The profit motive in medicine

And a little story about a potential insomnia recovery.

It’s been a while since I’ve posted; truthfully, because I’ve been thinking and writing about topics which don’t exactly fit into the theme of this blog. But something happened recently which I thought might be of use to someone, somewhere. It’s not the world’s most interesting topic, so feel free to skip if it doesn’t apply to you.

For over 16 years, I’ve had middle-of-night insomnia. That is, I sleep for about four to six hours, wake up for about two hours (but sometimes three or more), then finally doze off to finish the night’s sleep.

If something wakes me before my “natural” waking time, I also can’t go back to sleep for at least two hours. If I get woken after it, during the crucial final sleep phase, often I can’t get back to sleep at all and stumble through my day like an unproductive zombie.

This is extremely inconvenient, to say the least. The practical effect is to extend the entire period of time I’m in bed, so I wake up too late to take part in some normal activities (like having a “real” job, one of the reasons I freelance). It eliminates at least two hours from my life daily, as I’m too tired to do anything useful during the waking period but browse the internet (yes, I know you’re not supposed to but I won’t sleep no matter what).

A couple years ago I finally got around to mentioning it to my family doctor, who gave me a referral to a sleep clinic. I had an overnight sleep test, and was told that I had medium-severity sleep apnea.

I was a bit suspicious of this, but then people with sleep apnea don’t usually know they have it. One thing that struck me as odd was that this was the only issue they mentioned.

The sleep clinic gave me a referral to a CPAP clinic, where a machine would set me back about $500. Instead, I made an appointment for a one-month trial rental, which cost “only” $150. Given that difficulties many people have with CPAPs, I didn’t want to shell out $500 for something I wouldn’t end up using.

However, the appointment never happened, because I came down with a mild cold and when I called to ask if I could come in anyway, they said no. This was spring 2022, and covid hysteria reigned in healthcare facilities (and still does nearly a year later).

I decided I would try to find other ways to deal with the apnea. One issue was nighttime nasal congestion which seriously impeded breathing. I first tried a commercial nasal steroid spray which left unpleasant side effects and, I think, gave me the cold that prevented the CPAP appointment.

Next I found a recipe for homemade nasal rinse and started using that before bed.¹ Problem solved. I no longer have to use it every night, but I also no longer have congestion. I also use a humidifier at night during the winter.

Next, I found some sleep apnea exercise videos on YouTube. I did those regularly for a little while, although I’m uncertain of how helpful they were. Around that time I also started singing in my church worship team, and singing is supposed to have a similar beneficial effect of stretching and tightening the throat area.

I think I may also have become conscious of pushing my tongue forward to help keep my airways clear, as I often wake up with it in that position.

However, despite the improvement in nighttime breathing, the middle-of-night waking didn’t go away.

That is, until recently. All of a sudden, I’ve had a streak of nights where I am not waking up on my own. My husband still wakes me sometimes, which is another issue, but when he does, I’ve been able to get back to sleep quickly. No more two-to-four-hour awake sessions in the middle of the night.

Not only that, I feel amazing during the day. My mind is sharp and clear, I don’t have chest pains, I don’t get out of breath easily.

So what changed? I have one primary and one secondary guess.

Primary guess: I started taking a daily aspirin as I’ve read it’s beneficial to prevent cardiac problems and dementia. I started with the standard 325 milligram dosage, as that’s what I had around the house, but started getting stomach pain and digestive problems, so switched to an 81-milligram enteric-coated formulation.

Secondary guess: I started using a mouth guard to prevent tooth grinding, but I doubt that could have such a dramatic effect. It’s possible it is somehow helping keep my airway open, but I forgot it one night recently and didn’t have insomnia.

Although given the length of time I’ve suffered from this problem and how persistent it’s been, I am reluctant to declare a cure, I am cautiously optimistic. This long a streak of good sleep has not happened since my halcyon days of youth.

Pardon the lengthy and boring explanation of my sleep problems. I write about it for two reasons: one, it’s something I struggled with for many years and tried in vain to find solutions for. Given the strongly negative effect it has had on my life, I’m hopeful that the solutions I share could help someone else.²

Please note that I do not know what underlying issue the aspirin is (apparently) dealing with; so it’s not a substitute for a proper medical checkup.

However, the covid fiasco has made me suspicious of the entire medical field and prone to view profit motives in everything. Would my doctor ever have suggested something so simple and cheap as a daily aspirin? Why did the sleep clinic only mention apnea, when I know I have other problems like teeth grinding? Do I or did I really have it? Do they tell everyone who does a sleep test that they have apnea? Could it be because there are enormous amounts of profit in selling CPAP machines?

I don’t know, but I wonder, and I wouldn’t be confident that the answers to those questions are benign as I would have been “before” covid.

It is truly amazing how often the solutions to problems for which doctors wish to dispense expensive treatments with risky side effects, can be found in cheap or free alternatives without a prescription or wait time. Just today I read about a study which shows exercise to be more effective than medication in alleviating depression and anxiety. Last year, I had a terrible episode of back pain which resulted in sciatica and was prescribed a raft of medications which had little noticeable effect but ended up giving me heart pain. In contrast, some simple exercises I found online were effective in loosening up the seized muscles and relieving pain.

But you will never hear about these effective solutions from doctors, whose only recourse is drugs and more drugs. Please note I’m not saying doctors and medicine are never useful and should always be avoided. This is definitely not the case. But I am now strongly reluctant to get involved with the medical profit complex unless absolutely necessary, and will seek out alternative treatments whenever possible. Covid kind of “pulled back the curtain” for me and I now approach medical personnel with a default of suspicion, rather than trust. Which is a shame, but it may be a more accurate way of seeing things.

1. One cup distilled water, 1/4 teaspoon each baking soda and non-iodized salt, one teaspoon liquid glycerin, 1/2 teaspoon xylitol crystals. I originally didn’t add xylitol but did so following recent research which shows it is an effective anti-viral.

2. Obligatory disclaimer: I am not a doctor, this is not medical advice, talk with your licensed medical professional, blah blah blah.