A few weeks ago, (the night of December 26, in fact), I had
posted a status on Facebook that I was ensconced at the Courtyard Hotel in
Farmington, wired up like an astronaut (or maybe a lab rat) for a sleep study.
I haven’t said much about it since then and for anyone who cares, here’s the
whole story.
Sometime in late November, Joy couldn’t sleep one night. She
was awake in bed reading while I lay blissfully unaware, asleep and snoring.
[Let me digress a moment and tell you that my father had one of the worst
snoring problems you can imagine. How my mother put up with it I have no idea.
It was so bad that it reached the degree of sounding like snoring you’d hear in
a cartoon or Three Stooges movie. I’m not that bad but apparently I, too,
snore.] Anyway, there I was, sleeping and snoring…until I stopped snoring. Joy
noticed that not only was I not snoring, I wasn’t breathing. She started
counting and when she got to twenty or so, she shook me and told me to roll on
my side. [Another digression. Joy, prior to her weight loss surgery, had been
diagnosed with Obstructive Sleep Apnea. In her case, she was in the passenger
seat with her mother driving and she dozed off. Her mother, a retired nursing
instructor, noticed that she was periodically stopping breathing. A sleep study
or two later and she was diagnosed and had to sleep with a CPAP (Constant
Positive Air Pressure) machine that forced her to keep breathing by keeping the
air passage open while sleeping. She has not needed it since the day after her
surgery. This is a long way towards saying that she knows a thing or two about
sleep apnea.]
After that experience, she told me that I had to call our
primary care physician. I called and left a message. I was home from work by the
time he called. When I told him what had happened, he started asking about my
observations. I told him that since I was sleeping, I had no observations but
Joy could tell him what she had observed and I handed the phone to her. The
first thing he said to her was, “Congratulations, you may have saved your
husband’s life.” After they talked for a while, she handed the phone back to me
and he said that he was going to order a sleep study for me ASAP.
ASAP turned into three weeks, not because the sleep lab was
tardy. No, they called the day after and got me scheduled ASAP. But a bad cold
that segued into a sinus infection and bronchitis forced me to postpone it. I
scheduled it for December 26. Of course, that day, it chose to snow. Not a
nice, fluffy, powdery, man is it cold out snow. No, it was a just under
freezing point so it could snow but be heavy and sticky and messy snow. But
there I was at the Courtyard where the sleep lab was located (and getting there
was a real skid-fest). The technician (who came from a much farther distance
than I did, was SO happy to see me. Everyone else scheduled that night had
canceled.
So, after being wired up, I climbed into bed around 9:30,
watched TV until I felt sleepy and turned off the light around 10:15. The
technician woke me up (I later discovered around midnight) to tell me that I
had stopped breathing and that she needed to put a CPAP on me. I slept the rest
of the night with it. When the technician woke me up, she told me that I did
have several episodes of sleep apnea. At one point my oxygen saturation had
dropped to 75%. (A 6% drop is considered an “episode” so 25% is significant.
Before I left she asked me if I wanted to take the CPAP mask I had used with
me. I declined and said I was going to hope for the best.
January 1 we left for our cruise, returning January 13.
While we were away I had gotten a call for me to make an appointment for the
follow-up to get the results. I made the appointment, expecting the worst. It
turns out it was NOT the worst. I only have moderate obstructive sleep apnea,
not severe. It seems that at the worst, my oxygen saturation had dropped to
68%, dangerously low. That was what prompted the technician to put the CPAP on
me. I had averaged over thirty “events” an hour. That means I had stopped
breathing on an average of once every two minutes without the CPAP. Bottom
line: Despite my optimism, I need to sleep with a CPAP.
