Should a Full Physical Screen for Sleep Disorders?
Posted on Thu, Sep 22, 2011 @ 11:29 AM
After a many years of “encouragement” from my wife, I finally called and scheduled a physical with my family doctor. I knew the importance of a regular physical but like most men, had put off the inconvenience for many years. As a 40-something male, I had a list of minor issues that I wanted to discuss with the doctor but it was my wife’s insistence that I do something about my loud snoring that tipped the balance. Additionally, an article about how most men’s first complete physical is in the emergency room in the midst of their heart attack or stroke that caused some concern.
At the appointment I checked in and received a clipboard and a couple of forms to
be filled out. The forms were the standard checklist of medical conditions to mark if I, a parent or sibling had experienced or received treatment. The sheets seemed categorized; heart and vascular issues in one section, endocrine and diabetes in another, cancer, orthopedic, autoimmune, and more. I marked the few appropriate boxes, mostly indicating my parents because I have been fortunate to experience good health. But still I looked for the appropriate section to indicate that I snored like a freight train and that I consume coffee morning through late afternoon to maintain alertness and perform the duties of my job. I scanned the sheet twice before I finally found the section. It was labeled OTHER. I wrote down my concern in the small space provided because once the exam began, I didn’t want to forget the main issue that brought me here in the first place.
The exam proceeded swiftly and thoroughly, with sufficient time to question about family health history (he didn’t look at the sheet I previously completed). As the exam concluded we discussed a referral to dermatology and I was being directed to the lab for blood work when the doctor asked if I had any other questions. The physical was virtually over before I finally discussed my sleep concern. As I explained my snoring and coffee habit he gave me a slightly perplexed look and said, “You don’t fit the model for sleep apnea, but we should get a sleep study.” Only at my prompting was the first screening question for sleep apnea asked. “How big is your neck?” A neck circumference over 17 inches is a risk factor for sleep apnea. Mine is 17.5 inches.
Screening for sleep apnea was not routine for this practice, even when I asked for a “full physical” appropriate for my age. Ironically, many of the health issues that were focused upon can be caused by or exacerbated by sleep apnea or other sleep disorders. A simple Google search can produce a multitude of medical literature (not snake-oil salesmen ads) about the relationship between sleep apnea a various health problems that my physician was concerned with.
I previously wrote Dangers of Sleep Apnea Shouldn’t Be Dismissed and now I will soon have a sleep study. I plan to write about my experience with and what happens during a polysomnography (sleep study) so stay tuned.