Is sleep apnea a disability? Learn what sleep apnea is, if it’s covered by the Social Security Disability program and how to treat it.
According to a study completed by The American Thoracic Society, obstructive sleep apnea (OSA) affects nearly 1 billion people worldwide. This staggering trend shows no signs of improvement either, as obesity and the average age of the general population continues to rise. Disability resulting from sleep apnea continues to climb as well. In short, no one created a magic pill that allows us to eat what we want without gaining weight, or invented a youth serum. Bummer.
Alas, hopes and dreams for eternal youth and thinness are out of reach of current scientific capabilities. Until the day of the long-awaited magic pill, sleep apnea will maintain its prevalence all around the globe. And so, with approximately 12% of the worldwide population experiencing sleep apnea, it is crucial that medical providers, families and individuals remain informed on signs, symptoms and treatments of this disorder.
What is it, and when is it severe?
Okay, so now you know that sleep apnea is almost everywhere, but what is it? Sleep Apnea occurs when the upper airway becomes obstructed during sleep. Throat muscles fail to keep the throat open throughout sleep, resulting in a blocked airway. This obstruction halts breathing and causes a pause in respiration for at least ten seconds. So, basically, you stop breathing while you’re unconscious. Definitely not terrifying, right?
Although a common disorder, the level of severity plays a major role in the overall health of those affected. Sufferers of severe sleep apnea experience thirty or more episodes during each hour of sleep. These episodes often result in large drops of blood oxygen in the person’s blood stream. Usually, the person wakes from sleep to re-open their airway and begin breathing again.
What are the symptoms?
People commonly wake in a mild panic, coughing and gasping for air like a bad actor filming a poorly-written drowning scene. Much to the dismay of spouses and sleeping partners all around the world, this happens often. (Is it a murderer or just Harold gasping for air again?) Oxygen levels typically return to normal each time the person awakens, but episodes have lasting effects. In fact, there are many short and long-term effects of chronic sleep apnea.
One major sign of sleep apnea is snoring. Not the cute kind where you stare lovingly at your partner and think, “Wow, how did I get so lucky?” Nope, not that. It’s the kind of snoring where you wonder if a freight train entered your house. Is it a bird? Is it a plane? Oh, it’s just Harold snoring again. Before you know it, you’re in separate bedrooms and your marriage is on the rocks. Sleep apnea invades your relationship like lice on an elementary school playground. Side note, where do the kids go if neither party wants custody? So many complications, and that’s just the tip of the sleep apnea iceberg.
Poor sleep, cause by sleep apnea can cause unexplained fatigue, concentration difficulties and mood swings. Even more exciting symptoms include higher rates of: hypertension, cardiovascular disease, myocardial infarction, congestive heart failure, diabetes and metabolic syndrome, strokes and atrial fibrillation. Where is the guy with a sandwich sign that says, “The end is nigh?” Can someone ask him to stand outside of a sleep clinic? Yikes. Managing these symptoms often leads to extensive interruptions in the lives of those with sleep apnea, even interfering with work.
How does sleep apnea affect someone’s ability to work?
Due to the excessive sleepiness caused by this disorder, many people find it difficult to work. Some people even experience unemployment after the onset of their symptoms. The psychological symptoms of sleep apnea, like depression, irritability or difficulty remembering assignments can cause difficult as well.
One study found that the reduction in quality of life as a result of sleep apnea was just a detrimental as someone with diabetes or hypertension. That’s right. Not sleeping well is just as difficult as stabbing yourself with a needle multiple times a day, or becoming involved in politics. All joking aside though, severe sleep apnea can be just as disabling as these other, very serious disorders. With all these difficulties stemming from the disorder, some may wonder if sleep apnea is a disability. Especially those hoping to qualify for social security disability benefits.
What is Social Security Disability?
To understand if sleep apnea is a disability, it’s first important to understand what type of aid the government offers for those with disabilities. Currently, two programs offered by the Social Security Administration exist to provide financial stability. The first is Social Security Disability Insurance, or SSDI.
SSDI is a disability program that provides benefits to you if you have worked enough years to be “insured” by the Social Security Administration. If you’ve worked full time for about ten years, that is usually enough. The amount of aid you receive is based on how much you’ve paid into social security. The application process in very similar to their other program, Supplemental Security income, or SSI.
SSI is a needs-based program, offered by the Social Security Administration. It covers those with a disability who have not worked enough to be “insured.” You are eligible for the program based on your financial needs and disability. Both programs require that you receive eligibility through the Social Security Administration, after review by Disability Determination Services.
After an application is submitted and accepted by the Social Security Administration, they forward the case to Disability Determination Services. The application is assigned a case worker, who works the case to completion. It’s the job of this case worker to obtain and review all the pertinent medical, social and personal information of the applicant to determine whether or not they are disabled. After a decision is made, the case is transferred back to the Social Security Administration and benefits will be issued to the applicant.
Is sleep apnea a disability?
