OBSTRUCTIVE SLEEP APNEA (MISDIAGNOSIS AND HISTORY AND ETIOLOGY)

Dr. Michael Rack,

Thank you so very much for the answer you sent me on 10/21/2007 at 6:33pm to my questions concerning the etiology of OSA.  I had no idea that OSA, and I am quoting you, "obstructive sleep apnea often develops gradually, over a period of several years." 

Dr. Rack, could you provide me answers to the below questions.

1.  Where can I find out more information on how long it takes for a person to get severe obstructive sleep apnea? 

2. What are the early symptoms of OSA?

3. How long does it take for a person with sleep apnea to progress to obstructive sleep apnea, then progress to severe obstructive sleep apnea?

4. Dr. Michael Rack, do you know a specialist in San Diego County that you would recommend for me to consult with?

Your help has been most appreciated.

Thanks again.

Sincerely,

A. M. Lane

don't know any specialists in san diego personally; you can check the American Academy of Sleep Medicine web site to find an accredited sleep center in your area (google American Academy of Sleep Medicine).

common symptoms of obstructive sleep apnea include snoring and sleepiness.  Some things that could cause rapid development of sleep apnea include rapid weight gain or the sudden development of a medical disorder (hypothyroidism, stroke, congestive heart failure) that can cause sleep apnea.  Congestive heart failure can cause both obstructive and central sleep apnea.  I encourage you to find a sleep physician in your area to sort out your case.

good luck

Dr. Rack,

Thank you for answering my questions. I have been trying to find answers to several of my questions. Until talking with you, trying to find out how long a person can have SOSA before it is diagnosed seemed to be impossible question to get an answer to.  Especially for people who had symptoms of SOSA from 1991 thru 1997.

I am a recently retired Air Force member who was diagnosed with severe sleep apnea approximately 8 months after retirement.  During the past 5 years I've had numerous documented hospital visits for morning headaches, hypertension, and several complaints of memory loss.  Since I've never complained about morning fatigue and drowsiness (which were frequent), and was not diagnosed with sleep apnea while on active duty, the VA has denied my claim for disability for this condition.  I am considering submitting an appeal to this decision and would like to know if you recommend any reference that support the fact that it is not common to develop this condition is such a short period, and hopefully substantiate my claims that this condition was present while serving on active duty in the Air Force. 

Any assistance would be greatly appreciated.

v/r

Andy McLean

I am a retired Army member who was just diagnosed with severe sleep apnea about 4 months ago.  I went to the VA Hospital at the suggestion of a fellow veteran for the sleep study, because I was still having the same symptoms.  When I retired in October 2005, my VA rep put down "Insomnia", based on what was in my records...which started when I got back from Iraq.  I only went to sick call once, and the doctor gave me "Ambien"...my problem with sleeping didn't go away, and I didn't want to keep taking pills.  VA denied my original claim for "Insomnia" because I only went to the doctor once, and it was not chronic.  I now realized that it may have been OSA.  When I went in for my physical, the doctor who reviewed my records didn't mention "Sleep Apnea", and for that matter, I didn't know what Sleep Apnea was until last year.

So after I was diagnosed by the VA Hospital here in North Carolina, and given a CPAP machine, I decided to file a claim for Service-Connection, based on misdiagnosis for "Insomnia".  It was denied for Service-Connection.  I spent 21 years in the Army, and for VA to infer that I just acquired OSA is an insult.  For the past 3 years since I've retired, I still was not sleeping fully through the night, and now I have to put on a damn mask every night.  I haven't rapidly gained any weight over the past 3 years...but I still feel tired during the day and if I don't wear my mask, I suddenly jerk myself awake in the middle of the night.  I don't understand this at all...especially after serving over 20 years in the military.

I have put in 2 claims with the VBA for service connected sleep apnea (both denied). I got out of the marines when very little was known about sleep apnea 2/1997 but I had several symptoms documented in my military medical records that were simply overlooked due to medical personnel were just not familiar with sleep apnea as they are now, and the truth be told, there is still low awareness of the disease to this day. I went online and found several medical articles, especially VBA appeals cases where veterans had to appeal just to be diagnosed.  I even found a book written by a doctor who has been board certified since 1986.  I found 3 VBA cases where the Veterans were diagnosed 3, 8, and 35 years laters after being honorably discharged.  All had very very little to no evidence, one actually had no evidence documented in there military medical records.  Look up sleep apnea medical articles under emedicine, wikipedia, American Family Practice, etc.  I am about to submit a third claim because I found out that the VBA raters are not Board Certified Sleep Specialist; yet they are making decisions on persons health.  Got to ABSM.ORG, this website will tell you what doctors are board certified.  Read the entire webpage after you use the internet to find articles on sleep apnea. I asked myself this question, how can a person deny my sleep for service connected sleep apnea if he/she is not a board certified specialist in that field.  Board certifications means the person is an EXPERT.