I was the first speaker and my testimony begins after the first 4 minutes and extends for less than 10 minutes. While it has been 10 years since this event, I recall a question by Senator Jane Nelson that appears to be edited out and other information included that I doubt I stated. Unlikely I would recount my personal medical experiences for public viewing. I believe I mentioned William Dement MD by name while holding up his book as a reference.
The only way to deal with this evil influence is to hit it where it is most vulnerable. Where is it the most vulnerable? I say it is how it has (literally) taught physicians to misdiagnose illnesses in such a way as to support Big Pharma’s profits. This is how the 10 largest pharmaceutical companies had more gross profits than the other 490 companies comprising the S & P 500. The problem with missed diagnosis is so severe that many physicians have misdiagnosed their colleagues.
Think of the Big Pharma scam as an iceberg. The part of the iceberg above the water line you know about because of the many law suits and criminal charges for hiding drug side effects and manipulating the literature so physicians use that specific product (to the detriment of their patient who has the side effect). Now, how can you see the 90% of the iceberg, hidden beneath the waves? Well, ask yourself, why does Dr. William C. Dement of Stanford, in his book The Promise of Sleep, assert that 20% of the U S public has obstructive sleep apnea, a figure consistent with numerous research projects while textbooks of internal medicine and primary care have been asserting that it is 2% to 4% of the public? Finally, Cecil’s Textbook of Internal Medicine appears to have been shamed into putting accurate information into their 2008 edition, albeit without putting any explanation about why this info differs so greatly from their prior editions. Note, they haven’t even noted an excuse that the updated figures were controversial so they just decided to spoon feed the readers (physicians and medical students). While the subject under “obstructive sleep apnea” is fairly accurate, the section on arterial hypertension in the same 2008 edition is not. Sleep apnea causes about 50% of all cases (various authorities assert anywhere from 30% to 80%) of arterial hypertension and this has been known for almost 10 years (suspected for decades). You couldn’t tell that from the way the information is handled in the textbook!
Back to the issue of physicians being misdiagnosed: consider how many of the cases of medical malpractice…cutting out the wrong lung, writing down the wrong dosage, inappropriate surgery, etc. etc. are due to the physician being impaired? Physicians get the same illnesses that the general public does. If 20% or even 10% of physicians knew they had sleep apnea, there would have been a movement to educate their patients years ago. So, what does the medical industrial complex have to do to keep this covered up?
I know when I approached the designated top doc at a major hospital in Austin Texas about the fact patient care was being compromised every day by the failure to be sure vulnerable patients with sleep apnea were not stabilized before surgery, before being sent home, etc. I was told that I was behaving inappropriately. I know when I attempted to find an attorney in Austin Tx to sue my physician (the one most responsible) for failure to diagnose a major sleep medicine disorder before medicating me while pregnant, I could not find one willing to do so. I believe there is collusion between industry representatives and their colleagues in the Federal and State government at very high levels to arrange malpractice cases to set practice patterns in the USA (see blog AMFS).
I am ready to picket the medical schools, starting with UCSF in San Francisco. The head of the department of Neurology there was a prominent name on the 2008 edition of Harrison’s textbook of Internal Medicine, also a prominent influential text. How could he stand aside and let inaccurate misleading information about obstructive sleep apnea be published? Whose pocket is he in? Doesn’t he have pride in his work. Lets PICKET until he gets INVESTIGATED for CONFLICTS OF INTEREST and discredited or fired.
In 1993 a University of Wisconsin study, involving a cross section of middle aged men and women, produced results of 24% of the men fit the 5 apnea per hour of sleep criteria for the diagnosis of obstructive sleep apnea (OSA) and 9% of the women had OSA. Middle age was defined as between 30 to 60 years old. When the individuals were surveyed for symptoms, and they were asked if they were sleepy, 1 out of 6 men admitted to day time sleepiness. Since several years before, Dr. William C. Dement (prominent Stanford Sleep Medicine professor) had coined the diagnostic category of “sleep apnea syndrome” to include those individuals who presented to the physician with a primary complaint of day time sleepiness AND were found to have obstructive sleep apnea as the cause of this sleepiness, some authors appeared to have confusion. Hence “obstructive sleep apnea” does not equal “sleep apnea syndrome”. The textbooks began selectively quoting this research and noted that “sleep apnea syndrome” affected 4% of the men in this study and failed to include the observation that 24% of the men actually had obstructive sleep apnea. This issue confused me why some authors said 24% and others notes 4% until I came across the Psychiatric Clinics of North America article where Dr. Dement coined the expression “sleep apnea syndrome” and defined it. I also came across his research where older men who had 5 episodes of sleep apnea per hour of sleep BUT NOT 4 episodes (or less) of apnea per hour would have adverse effects from 2 (and only two )alcoholic beverages. These men would have up tp 4 times (and some authors say 5 times) as many apneas per hour of sleep with only such minimal apnea to begin with. If there was any doubt, Dr. William Powell also of Stanford published research in 1999 demonstrating that persons with mild to moderate obstructive sleep apnea were worse drivers than individuals (without sleep apnea or sleep deprivation) who were legally drunk (California commercial code .04% alcohol level).
I’ve reviewed textbooks of internal medicine and family medicine/primary care) from before 1994 through 2008. Finally, one textbook (Cecil’s) got the 1993 University of Wisconsin study accurate. In 2008 Cecil’s Textbook of Internal Medicine is the first major textbook to clarify this issue. A point I would like to make is that this was a major departure from their prior coverage and it would have been useful if they had noted this and discussed this. Meanwhile, in the face of data to the effect that approximately half of hypertension cases have OSA as a major etiology, Cecil’s coverage of arterial hypertension glosses over this. It truly is a snow job. Midway through the coverage of arterial hypertension is a chart listing different causes of secondary hypertension including OSA. Several pages prior to this chart there is a separate reference to this chart and noting that it is cost prohibitive to actually check people for these disorders.