But it ultimately wears you down. If snoring doesn’t drive you to the doctor, fatigue may. Still, many power through, gradually becoming too tired to perform their jobs well or safely. Untreated train, bus and truck drivers clearly pose a significant public safety risk.
Definitively diagnosing the condition requires a sleep test — either at home, or more extensively in a lab. Getting wired up for bed isn’t much fun, which is another reason people may avoid seeking a diagnosis. Professional drivers and train operators also may worry that doing so could threaten their livelihood. To dodge screens for the condition, they may underreport feeling drowsy.
There may also be fear of sleep apnea treatments. The gold standard for treatment is a continuous positive airway pressure machine, which forces the airway open with pressure delivered through a mask. The prospect of sleeping with a mask, and next to a machine, can be off-putting and, for some, uncomfortable. Compliance with treatment is about 60 percent. But the devices have become far more comfortable and quiet over the years. (The newest models are entirely silent.)
For obese patients, losing weight can reverse sleep apnea. But keeping the weight off is notoriously hard.
Other options include oral appliances (think of them as fancy mouth guards), nasal patches and, for extreme cases, surgery. Costs for devices can range from hundreds of dollars to thousands. Even at the high end, you may feel a considerable boost in quality of life that could be worth the cost.
Although these options work for snoring, too, insurance won’t cover them for that condition. Similar over-the-counter oral appliances are cheaper, but less extensively studied, making it hard to say for whom they will work well. Studies document that patients use over-the-counter versions less, perhaps because they may be less comfortable than professionally customized ones. So, although snoring is highly curable, the cost and uncertainty of exactly how to do so may be a barrier for many to treat it.
There’s a public safety interest in treating sleep apnea more widely. Yet last summer, in an effort to reduce regulations, the Trump administration withdrew a proposed rule that would have required drivers of trucks and buses, as well as railroad engineers, to be tested for the condition. This may be one area where a little more regulation is warranted.