One of the most common complications of obesity is obstructive sleep apnea (OSA).  In my daily discussions with patients around testing and treating sleep apnea, I have often noticed that sometimes, people seem to be a little resistant towards considering that they may suffer from this condition. 
In follow up from last week’s post
Sadly, obstructive sleep apnea is not tested for often enough.  In my practice alone, I diagnose sleep apnea at least a half dozen times a week.  Amongst those in whom I suspect OSA, I have noticed that only about two thirds agree to go for testing, and only about half of those diagnosed agree to treatment.  I have also noticed that the way I start the conversation can have us ending the conversation in two totally different places.…
If I start by asking ‘Have you ever been tested for sleep apnea?’, the answer I often get is ‘No, but there is no way I have it’, or ‘No, no way, no one has ever said I snore.’  And from there I find it is often very difficult from there to convince my patient to get tested.
However, if I start by asking ‘How do you sleep?’, the answer I often get is ‘Terribly, and I am so exhausted’.  If I ask ‘Do you wake feeling unrested?’, the answer is often ‘YES!’, and at that point I start sensing perhaps even some gratitude or relief that finally, someone cares enough to ask about sleep. From there, I then suggest that we test for sleep apnea, and I find that people are often more likely to agree (though often still reluctantly) to testing.  
When I ask my patients about why they may be reluctant to consider whether they have sleep apnea, there is sadly often a feeling of shame that comes through.  They say that they feel embarrassed that their weight struggle could have led to this condition, and they do not like the idea of possibly having to wear a machine at night (called CPAP) as part of their treatment. Some have said that they see it as a label of being ‘really sick’ with their obesity and would be embarrassed to use the CPAP machine around their family or people they live with.

I want to put it out there for anyone that this may resonate with, that there is absolutely no shame in having sleep apnea.  This is a medical condition, just like diabetes, hypertension, or obesity, which is important to treat. People of all shapes and sizes can suffer with sleep apnea.  For people struggling with excess weight, untreated OSA is a major barrier to successful weight loss, because of the hormone changes that occur.  Not only is treating obstructive sleep apnea important for decreasing the health risks associated with it, but it is also an important part of a successful weight reduction plan in those who carry excess weight. 

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