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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.