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Is There A Stigma Against Obstructive Sleep Apnea?

>> Thursday, February 11, 2016

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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Scottie December 18, 2016 at 11:17 AM  

I have sleep apnea. My family and friends know this, and when we are together, there are constant comments, like "wake up!!" or "you look sleepy" or "why can't you stay awake!"
It is, of course, hurtful. I do not hear people with other disabilities, like hearing or sight impediments, or having to use a walking aid, having to endure constant public comments about their imnpediments.
I have been thoroughly tested, and have used an excellent CPAP machine with mask every night (it is not pleasant, believe me) for the past three years, and there is nothing more that I can do. I try to take short naps before visiting people, and I am sure that I do not often exhibit signs of my condition, but the constant reminders/comments/jokes get me down. I seriously consider becoming reclusive, purposely.

Dr. Sue Pedersen December 18, 2016 at 1:27 PM  

Dear Scottie,

Thank you so much for your comments and contribution. Please know you are not alone in these feelings and experiences - this is exactly why I wrote this blog post. Together, we need to educate people about sleep apnea so that this stigma that you and literally millions of others feel can be conquered. Please feel free to share my post with your family and friends, in hopes that this will help give them a better understanding.

Dr Sue

Mwilliams April 23, 2017 at 3:30 AM  

I've been on cpap for 4 years now and there is every reason I should feel ashamed for it. It's disgusting that I have let myself get to this condition. It's pathetic that I can't get myslef out of it. I have hidden it from all people apart from my wife and my very immediate family.

And my shame is my punishment for not being able to stick to the simple premise that consuming more calories than I use on a daily basis = fat.

Dr. Sue Pedersen April 23, 2017 at 7:25 AM  

Dear MWilliams,

Thank you for your comments. I am so saddened to hear that you feel this way. Remember that there are many contributors to weight struggles, from genetics, to medications, to the bacteria that grow in our intestines, to the emotional relationship with food, and many others. I encourage you to find and reach out to health care providers that can engage in helping you explore the contributors in your case, such that you can have any needed support and help in your journey.

Dr Sue


I am excited that you have arrived at my site, and I hope you are too - consider this the first step towards a Healthier New You!! As a medical doctor, Endocrinologist, and obesity specialist, I am absolutely passionate about helping people with weight management. Though there is certainly no magic cure for obesity, there IS a successful treatment plan out there for you - it is all about understanding the elements that contribute to your personal weight struggle, and then finding the treatment plan that suits your needs and your lifestyle. The way to finding your personal solution is to learn as much as you can about obesity: how our toxic environment has shaped us into an overweight society; the diversity of contributors to obesity; and what the treatment options out there are really all about. Knowledge Is Power!!

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