Charles, you did well to figure out what was causing your problems. You mention several symptoms that should cause a doctor to at least consider sleep apnea. While each taken alone might have another cause, apnea is famous for causing such a wide variety of symptoms.
I share your frustration, and struggle to understand why people with sleep apnea have to educate themselves and identify their own problems, when we have experts who are supposed to know how to identify health problems: doctors!
Health care is an extremely dysfunctional system that may take decades to integrate new knowledge. Bill Dement, one of the founders of sleep medicine, ran a study in a few primary care offices/clinics. One part of the study was to interview patients when they came in for their appointments; questions were to pinpoint likely sleep problems. A lot of patients had indications of treatable sleep problems.
The other part was to look at the records of the patients. Typically *no* or a very few instances of sleep disorders were found in the records.
A sample of people whose questionnaires suggested a sleep problem were given overnight sleep studies to confirm that the questionnaires were picking up actual sleep disorders.
Doctors were missing almost all cases of sleep disorders.
After decades of scientific understanding of common sleep disorders like apnea, sleep medicine is not taught in a serious way in most medical schools; and doctors still neglect to ask a few questions that would pinpoint sleep disorders.
So it is not surprising that your list of complaints tracks the known symptoms of sleep apnea. And that your doctors never thought to suspect a sleep problem.
As to the use of a computerized screening process: people have worked on such systems which make sense, to me at least, as a complement to a good physical workup and talking with the doctor who knows how to listen. Clinical diagnosis may be just too complex, with too many variables, for most humans to manage--why not use a computer to assist?
But for finding possible cases of sleep apnea, the job can be easier. Apnea can cause a wide variety of seemingly unrelated symptoms, as you have experienced. While each of the symptoms might not be related to apnea, a cluster of them should be easy to spot. Since 1992, Phantom of the Night has contained a "Quiz to Identify Sleep Apnea Syndrome" http://www.healthyresources.com/sleep/apnea/question/quiz.html with the idea of encouraging people with common apnea symptoms to seek medical evaluation.
A primary care physician with a rudimentary grasp of sleep disorders should be able to accurately identify people with sleep apnea, and refer them on for professional evaluation. There are condensed presentations in "doctorese" designed to help the busy primary care physician identify sleep apnea in their patients.
I hold that it might take a determined effort by patients to help educate and motivate physicians to pay attention to apnea and other sleep disorders.
Patient, Diagnose Thyself!
Charles, you did well to figure out what was causing your problems. You mention several symptoms that should cause a doctor to at least consider sleep apnea. While each taken alone might have another cause, apnea is famous for causing such a wide variety of symptoms.
I share your frustration, and struggle to understand why people with sleep apnea have to educate themselves and identify their own problems, when we have experts who are supposed to know how to identify health problems: doctors!
Health care is an extremely dysfunctional system that may take decades to integrate new knowledge. Bill Dement, one of the founders of sleep medicine, ran a study in a few primary care offices/clinics. One part of the study was to interview patients when they came in for their appointments; questions were to pinpoint likely sleep problems. A lot of patients had indications of treatable sleep problems.
The other part was to look at the records of the patients. Typically *no* or a very few instances of sleep disorders were found in the records.
A sample of people whose questionnaires suggested a sleep problem were given overnight sleep studies to confirm that the questionnaires were picking up actual sleep disorders.
Doctors were missing almost all cases of sleep disorders.
After decades of scientific understanding of common sleep disorders like apnea, sleep medicine is not taught in a serious way in most medical schools; and doctors still neglect to ask a few questions that would pinpoint sleep disorders.
So it is not surprising that your list of complaints tracks the known symptoms of sleep apnea. And that your doctors never thought to suspect a sleep problem.
As to the use of a computerized screening process: people have worked on such systems which make sense, to me at least, as a complement to a good physical workup and talking with the doctor who knows how to listen. Clinical diagnosis may be just too complex, with too many variables, for most humans to manage--why not use a computer to assist?
But for finding possible cases of sleep apnea, the job can be easier. Apnea can cause a wide variety of seemingly unrelated symptoms, as you have experienced. While each of the symptoms might not be related to apnea, a cluster of them should be easy to spot. Since 1992, Phantom of the Night has contained a "Quiz to Identify Sleep Apnea Syndrome" http://www.healthyresources.com/sleep/apnea/question/quiz.html with the idea of encouraging people with common apnea symptoms to seek medical evaluation.
A primary care physician with a rudimentary grasp of sleep disorders should be able to accurately identify people with sleep apnea, and refer them on for professional evaluation. There are condensed presentations in "doctorese" designed to help the busy primary care physician identify sleep apnea in their patients.
I hold that it might take a determined effort by patients to help educate and motivate physicians to pay attention to apnea and other sleep disorders.