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Snorin’ In The USA

Guest post by Dr. John Henning Schumann

I’m not a drum banger for the latest “epidemics” to come to media attention, whether it’s H1N1, Vitamin D, or getting your kids CAT-scanned routinely.

But there comes a time in every blogger’s life when he must comment on something that does bubble up into consciousness a tad, shall we say, often.

I’m talking here about an epidemic that we are learning more about each passing day. Something that you or someone you know or sleep with may be diagnosed with, and ultimately treated for (an interesting national problem in its own right): Obstructive sleep apnea (OSA).

What is it, you ask? A new national scourge? Stop the presses! Can I catch it?

Well, the main thing you should know is that the rise in prevalence of OSA is directly proportional to two main factors:

–We now have a treatment that works, thus making us look to diagnose the condition more.

–Probably the key factor: OSA is most often (note not always, for there are variants) correlated with being overweight or obese. As we are a nation of expanding waistlines, you can see the correlation.

Do you snore? Is your sleep fitful, and are you tired a lot of the time? Ever fallen asleep at the wheel? Has a bed partner ever commented that even through your snoring, you sometimes stop breathing?

A “yes” to any of those (even basic old snoring) can be suggestive of sleep apnea.

To get tested, of course: “Talk to your doctor or healthcare professional.” You’ll spend the night in a sleep lab, hooked to a polysomnogram (poly=many, somno=sleep, gram=tracing or recording): A device that records your pulse, heart rhythm, blood oxygenation, breathing, muscular contraction and brain wave activity while you sleep. If you stop breathing or “under breathe,” resulting in a loss of blood oxygen, you test positive.

How can we treat it? Lose weight! Exercise!

But what do we really do? Welcome to CPAP-land. CPAP stands for continuous positive airway pressure. In a nutshell, you use a machine that blows air into your nose or mouth, keeping your airway open. Volia. No more snoring. No more apnea (stopping breathing). Better sleep. Less fatigue. More energy.

Since this is now a well-recognized medical problem, health insurers pay for this equipment. Hello, another billion dollar medical industry. So classically American: Using technology to work around the underlying problem — our inability to lead less sedentary, gluttonous lives. I’m scared we’re evolving into the blobby people portrayed in the film Wall-E.

What is the endpoint of all this? Are we destined, as a people, to hook ourselves to machines all night so that we can sleep better? If you’re an insomniac, it’d be a worthy tradeoff.

Can the day be not too distant when we hook machines to us all the time (I don’t just mean iPads.)? Will we be able to implant electrodes in our head so that we can e-learn without having to crack the books?

What other bodily functions can be augmented by hook-on machines that work while we sleep?

All right, then. Sleep tight!

This post originally appeared at GlassHospital. John Henning Schumann is a general internist in Chicago’s south side, and an educator at the University of Chicago, where he trains residents and medical students in both internal medicine and medical ethics. He is also faculty co-chair of the university’s human rights program. His blog, GlassHospital, provides transparency on the workings of medical practice and the complexities of hospital care, illuminates the emotional and cognitive aspects of caregiving and decision-making from the perspective of an active primary care physician, and offers behind-the-scenes portraits of hospital sanctums and the people that inhabit them.

*This blog post was originally published at ACP Hospitalist*


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