In this episode, David and Yvette discuss the three reasons why sleep apnea can go undiagnosed for years or even decades.  

1. Fatigue becomes normal to the individual due to their life circumstances
2. Uneducated about sleep disorders and sleep hygiene
3. You slowly become the person 

We are faced with managing fatigue within the context of what is happening in and around our lives.  We often (especially when younger) can just adapt to being tired all of the time.  In David and Yvette's lives, the birth of their first child and the effort that went into building their careers, prevented them from sleeping the recommended 8 hours.  We normalize being tired, and even most people in your circle may even talk about how tired they were when they first had children.  The fatigue even can become a shared type of tired when both parents are chronically sleep deprived.  Or maybe the don't have children, but they put everything into building their careers.   There were other instances where fatigue was just a part of daily life.

While in our youth, many people are very social, and the thought of being tired due to a sleep disorder was not top of mind.  In fact, sleep hygiene (soft lights, no digital devices, leave enough time for winding down, etc.) was not a term that was discussed often.  Despite symptoms (headaches, pain in eyes, trouble concentrating, health palpitations, snoring, restless legs) being evident to Yvette, David still felt that they were unconnected.  There was no indication that these symptoms were connected somehow.  Even a trip to the primary care physician after heart palpitations/tightness in chest were not enough for the doctor to refer to a sleep physician. 

Symptoms of sleep apnea which may be described as more classical symptoms (sleepiness all the time, snoring, falling asleep in strange places) develop slowly.  The symptoms rising to the level of a disorder is often missed by the individual.  Symptoms are minimized and when combined with normalizing fatigue, a person can find themselves meeting the criteria for a sleep disorder without even realizing the seriousness of their symptoms.   Those around them can readily see the falling asleep at parties, dinner, and breakfast.   As that process slowly becomes more regular, the debilitating fatigue overtakes many areas of someone's life.  

These three reasons can combine to keep sleep apnea from being a focus for the individual and physician.  While the individuals family can tell that sleep is an issue, it is often very difficult to get a loved one to work with primary care to seek further evaluation through a sleep study.

There are a number of other reasons and contributing factors which keep sleep apnea invisible for millions of people around the world.