Sleep Apnea Denial

Here’s a common situation that I see almost every day: A middle-aged, overweight man who snores, has high blood pressure, depression and low energy levels that comes in for a throat and sinus infection, not responding to oral antibiotics. He’s found not to have an infection at all, but inflammation of his throat and sinuses from laryngopharyngeal reflux disease, most likely due to his underlying possible sleep apnea. His problems are taken care of with conservative treatment, but when I mention the possibility of obstructive sleep apnea, he refuses or politely declines  to undergo a sleep study. Some agree to undergo the test, but delay and procrastinate, saying that they’re too busy.

 

When this situation happens, there are two possible explanations: The more common type of patient is one that truly believes that his or her sinus infection is causing all the symptoms. No matter how much I explain the importance of undergoing a sleep study (including the fact that his father died of a heart attack at age 45), this patient refuses to take this explanation seriously. Eventually, months or years later, they usually come around, but only after the condition worsens.

 

The other type of patient is one that’s already done all the research, and knows about sleep apnea. Usually, they’ll have a family or friend with known sleep apnea and has seen one of the treatment options. This person refuses to even undergo a sleep study, since all the available treatment options are not too appealing. If you don’t have a diagnosis, then there’s nothing to worry about. Except that their other chronic medical conditions continue, causing the person to repeatedly go back to their doctors for their general ailments or seeing a number of specialists for various other conditions. These patients are more difficult to convince, and usually, they’ll find and accept every other medical diagnosis (hypothyroidism, anemia, chronic fatigue syndrome, migraines, sinusitis, etc.) before being convinced of the fact that they have a sleep-breathing disorder that’s at the root of many of their medical ailments.

 

If you’re the type of person that I’ve just described, what will it take for me to convince you to take your sleep-breathing condition more seriously? Please enter your answer in the comments box below.


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5 thoughts on “Sleep Apnea Denial

  1. I can’t help you on this problem. I have friends and relatives with obvious signs of sleep apnea who are in denial. Nothing I say will get them into the sleep lab.

  2. Maybe this is why, after even just a few glasses of wine, I wake up feeling like I have a major sinus infection (chronic sinus infections is a problem of mine) and feel groggy the next day. Also, I am a very loud snorer especially when I’ve had a few drinks at night, not a lot, just a few. Could some of those sinus infections and some of that lethargy be a result of sleep apnea.

    Interesting.

    Rick

  3. Now that the possibility of sleep apnea has entered your thoughts, it would be interesting to know what steps you will take.

  4. Denial appears to be a common part of the disease. MRI-DTI brain scans reveal a predilection for white matter lesions in the frontal lobes in sleep apneics. Denial of illness results when the anterior cingulate gyrus, located in the mid-frontal region, is damaged from one of these white-matter strokes.
    This the same lesion is responsible for denial of illness in those with the hoarding syndrome. (One reason the new DSM-V is moving hoarders into their own separate category).
    There is an example of the lesion depicted on the cover of my book, “Deadly Sleep.” It’s the largest of the lesions in the frontal region in the MRI-DTI brain scan illustrated.

  5. I am being scheduled for a sleep study. I have chronic sinus infections and I can not breathe through my nostrils once I lie down in bed. As a result, I breathe through my mouth, then my mouth dries shut and — not being able to breathe — I wake up. I am claustrophobic and panic if my face is enclosed so I question whether the device for monitoring apnea does, itself, cause “proof” of sleep apnea in some patients. Also, my wife and I aren’t thrilled about my possibly having to sleep together with a device over my face for the rest of my life. Surely modern medicine must have a cure for sleep apnea, not just a mechanical treatment of symptoms?.