7 ms·

why treat “sleep apnea” and not the actual root cause? if you’re not fat and have sleep apnea, the other major cause is alcohol consumption/smoking. seems odd

by tempsy 4y ago

why treat “sleep apnea” and not the actual root cause? if you’re not fat and have sleep apnea, the other major cause is alcohol consumption/smoking. seems odd to treat the symptom eg sleep apnea and not try to cut out alcohol and smoking and then reevaluate.

rco8786 4y ago
Doctors aren’t typically incentivized to treat things with lifestyle changes. For better or worse, that’s something you need to self advocate for.
- kevviiinn 4y ago
  That's because nobody listens, doctors have more or less given up. People want meds, they always want a quick fix not to exercise and eat better
  - tempsy 4y ago
    that isn’t true. i’ve never received nutritional advice from a doctor, and if i did i doubt it would be much more than “eat fruits and veggies and exercise” the “official” food pyramid put out by the government still tells people to eat mostly refined grains and carbs.
    - kevviiinn 4y ago
      Your statement is not at odds with my claim, not to mention eating more fruits and veggies is an improvement for 85%+ of Americans so yea that's actually solid advice. I don't know why you think it isn't Most Americans are also sedentary and don't exercise at all so again, even just walking more is an improvement for most people. All that being said, I also have not had a doctor who didn't first ask me what my diet and exercise are like before making suggestions
      - rco8786 4y ago
        Eating fruits and vegetables is not typically good medical advice when we’re talking about acute issues. Advice for a healthier lifestyle, more energy, longevity, etc? Yes of course. Advice for sleep apnea that’s already set in and affecting a patient nightly? Not at all.
        kevviiinn 4y ago
        I wasn't aware that sleep apnea is an acute issue, I could have sworn that's chronic
        rco8786 4y ago
        I am not a doctor so it’s entirely possible I am misusing a term here. But afaik chronic is something that cannot be cured. This is not the case with sleep apnea. It just can’t be cured with vegetables.
        kevviiinn 4y ago
        A condition is described as acute when the onset is sudden and duration is short, a condition is chronic when it persists over a long period of time. It has nothing to do with curability One of the major causes of sleep apnea is being overweight, so it can definitely be helped with a change in activity levels a diet modification https://medlineplus.gov/ency/imagepages/18126.htm https://medlineplus.gov/ency/imagepages/18126.htm
      - tempsy 4y ago
        a doctor giving generic “eat fruits and vegetables” doesn’t mean anything. it’s just generic words an 8 year old could tell you you don’t take nutrition in medical school. doctors wouldn’t be able to prescribe a more personalized nutritional plan even if they wanted to whether or not they say this or don’t won’t change anyone’s life
    - hnu0847 4y ago
      > the “official” food pyramid put out by the government still tells people to eat mostly refined grains and carbs. Apparently this isn't true anymore. The Food Pyramid was replaced with the current "MyPlate" model in 2011 [1]. That said, grains still feature prominently on the plate and the details say up to half of those can be refined [2], which still seems high. [1] https://www.health.harvard.edu/blog/crumbling-confusing-food-pyramid-replaced-by-a-plate-201106032767 https://www.health.harvard.edu/blog/crumbling-confusing-food... [2] https://www.myplate.gov/eat-healthy/grains https://www.myplate.gov/eat-healthy/grains
  - rco8786 4y ago
    Maybe in part. But it’s also because medical practices are for profit enterprises and don’t make any money by telling patients to stop drinking alcohol, but make a bunch of money charging out CPAP machines to insurance companies. Doctors “have given up” implies there was a time when doctors would dish this stuff out as a treatment plan. At least in the US, I don’t know if that’s ever been true.
    - kevviiinn 4y ago
