Psych Assoc.(Once Labeled Being Gay as a Disease) Says Your Sleep Apnea is All in Your Head
When science intersects with money, science gets tossed out the window. We see this with global warming deniers. The same is true of medical science. There is no medical textbook as politically---and economically---controversial as the DSM---short for Diagnostic and Statistical Manual of Mental Disorders. In its earlier incarnations, the DSM labeled homosexuality a mental illness. In 1986, seventeen years after Stonewall, the “disease” of being gay was removed from the list of psychiatric disorders. In DSM IV, homophobia is now a disease.
Volume five of the DSM is currently in the works. The disorders described in the book will have a massive impact on health care for years to come, since your doctor (family physician as well as psychiatrist) can bill your insurance for treating you for one of these problems. They will also allow Big Pharm to make (even bigger) profits, by selling drugs to treat these disorders. But at what cost to you, the patient/health care consumer?
In case you have missed my previous journals on OSA (Obstructive Sleep Apnea), sleep apnea is the most common unrecognized disease in the US. The incidence has risen from about 4% of Americans over 40 to an estimated 15% of all adult Americans in recent years. Though the disease is becoming increasingly common, thanks to our obesity epidemic and the aging of the population, diagnosis of the condition is still a huge problem. Less than 1 in 5 people with OSA know that they have it.
http://journals.democraticunderground.com/McCamy%20Taylor/462
Untreated OSA leads to 1) increase in car wrecks 2) lost work productivity 3) increased utilization of health care resources 4) heart disease 5) high blood pressure 6) stroke 7) depression 8) migraine headaches and other pain disorders. It causes bright children to perform poorly in school. It makes people crabby (due to chronic lack of sleep) so that they are more likely to anger easily. It causes erectile dysfunction in men and a loss of libido in women. Who wants to have sex when they have not had enough sleep in years? Show a victim of untreated OSA a bed, and all he/she wants to do is sleep.
Right now, there are a bunch of people in this country being treated for a variant of bipolar disorder (one in which there is no actual mania), because no one has thought to check them for sleep apnea. They are given psychiatric medications that help their emotional symptoms but which do nothing about the damage to their hearts, lungs and brains. These medications generally cause weight gain, which makes the OSA worse. And they do nothing to improve road safety. Remember, untreated sleep apnea sufferers drive like a drunk driver even when sober. Treat the sleep disorder, and their driving returns to normal. Treat their emotional symptoms without addressing the sleep disorder, and they continue to be a menace to themselves and to everyone else on the highway.
The economic costs of untreated OSA are staggering.
http://www.nap.edu/openbook.php?record_id=11617&page=137
Hundreds of billions of dollars. Note that these are hundreds of billions of dollars that flow into the hands of health care providers for treating the symptoms of OSA rather than the disease itself. Hmm. Maybe there is a sound economic reason that no one bothers to improve the rate of sleep apnea diagnosis and treatment in the U.S.. If we had a single payer cradle to grave system that rewards disease prevention, we might be more interested in treating the disease and cutting the costs associated with it. But since “the best health care system in the world” is driven by the money that can be made from fee for service, there is little economic incentive for health care researchers to come up with ways to prevent disease and a lot of economic incentive to come up with ways to treat the complications of disease. For instance, if undiagnosed OSA is a huge cause of erectile dysfunction and you make Viagra, do you really want all those customers to get their sleep disorder under control?
Now, the American Psychiatric Association appears poised to treat even more of the symptoms of OSA with Band-Aid medicine. Among the changes being considered for the new DSM
http://www.star-telegram.com/2012/01/28/3695134/effort-to-broaden-mental-illness.html#tvg
I. Adult Type ADHD Loosening the diagnostic criteria for adult type ADHD. Right now, you have to have shown symptoms before the age of 7 to qualify for (very expensive) medical treatment with stimulants and other drugs. The new DSM will eliminate that criterion, meaning that if the OSA you developed as a middle aged adult has you feeling out of it---can’t concentrate, can’t remember, can’t do your work, all signs of sleep disorder---you can now skip the sleep study you so desperately need and go straight on to speed.
And ADHD treatment is huge business in this country.
http://www.cdc.gov/ncbddd/adhd/data.html
Don’t look now, but ADHD is about to become even more “prevalent.”
On the plus side, all those stimulants may offset the weight gain from the bipolar medication. They may even make the underlying OSA better, if enough weight is lost. However, diet pills and a weight loss diet would be much cheaper.
II. Frigid 2.0 The DSM will create a new mental health diagnosis for women that isn’t really new at all. Remember when women who would not put out were labeled frigid? Those days are back. If you are a woman who is not interested in sex, you will now be referred to a psychiatrist. The psychiatrist almost certainly will not perform a sleep screen on you and he or she will not order a sleep study to see if your decreased libido is a natural response to your lack of sleep. Instead, you will receive counseling and medication. What medication? I am sure that Big Pharm can come up with something, so that you can have more sex before your (premature) stroke puts an end to your sex life completely. Or maybe you will see an ad on television that promises that “Viagra for Women” can make you feel like a real woman again. Go to your FP, and he or she will write you a prescription---which will be much simpler and quicker than trying to do a sleep history and ordering a sleep test. And cheaper, too, for those tens of millions of Americans without health insurance.
III. Bitch We all get crabby when we are deprived of sleep, right? People with untreated OSA are a bundle of nerves. They used to shrug off stress like water from the back of a duck, but now every little thing gets them down. And mad. Well, guess what? Having three “bitchy” episodes a week will now qualify you for psychiatric care. And once again, no one will notice that you are slowly killing your heart---until you show up one day in the emergency room with full blown congestive heart failure.
These three “mental health disorders” also happen to be some of the most annoying symptoms of OSA. People who do not know that they snore or stop breathing at night will notice if they lose interest in sex, have diminished work performance or can’t get along with their family. They will see ads on television telling them that a pill can make their lives oh so much better. They will go to the doctor demanding medication. The doctor will prescribe said medication. If the first pill does not work, they will try another. If the second does not work, they will be sent to a psychiatrist who will prescribes experimental drugs. Their eventual sleep apnea diagnosis will be delayed for years, giving them plenty of time to develop more medical complications—or die on the road, maybe taking a few innocent passengers in another car with them.
I can see why the APA has considered making three new mental health diagnoses. They probably see millions of people who suffer from these three symptoms, and they think Ah ha! It must be an epidemic. Let’s treat it. But there is no epidemic of 1) bitchiness 2) frigidity 3) poor mental concentration. There is an epidemic of one condition that causes these three symptoms. And the APA is about to make it that much harder for the people suffering from OSA to get the care they need, by slapping them with the label of “mental health disorder”, ignoring the fact that our minds and bodies are intimately linked.
The APA will be guilty of medical malpractice if they do not attach a diagnostic criteria to each of these new three mental health disorders. Under each heading, in big bold letters it should say Must exclude sleep disorder such as OSA before this diagnosis can be made.
Will they? They don’t include this in DSM IV (the current version).
http://nobedwetting.com/p-add-adhd.htm
= new reply since forum marked as read
I am assuming that's the time-release developed to keep something under patent.
Pharma is hilarious with that shit... the tiny change to start a new patent. (It has a red stripe on the pill now... A RED STRIPE!)
Thanks for the answer.
