August 10, 2006

Traveling to Milwaukee

Public speaking is not something I do very often, though suspect that will change... and will, thanks to friends of the ASAA.

I traveled to Milwaukee earlier this week at the invitation of the Reggie White Sleep Disorder Research and Education Foundation. They held a fundraiser - their first, and wanted someone to speak on the seriousness of sleep apnea as a medical condition. The idea was to inspire the attendees to contribute more... here is the text of my remarks, you decide:

I suspect Reggie would be surprised to know of the influence his too early departure has had on the thousands of people who suspect they suffer from sleep apnea, as he did. Since Reggie White’s death, I have received hundreds of calls asking about sleep apnea and mentioning his passing as the motivation for the call.

Sleep apnea is a chronic medical condition that affects at least 20 million Americans. Sadly, we estimate that about 90% of those who have symptoms of sleep apnea remain undiagnosed and untreated; of great concern to us is that people of color are disproportionately afflicted.

Sleep apnea is what I call a portal disease. It is a condition that left untreated, leads to, or in some cases exacerbates, potentially life-threatening illnesses. The list of co-morbidities gets longer and longer with each new study that is published – cardiovascular disease can lead to heart attacks, hypertension to stroke, metabolic syndrome to diabetes and obesity, to name only a few of the more serious.

When sleep apnea is untreated, others suffer as well. This is particularly true when one partner snores…snoring is a common symptom of sleep apnea, though not everyone who snores has the sleep disorder. According to a recent poll by the National Sleep Foundation, two-thirds of partnered adults say their partner snores. It is not uncommon for one bed partner to be disturbed, and lose sleep, because the other bed partner snores. In addition to the snoring, the patient with untreated sleep apnea is probably waking up many times during the night because of apneic episodes – pauses in breathing during sleep. These too, can disturb a bed partner. The poor sleep that results for both bed partners can have a devastating impact on social and personal relationships, including intimacy.

There are other consequences of untreated sleep apnea that extend beyond the immediate family and into the community and to some extent the entire country. Because of interrupted sleep, people with sleep apnea often experience excessive daytime sleepiness. This can mean higher costs to employers because of lost time and decreased productivity. Our roads are made more dangerous because of an increased risk of people with sleep apnea driving while drowsy or, even worse, falling asleep at the wheel.

Recognition of sleep apnea in people in its more serious manifestation is uncomplicated. I will repeat the hallmarks - - persistent/loud snoring, noticeable pauses in breathing during sleep and excessive daytime sleepiness.

Currently the diagnosis of sleep apnea requires an overnight polysomnographic examination, or sleep study. The result of the study is the apnea-hypopnea index or AHI and the level of severity determines the most appropriate treatment options. The sleep study is a painless procedure that can be a life saver.

For the most severe cases of sleep apnea, the only truly effective treatment is continuous positive airway pressure, or CPAP therapy. This involves a small machine that delivers ambient air at a constant pressure through a hose connected a mask that fits over the nose and/or over the mouth.

As a side note – 2006 is the 25th anniversary of the publication of a study showing Continuous Positive Airway Pressure to be an effective therapy for sleep apnea.

In my capacity as executive director of the American Sleep Apnea Association I have the opportunity to speak with many men and women at varying points along their treatment path. For everyone I speak with who is struggling to get diagnosed, treated, or stay with treatment; I speak with people who feel their lives were given back by getting treated. Many are upset that they did not get treated sooner. I can also report there are those who have reduced or eliminated other medications they take because their sleep apnea is treated. So there is reason for hope.

One man told me that given the choice between his machine and his wife, he would take the machine. Another man expressed the feeling of exhilaration of getting a good night’s sleep. A woman expressed a sense of relief that her husband was breathing through the night and now she was able to sleep as well.

Thank you again for the opportunity to speak with you this evening and please give generously in memory of Reggie White, Green Bay Packer #92, and help the Reggie White Sleep Disorders Research and Education Foundation to accomplish its important work.
I was concerned that my speech would be lost while people were looking at the silent auction items, eating and drinking. When I was introduced as someone who had such a passion for helping those with sleep apnea that I am considered an honorary hosehead the room fell silent and I delivered my message.
Another reason I accepted the invitation to speak at this event was the opportunity to meet and speak with Sara White, widow of Reggie White. I wanted to thank her for her efforts to raise awareness about sleep apnea following the death of her husband. I did that and even managed to get a grainy image of us gripping and grinning.
The most moving part of the evening came near the end when Sara's daughter, Jecolia sang a song she had written for her father.
The Reggie White story is far from over - in some quarters there is the feeling that is just getting started.
The ASAA will stay close to developments and will lend our resources to continue to raise awareness about sleep apnea.

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