      Believe it or not, most doctors don't own their own practice and don't make more money for giving out treatments. Most of them did get into the field because they want to help people and it's a pretty small minority that profits off handing out treatments
      - rco8786 4y ago
        Believe it or not, I am not blaming doctors. I respect doctors, and go to them frequently. But it's useful to go in with open eyes. Even doctors that do not own their own practice are incentivized by the people who do own the practice. In the same way that a store clerk is incentivized to sell high margin items over low margin items. Or a Facebook engineer is incentivized to get users to engage in unhealthy social media addiction. There's nothing wrong with the individuals, its the incentive system that they are operating within.
        kevviiinn 4y ago
        What is the evidence for your claim? As far as I'm aware, insurance shoots down as much as possible When a physician works for someone else's practice or hospital, generally they're pressured to see as many patients as possible
        rco8786 4y ago
        My claim is as simple as the claim that for-profit enterprises are incentivized by profit and will prioritize profit-making activities over not-profit-making activities. If you have even a passing belief in capitalism then you have all the evidence necessary. Every single doctor (in the US) profits off of handing out treatments. It's a pivotal part of how the economics of medicine works in this country. The entire thing would, quite literally, fall apart if doctors/practices did not profit from handing out treatments. Note that I am not claiming that doctors are out there prescribing medicine they shouldn't be prescribing just to line their pockets or whatever...you seem to be convinced that I have some sort of negative view of doctors and I don't. What I am saying is that they operate within a system that literally requires them to prescribe medicine in order to stay in business. So given the option of "prescribe medicine, bill insurance, and see the next patient in line" or "suggest a lifestyle change and work with the patient over the course of months and years to monitor those changes"...they all choose the former. AND THAT IS FINE. But to be blind to it is simple ignorance. Hell, it's what most patients want. Most people go to a doctor for medicine, not lifestyle advice. > generally they're pressured to see as many patients as possible That is because this is what maximizes profit for the parent company. It is a business like any other.
elric 4y ago
Bit rude of you to assume that I'm apparently an alcoholic or a smoker. Nice illustration of my point that public awareness on sleep apnea is lacking. Good luck figuring out the root cause of sleep apnea. Years of research hasn't turned one up. There's a wide variety of contributing factors (including weight, alcohol, asthma/COPD). But there's also plenty of fat asthmatic drunks who don't have sleep apnea. It's obviously not as simple as you're making it out to be.
- tempsy 4y ago
  Do you have trouble breathing through your nose only? Other issue is people breathe through their mouth instead of nose. Get some nose strips and tape mouth shut and train yourself to breathe through your nose.
  - elric 4y ago
    Please stop trying to diagnose me on HN without any context or background information. It's not helpful, and it's extremely condescending.
    - Cpoll 4y ago
      No one cares specifically about _your_ diagnosis, obviously we don't know you. You put yourself up for discussion when you posted your stance. You yourself called it a soapbox. Now people are using you as the obvious example and satisfying their curiosity. According to your initial post, you should be glad for the questions so that you can combat misconceptions.
  - antisthenes 4y ago
    Did it ever occur to you that sometimes the structure of people's face makes it harder or easier to breathe through the nose exclusively? Unless you're a doctor, you should probably stop giving unsolicited medical advice on the internet.
    - tempsy 4y ago