Disability Determination works directly with Social Security on determining what is considered a disability and what is not. There is a list of impairments for adults and children, and every disability accepted by the administration is listed. Each person has to meet the criteria set by the administration to qualify. So, is sleep apnea a disability?
Unfortunately, no. Sleep apnea is not listed under The Social Security Administration’s list of impairments. However, some illnesses precipitated by sleep apnea are listed. A couple examples of disabilities perpetuated by sleep apnea, that are included in the list of impairments are: chronic pulmonary hypertension, chronic heart failure, and disturbances in mood, cognition, and behavior.
Whether you apply for SSI, SSDI or both, the disability requirements are the same, and each case must qualify to receive benefits. If you feel sleep apnea is affecting you to the point of disability and an inability to work, talk to your doctor about your symptoms. There may be treatments or things you can do to improve or even eliminate your sleep apnea.
If I lose weight, will my sleep apnea go away?
There’s a common misconception that sleep apnea is strictly a result of excess weight. While it is true that excess weight is a probable cause, it is not the sole cause. Other risk factors include: smoking, nasal congestion, alcohol or drug use, large neck circumference, narrow airway, being male, aging and a family history of the disorder. It’s always best to talk to your doctor to determine the causes of your sleep apnea. Evidence consistently shows that lowering a high BMI, can help curb apnea symptoms. Talk to your doctor if you suspect your weight is a factor.
The correlation between weight loss and a decrease in sleep apnea symptoms, simply has to do with the amount of fatty deposits present in patients struggling with obesity. These fatty deposits put pressure on the upper airway, which cause obstruction and make it more difficult to breathe. When someone loses excess weight and maintains a healthy BMI, there is less pressure on their respiratory system. Less pressure means it is easier to breathe.
If you’re reading this and ready to dust off your old Jane Fonda workout DVDs, be sure to check with your doctor before squeezing into a leotard. It’s always important to be cleared by your healthcare provider before starting any new diet or workout routine. After you get the all clear, feel free to boogie to your heart’s content, and hopefully get some better sleep thanks to your weight loss.
What about CPAP?
Okay, okay, so you’re not the Jane Fonda type, or maybe you don’t have excess weight to lose. What other options are there for you? The most common solution is using a continuous positive airway pressure (CPAP) machine at night.
A CPAP machine works by increasing the amount of pressure in your upper airway. This prevents your throat from collapsing during the night. As an added bonus, it also cuts way down on snoring, so it may even save your marriage! (We’re looking at you, Harold.) The machine includes a water tank that acts as a personal humidifier for your throat, as well.
So, a machine that takes care of sleep apnea- without the need for cutting down on tacos. What could be better, right? Well… there’s some down sides too. One big side effect is that, at least for a while, you will probably feel like Darth Vader. Although CPAP machines continue to get smaller as technology advances, they are still pretty difficult to get used to. You may wake up thinking you have one of the creatures from Alien on your face. Eventually this will pass though, and you will stop feeling the need to call Sigourney Weaver up to protect you each night.
Other potential problems are: dry nose and sore throat, increased dreaming and nightmares, abdominal bloating, nasal congestion, sneezing, and irritation of the face. While all of these CPAP side effects are uncomfortable, let’s not forget about the sandwich sign guy outside of the sleep clinic. Many of the symptoms of sleep apnea can be much worse than those of wearing a CPAP. Any and all concerns about treatment with a CPAP machine should be discussed with your primary care provider though, and not through Dr. Google.
Are there other treatments?
Dental apparatuses that reposition the jaw and tongue have also been effective in treating sleep apnea but are less common. In addition to dental appliances, hypoglossal nerve stimulators may also be used. According to The Sleep Foundation, hypoglossal nerve stimulation occurs when a stimulator is implanted in the patient’s chest. This sensor contains leads that are connected to the hypoglossal nerve. These leads control tongue movement and also uses a breathing sensor. The sensor monitors breathing patterns and stimulates the hypoglossal nerve during sleep. If it detects a pause in breathing it will move the tongue to maintain an open airway. Whoa, science. Why does that sound like a Star Trek episode?
Lastly, a much more invasive option, is surgery. In rare cases, when weight loss and other measures prove ineffective, surgery to remove excess tissues in the nasal passage and upper airways ensues. This procedure is a last resort though, and used only in extreme cases.
Is there a way to stop my sleep apnea naturally?
Some people have found success through snoring and sleep apnea exercises, that can naturally help with snoring and apnea symptoms. The most effective, evidence-based approach to curing or improving symptoms of sleep apnea is through weight loss. Following a healthy diet and exercise program, with the assistance of a medical professional can curb, and even cure, sleep apnea.
So, whether you are a chronic snorer like Harold, or have a confirmed diagnosis, make sure you are taking steps to prevent or manage sleep apnea by trying exercises, weight loss or talking to you doctor about a CPAP machine. In a world of constant motion and activity, health is wealth, and there’s nothing more important than protecting yours.