An Open Letter to the President of the United States and Members of Congress

April 6, 2009

The task of reforming the health care system in the United States will be a major effort. As you work with Congress and the stakeholders on the needed changes, the American Sleep Apnea Association urges you to keep in mind the following points.

Sleep apnea is a serious medical disorder that leads to or exacerbates other potentially life-threatening medical conditions among a significant portion of the population, both children and adults.

Although we don't have recent prevalence data from an institution like the Centers for Disease Control and Prevention, a major study published in the New England Journal of Medicine in 1993 reported that 4 percent of men between 30 and 60 suffered from sleep apnea severe to require treatment; 2 percent of women of the same ages were similarly affected.

Of the risk factors that predispose individuals to sleep apnea, obesity has been identified as one of the most significant. With the advance of the current obesity epidemic and the direct link between obesity and sleep apnea, the prevalence of sleep apnea is expected to expand significantly.

Current medical research has demonstrated that untreated sleep apnea is a risk factor for all the medical conditions driving the increase in health care costs in the United States—heart disease, type 2 diabetes, and depression. In October 2007, the Milken Institute released a report estimating that seven of the most common chronic diseases in the United States cost the economy more than $1 trillion annually. These conditions are heart disease, mental disorders (including depression), and diabetes. The economic burden of these chronic diseases is projected to increase roughly threefold in the next 20 years.

Since sleep apnea was first identified in 1965, the means of diagnosing and treating the condition have improved greatly. Originally the only treatment was to insert a tube into the throat of the apnea patient and bypass the upper airway. While this treatment option is still used occasionally; for most people effective, life-saving treatment can be administered by modifying the position in which the patient sleeps, by use of an oral appliance that pulls the jaw forward and thus expands the opening to the upper airway, and by use of a device that pressurizes room air and delivers it through a mask that stents open the airway.

The presence of sleep apnea can now be diagnosed with a test administered in the comfort of one's own home.

As you consider the options for health care reform that you:

• Take into account the prevalence of sleep apnea in the adult population.
• Recognize that proper diagnosis and successful treatment of sleep apnea will save the health care system money by reducing outlays for treatment of heart disease, diabetes and depression.
• Understand that the cost of diagnosing and treating sleep apnea is considerably less than what is currently being spent on health care by the millions who are undiagnosed and untreated.

I wish you courage in your efforts to help the American people get the health care they deserve and need. Let me conclude with a familiar bit of wisdom from Benjamin Franklin that is particularly appropriate here:
An ounce of prevention is worth a pound of cure.

Sincerely,
Edward Grandi
Executive Director
American Sleep Apnea Association

I encourage all apnea patients to write your own letter from the ASAA web site add some of your own words, and send it to your members of Congress and to the President. Tell how treatment of your sleep apnea has enriched your own life. I can give you the names of your House and Senate members if you don't know them.