by tempsy 4y ago

rco8786 4y ago

Doctors aren’t typically incentivized to treat things with lifestyle changes. For better or worse, that’s something you need to self advocate for.

kevviiinn 4y ago
That's because nobody listens, doctors have more or less given up. People want meds, they always want a quick fix not to exercise and eat better
- tempsy 4y ago
  that isn’t true. i’ve never received nutritional advice from a doctor, and if i did i doubt it would be much more than “eat fruits and veggies and exercise” the “official” food pyramid put out by the government still tells people to eat mostly refined grains and carbs.
  - kevviiinn 4y ago
    Your statement is not at odds with my claim, not to mention eating more fruits and veggies is an improvement for 85%+ of Americans so yea that's actually solid advice. I don't know why you think it isn't Most Americans are also sedentary and don't exercise at all so again, even just walking more is an improvement for most people. All that being said, I also have not had a doctor who didn't first ask me what my diet and exercise are like before making suggestions
    - rco8786 4y ago
      Eating fruits and vegetables is not typically good medical advice when we’re talking about acute issues. Advice for a healthier lifestyle, more energy, longevity, etc? Yes of course. Advice for sleep apnea that’s already set in and affecting a patient nightly? Not at all.
      - kevviiinn 4y ago
        I wasn't aware that sleep apnea is an acute issue, I could have sworn that's chronic
        rco8786 4y ago
        I am not a doctor so it’s entirely possible I am misusing a term here. But afaik chronic is something that cannot be cured. This is not the case with sleep apnea. It just can’t be cured with vegetables.
        kevviiinn 4y ago
        A condition is described as acute when the onset is sudden and duration is short, a condition is chronic when it persists over a long period of time. It has nothing to do with curability One of the major causes of sleep apnea is being overweight, so it can definitely be helped with a change in activity levels a diet modification https://medlineplus.gov/ency/imagepages/18126.htm https://medlineplus.gov/ency/imagepages/18126.htm
    - tempsy 4y ago
      a doctor giving generic “eat fruits and vegetables” doesn’t mean anything. it’s just generic words an 8 year old could tell you you don’t take nutrition in medical school. doctors wouldn’t be able to prescribe a more personalized nutritional plan even if they wanted to whether or not they say this or don’t won’t change anyone’s life
  - hnu0847 4y ago
    > the “official” food pyramid put out by the government still tells people to eat mostly refined grains and carbs. Apparently this isn't true anymore. The Food Pyramid was replaced with the current "MyPlate" model in 2011 [1]. That said, grains still feature prominently on the plate and the details say up to half of those can be refined [2], which still seems high. [1] https://www.health.harvard.edu/blog/crumbling-confusing-food-pyramid-replaced-by-a-plate-201106032767 https://www.health.harvard.edu/blog/crumbling-confusing-food... [2] https://www.myplate.gov/eat-healthy/grains https://www.myplate.gov/eat-healthy/grains
- rco8786 4y ago
  Maybe in part. But it’s also because medical practices are for profit enterprises and don’t make any money by telling patients to stop drinking alcohol, but make a bunch of money charging out CPAP machines to insurance companies. Doctors “have given up” implies there was a time when doctors would dish this stuff out as a treatment plan. At least in the US, I don’t know if that’s ever been true.
  - kevviiinn 4y ago
    Believe it or not, most doctors don't own their own practice and don't make more money for giving out treatments. Most of them did get into the field because they want to help people and it's a pretty small minority that profits off handing out treatments
    - rco8786 4y ago
      Believe it or not, I am not blaming doctors. I respect doctors, and go to them frequently. But it's useful to go in with open eyes. Even doctors that do not own their own practice are incentivized by the people who do own the practice. In the same way that a store clerk is incentivized to sell high margin items over low margin items. Or a Facebook engineer is incentivized to get users to engage in unhealthy social media addiction. There's nothing wrong with the individuals, its the incentive system that they are operating within.
      - kevviiinn 4y ago
        What is the evidence for your claim? As far as I'm aware, insurance shoots down as much as possible When a physician works for someone else's practice or hospital, generally they're pressured to see as many patients as possible
        rco8786 4y ago
        My claim is as simple as the claim that for-profit enterprises are incentivized by profit and will prioritize profit-making activities over not-profit-making activities. If you have even a passing belief in capitalism then you have all the evidence necessary. Every single doctor (in the US) profits off of handing out treatments. It's a pivotal part of how the economics of medicine works in this country. The entire thing would, quite literally, fall apart if doctors/practices did not profit from handing out treatments. Note that I am not claiming that doctors are out there prescribing medicine they shouldn't be prescribing just to line their pockets or whatever...you seem to be convinced that I have some sort of negative view of doctors and I don't. What I am saying is that they operate within a system that literally requires them to prescribe medicine in order to stay in business. So given the option of "prescribe medicine, bill insurance, and see the next patient in line" or "suggest a lifestyle change and work with the patient over the course of months and years to monitor those changes"...they all choose the former. AND THAT IS FINE. But to be blind to it is simple ignorance. Hell, it's what most patients want. Most people go to a doctor for medicine, not lifestyle advice. > generally they're pressured to see as many patients as possible That is because this is what maximizes profit for the parent company. It is a business like any other.

elric 4y ago

Bit rude of you to assume that I'm apparently an alcoholic or a smoker. Nice illustration of my point that public awareness on sleep apnea is lacking. Good luck figuring out the root cause of sleep apnea. Years of research hasn't turned one up. There's a wide variety of contributing factors (including weight, alcohol, asthma/COPD). But there's also plenty of fat asthmatic drunks who don't have sleep apnea. It's obviously not as simple as you're making it out to be.

tempsy 4y ago
Do you have trouble breathing through your nose only? Other issue is people breathe through their mouth instead of nose. Get some nose strips and tape mouth shut and train yourself to breathe through your nose.
- elric 4y ago
  Please stop trying to diagnose me on HN without any context or background information. It's not helpful, and it's extremely condescending.
  - Cpoll 4y ago
    No one cares specifically about _your_ diagnosis, obviously we don't know you. You put yourself up for discussion when you posted your stance. You yourself called it a soapbox. Now people are using you as the obvious example and satisfying their curiosity. According to your initial post, you should be glad for the questions so that you can combat misconceptions.
- antisthenes 4y ago
  Did it ever occur to you that sometimes the structure of people's face makes it harder or easier to breathe through the nose exclusively? Unless you're a doctor, you should probably stop giving unsolicited medical advice on the internet.
  - tempsy 4y ago