I have learned that I have sleep apnea. It's more serious than many people realize.

But that ends up exhausting you. If snoring does not take you to the doctor, fatigue can. Yet a lot of power through, gradually becoming too tired to do their job well or safely. Untreated train, bus and truck drivers clearly pose a significant risk to public safety.

Definitively diagnose the condition requires a sleep test – either at home, or more broadly in a laboratory. Getting to bed is not very fun, which is another reason why people can avoid looking for a diagnosis. Professional drivers and train drivers may also be concerned that this could threaten their livelihood. To dodge the screens for the condition, they may under-report the feeling of sleepiness.

There may also be a fear of sleep apnea treatments. The gold standard for treatment is a continuous positive airway pressure machine, which forces the airways to open with the pressure delivered by a mask. The prospect of sleeping with a mask and beside a machine can be daunting and, for some, uncomfortable. Compliance with treatment is about 60%. But the devices have become much more comfortable and quiet over the years. (The latest models are completely silent.)

For obese patients, losing weight can reverse sleep apnea. But keeping the weight is notoriously difficult.

Other options include mouth appliances (think of it as fancy mouthguards), nasal patches and, in extreme cases, surgery. Device costs can range from hundreds of dollars to thousands. Even at the top end, you can feel a significant improvement in the quality of life that could be worthwhile.

Although these options work for snoring, too, insurance will not cover them for this condition. Similar over-the-counter oral appliances are cheaper, but less studied, which makes it difficult to say for whom they will work well. Studies document that patients use less over the counter versions, perhaps because they may be less comfortable than professionally customized ones. So, while snoring is highly curable, the cost and uncertainty of exactly how to do it can be a barrier for many people to treat it.

There is an interest in public safety in the treatment of sleep apnea more broadly. Yet last summer, with the goal of reducing regulation, the Trump administration withdrew a settlement proposal requiring drivers of trucks and buses, as well as railway engineers. , are screened. This is perhaps an area where a little more regulation is warranted.