuming (falsely) that if I could get past the clerks I might be able to speak with someone more intelligent, I asked for a supervisor. It turned out that she, too, was incapable of any action beyond reading from a prepared script. I had to 1) Get a prescription for a sleep study; 2) Wait a month or more for the study; and 3) Wait for Blue Cross to decide whether they would supply the machine. Never mind the fact that being without the machine could cause serious medical problems that would cost them far more than the machine, and never mind the fact that waiting a month could be life-threatening. That's what the rule book says.
Assuming (falsely) that they would listen to a Medical Doctor, I asked my very busy physician to call Blue Cross, and he was kind enough to do so (thank you, Dr. Liporace, and your wonderful office manager, Jackie). Surely these pencil-necked clerks would not ignore the advice of a trained physician! Wrong again. He told them that sleep apnea is not a condition that reverses itself. If I had it six years ago when they did the first study, I still have it today. He also confirmed that his clinical findings were that I currently have sleep apnea, and that it was imperative that I continue to receive CPAP treatment. He sent them a prescription for the machine, and a Letter of Medical Necessity, confirming that the device was necessary for my health. Their response? "Sorry."
Still believing (falsely) that these people would not be so stupid as to ignore the relative costs, I pointed out that CPAP machines cost between $600 and $800, and that the sleep study would cost between $2500 and $3000.
"Why would you want to spend thousands for a sleep study instead of hundreds for a CPAP, just to find out what a Medical Doctor has already told you?"
Well, it turns out that they ARE that stupid.
I bring these things up for two reasons. First, America needs to realize that idiotic decisions by insurance companies such as delaying treatment for my tailor friend, or denying less expensive preventative treatments, are causing medical insurance costs to sky-rocket, and in many cases are costing people their lives.
Second, not everyone has the options I have. I will purchase my own CPAP machine, and then spend whatever time it takes to force Blue Cross to reimburse me, because I cannot afford to go any longer without therapy. But there are hundreds of thousands of people in this country who don't have that option. They pay the unconscionable rates these companies charge, and can't afford to pay extra for necessary treatments when they are arbitrarily denied by their insurance companies.
Enough about insurance companies. You can expect to see more in this column about the abuses of these companies who advertise about how much they care about us, but who treat us like we are beggars when we expect the treatment we pay for. Let me end by encouraging you to be aware of the problem of sleep apnea.
Because of the disturbances in their normal sleep patterns, people with sleep apnea often feel very sleepy during the day and their concentration and daytime performance suffer. The consequences of sleep apnea range from annoying to life-threatening. They include may include symptoms such as depression, irritability, sexual dysfunction, learning and memory difficulties, and falling asleep while at work, on the phone, or driving. If you have these symptoms, or if you experience sleepiness during the day, loud snoring or pauses in breathing during sleep or any other sleeping difficulties, make an appointment to discuss these problems with your doctor.
INTERNET RESOURCES:
www.sleepfoundation.org
www.sleepapnea.org
(Printer friendly version) Email: Tom Barrett