I started looking around on the Internet
about obstructive apnea and a lot of seemingly disconnected things started falling
into place. First off, I wondered how I had developed it. I’m somewhat
overweight
but not obese. I found this list of risk factors:
· Being male
· Being overweight
· Being over age 40
· Having a large neck size (17 inches or greater in men and 16
inches or greater in women)
· Having large tonsils, a large tongue, or a small jaw bone
· Having a family history of sleep apnea
· Gastro-esophageal reflux, or GERD
· Nasal obstruction due to a deviated septum, allergies, or sinus
problems
With the exception of the neck
size, I had all the risk factors. It also seems that the reason I woke up most
mornings with a headache can be traced to the apnea. They’re not sure what the
connection is but seems undeniable. Apnea also leads to hypertension and high
cholesterol. My blood pressure has been higher than I would expect and I am on
cholesterol medication even though my diet is not horrible. The negative
pressure created by not breathing can cause stomach reflux, something that has occurred
a number of times in the past year. Another symptom is being constantly sleepy
during the day. Any chance I got I would take a nap…or simply doze off.
Something that happened a number
of times, although not in the last 25 years or so was that on several times, I
would wake up and be paralyzed from the neck down. It would take several
minutes for me to be able to move. I had concluded that the reason for this was
that I had been sleeping in a certain way and that I must have pinched the
nerves or spinal cord at the level of my neck. What I have, since, learned is
that when we are in REM sleep, the brain shuts the body down so that we do not
“act out” our dreams. There is a form of sleep disorder where REM sleep is
interrupted and the sleeper awakens before
the brain has restored motion to the body. Although this hasn’t happened
recently, it placed me on the sleep disorder spectrum long before apnea.
What my doctor meant by telling
Joy that she had saved my life is very simple. Obstructive sleep apnea has been
linked with increased risk of stroke, heart attack and type-2 diabetes. The
stress that lack of oxygen places on the heart weakens the heart. The increased
risk of cholesterol leads to plaque build-up. Although a good diet and regular
exercise are still necessary, addressing the apnea decreases the risk factors
significantly.
I saw the sleep doctor on
Monday. On Wednesday I got a call from the medical device provider and made an
appointment for the following day. That morning, I went to get checked out on
the CPAP. It’s actually rather small and comes in two pieces, the air pump and
the humidifier. The mask they had selected for me is not so much a mask as a
thick oxygen cannula. The plugs that actually blow air into my nostrils act as
seals to prevent the air intake from leaking. [Yet another digression: The way
a CPAP works is it provides a constant flow of oxygen (the constant positive
pressure part). It forces the airway to remain open when you’re sleeping which
prevents the throat from closing up and causing apnea. Therefore, a tight seal
of the mask is crucial.] I sat with it on for about ten minutes and had no
problem. So, off I went with my new device.
I found myself being fairly depressed and could not place a
finger on what had occurred to make me depressed. We had just gotten home from
a great vacation. In general I have been feeling good. After doing a bit more
reading, I put it together. I was grieving. Life as I had known it had
irrevocably changed. I will have to use a CPAP for the rest of my life. Every
night for the remainder of my life, I will need the assistance of a mechanical
device to be able to sleep properly and not starve my body of oxygen.
Intellectually, I have accepted that reality. Emotionally, I am still
struggling with it. But the success that I have had with it has been very
encouraging. I don’t have headaches when I wake up. I sleep better and more
restfully. Joy tells me that I am not as restless in terms of changing
positions as I had been and don’t snore anymore. I’m not sleepy during the day
and my general outlook on life has gotten better. Will the positive changes
last? Only time will tell. I know I still need to get off my butt and get some
exercise and I’m hoping that my endurance will have increased thanks to getting
more and better sleep.
Unlike many people I have encountered on on-line CPAP
forums, I have had no problem sleeping with the mask. Part of that may be that
it is not really a mask. But that may only be part of it. I have never had a
problem falling asleep. It’s almost a joke among family and friends that if I’m
sitting in the same position for five minutes, I’m probably asleep. So the
physical adjustment has been the least of my problems. And if I have to be tied
to this thing the rest of my life, I guess it’s not that much of a price to pay
for the benefits. So, sleep well, everybody, and if you’re NOT sleeping well,
find out why.
