I have often wondered why it is that doctors do not seem to see sleep apnea. Why do they still seem to miss this diagnosis some 80% of the time?

In most cases I do believe it makes itself very apparent. High BMI (abdominal), receded jaw, and large neck can often be observed in the first few seconds of seeing the person. Most of the self test and/or professional assessment guides can be completed in less than five minutes (usually half of that time)[1]-[2]. The things that most often show you where you should be looking are obvious and easily obtainable. So why not go there?

In a recent post here[3] I discussed the fact that most people find CPAP unusable. Over time less and less people find they can continue to use it. And finding out you cannot use CPAP is very often a very unpleasant journey.

As far as I can tell from reading tens of thousands of posts on sleep apnea Internet forums as well as what I see discussed in the medical research – the doctors consider it to be the patients fault if they cannot use CPAP. But I see it as relating to physiological issues[3] and frankly find the position that “it is the patients fault” is both extremely offensive and indicative of a general ignorance within the medical community. But regardless of what I think the person does not have the support they need to deal with the nonanatomic issues involved and so stops CPAP because it does not work for them.

Not only does the CPAP use end badly but most likely I think the relationship with the doctor is severely strained by the whole experience. So most of the time that CPAP is obtained it ends badly, which is somewhere between 55% and 78% of the time[3]. Most of the time. Perhaps a whole lot of the time.

When CPAP is involved I believe most of the time it turns out bad.

So if you are a doctor and would like to keep happy relationships with your clients perhaps CPAP is not a direction that works out often enough and well enough for you to want to go there. Perhaps you see the sleep apnea indications but then decide to simply move the patient away from the sleep apnea by other means. And in the current “do not support the patient” along with “blame the patient for any failure of the therapy that comes to be” – well – perhaps you made the right decision.

[1] http://umm.edu/programs/sleep/health/quizzes/sleep-apnea

[2] http://www.sleepapnea.org/treat/test-yourself.html

[3] https://honesttocpap.wordpress.com/2014/08/27/how-usable-is-cpap/