Diabetes Complications, Diabetes Developments, Diabetes Medication

Conquering Sleep Apnea

You can conquer sleep apnea. I know you can because I conquered a most severe form of it. And I’ve now even given away both of my continuous positive airway pressure (CPAP) machines, which is the standard treatment for overweight people who have sleep apnea.

About half of all of us who have diabetes also suffer from sleep apnea. While not all of us who have diabetes suffer from it, everyone with sleep apnea suffers. People lose their jobs because they nod off to sleep at work rather than at night. People crash their cars because they fall asleep at the wheel. Even those who don’t get fired or have traffic accidents suffer by being sleepy much of the time.

My fear of killing myself and my passengers by nodding off during an afternoon drive was in fact what finally persuaded me to seek treatment. Four years ago, when I finally began to get my sleep apnea under control with a CPAP machine, I wrote my first article about it. That article, for Diabetes Wellness News, is now online.
Since then, I have written here about “The Sleep Apnea-Diabetes Connection” and “Treating Sleep Apnea” in January 2007 and “Successful Sleep Apnea Therapy” in March 2007.

Later that month came my preliminary report on “Testing Sleep Apnea at Home.” One year later the Centers for Medicare & Medicaid Services finally approved payment for CPAP machines with a diagnosis on the basis of unattended home sleep monitoring. The “Decision Memo” is online.

This is big news. Medicare and Medicaid not only provide health insurance to more people than any other provider, but private organizations usually adopt similar policies. Many commenters to CMS supported the decision, noting, “That Medicare coverage of home sleep studies to diagnose OSA [obstructive sleep apnea] to qualify for CPAP therapy will improve access to care, and that home sleep tests are more accurate since you sleep more naturally in the home setting.”

I couldn’t agree more. Now you can probably avoid the hassle of going to a sleep lab overnight. I have had to do that twice — once when I suspected that I had sleep apnea and again last year when I was pretty sure that I had reversed it. I didn’t particularly enjoy being connected to all these wires:

At Boulder Community Hospital, July 2007

At that time I had been able to bring my weight down from 312 pounds (morbidly obese) to 181 (a normal body mass index). Since then, I’ve been able to bring it down further to 153 today.

I’m sure that my weight loss has everything to do with reversing my sleep apnea. In general, the professionals agree.

“Weight loss should be the primary treatment strategy for OSA in people who are overweight or obese,” the International Diabetes Federation says in its consensus statement the organization released in a presentation at the Scientific Sessions of the American Diabetes Association in June. “Additionally, reduction of daytime fatigue may lead to increased physical activity, which in turn with have positive effects on glucose metabolism and on achieving and maintaining a healthy body weight.” That’s what I call a virtuous cycle.

The next best thing for sleep apnea is using a CPAP machine while you sleep, the IDF says. Just about everybody must agree with that. And now because of the government’s recent decision, getting one has become a lot easier.

This article is based on an earlier version of my article published by HealthCentral.

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