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Dream on: Treating a sleepy situation

Sleep apnea has a grave impact on a person's health and quality of life. The good news is that the disorder is increasingly on physicians' and patients' radar screens.

By Kathleen Phalen Tomaselli, amednews correspondent. May 3, 2004.

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Nights riddled with sudden starts and stops. Days marked by bouts of nods and yawns. Inappropriate daytime dozing. Labels like sleepy and lazy.

For many people with sleep apnea, these characteristics are a part of daily life, not "symptoms" or difficulties, until someone else pushes the issue.

There's a classic scenario, says Kevin Gleeson, MD, professor of medicine at Pennsylvania State University College of Medicine. A husband and wife come for an appointment. "I ask the man, 'What brings you here?' He looks at his spouse. 'I don't have a problem, she's the one with the problem,' " says Dr. Gleeson. "They don't know they snore, they don't know they are sleepy during the day." And he can point to about 4,000 or 5,000 similar tales.

Because of such denial, Dr. Gleeson says, he's got a drawer full of snoring tapes. "The wives frequently bring in an audiotape of their husband snoring. They feel they need to testify that the snoring is present."

Sleep apnea is increasingly on physician radar screens. And recognition of this insidious and potentially life-threatening condition by family doctors has increased nearly twelvefold in the past decade, says Robert Ballard, MD, a pulmonologist and director of the Sleep Center at National Jewish Medical and Research Center, Denver.

Still, there's room for improvement. An estimated 80% of people with sleep apnea remain undiagnosed.

There are multiple reasons: The person has no idea it is happening; doctors often fail to ask the right questions about sleep; and cultural mores suggest that sleep is unimportant or even a sign of weakness.