Sunday, May 20, 2007

Snoring and sleeping are two things that fall on a very short list of items that one cannot observe about oneself. Because of that, there's a strong tendency toward denial. It's a natural human tendency.

As I mentioned the other day, on Thursday night I went to a local sleep lab and spent the night there hooked up to a bunch of wires and stuff to find out what might be going on with me. I've been waking up tired for some time, feeling like I am getting little rest, etc. You can read more about that in the original post.

Anyhow, as you can sort of see in the bad-angle and bad-hair picture there on the right, I got a zillion wires, sensors and bands stuck to me (which it turns out was not as bad as people thought it would be) and fell asleep after spending the evening watching some TV and taking a Lunesta provided by the physician.

I remember waking up a few times throughout the night, which is pretty typical of me. Once the technician (who was very cool, by the way) had to come in and re-attach an airflow sensor that worked its way loose from my face, but overall I figured I slept as well as I do normally, or maybe even a little better than normal. I'll chalk that up to the pill.

The way the study worked was if you exhibit severe apnea within the first few hours they hook you up to a CPAP machine for the rest of the night. That didn't quite happen with me, so I was not woken up for that change of equipment. So in the morning I did the typical rationalization things and figured I was in the clear, no problems, must just be my head or something.

But when the doc came in the next morning (It's a great arrangement by the way - You fall asleep and the doctor shows up first thing so you don't have to come back for another office appointment), he showed me the data printouts and graphs from the night. Turns out I am waking up about 60 times an hour due to breathing problems - Apnea to be specific. People tend to be surprised by the facts since they can't observe it themselves, so when you can see your own stats and see that, hey look - I stopped breathing completely there for like 5 or 10 seconds and then make a loud snore and took a huge gasping set of breaths... My blood oxygen level dropped to like 80% in many cases. Well, let's just say the evidence speaks for itself.

I actually remembered waking up maybe 4 times or so because that's how many times I was awake long enough to form a memory and to become fully lucid, the doc explained. The other several hundred times were enough to be awake but not long enough to remember.

According to the doc I have at least moderate sleep apnea. Because I shifted off my back to sleep my side for most of the night, the apnea signs were probably not as bad as they would have been otherwise (it tends to be worse if you are positioned on your back, and during the time I was on my back the data shows it was in fact worse).

Apnea is simply the closing of your airway while you breathe during sleep. When you sleep your body relaxes, and that includes the muscles that shape the upper part of your airway (the part above the Adams apple is flexible, the rest is rigid). If the airway closes you get no air. If you get no air the brain is not happy. If the brain is not happy it wakes you up to move the muscles needed in order to open the airway. If this happens often enough, you never get long enough sleep to enter that REM phase, or deep sleep, which is needed to get "real" rest, or restorative sleep. And if that happens you have to deal with the problems of sleep deprivation. As mentioned earlier, you don't wake up long enough to remember anything, so it's hard to know when this is happening unless someone else sees it and knows what to look (and listen) for.

My doc said to think of the collapsing airway as being similar to the effect of trying to suck a milkshake through a straw: The straw collapses from the negative pressure and nothing can get through. The same is true for the throat for many people. That's really what snoring is - a collapsing or blocked airway.

So, long story short (too late), I will be going back to the sleep study place in a couple weeks for one more night, during which they'll hook me up to a CPAP machine. That stands for Continuous Positive Airway Pressure. It's a thing you wear on your face to blow some air into your airway to maintain enough positive pressure there to keep the airway open. I have spoken over the past few days will a surprisingly large number of people (some of whom commented here) who tell me they use a CPAP machine when they sleep and it's changed their lives. Well, worth a try then I guess. I have to admit I am not thrilled about the idea of wearing a mask when I sleep (it seems to me to be such a tied-down option) but I will try it if it might help. You never know.

More in a couple weeks, after the next phase of this whole deal is complete. Meanwhile if you ever need to do the sleep study thing, Oregon Sleep Associates is a good group of professional people and the sleep center is nice - not at all hospital like and easy to relax in. My doc's name is Scott Fromherz, MD and he's great at explaining things and answering questions. Definitely recommended if you find yourself needing a place to fulfill the need.



Add/Read: Comments [7]
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Monday, May 21, 2007 6:04:18 AM (Pacific Daylight Time, UTC-07:00)
Greg,

I feel for you. I was diagnosed 1 year ago with sleep apnea. The CPAP changed my life. A personal preference on the mask. I have also recomended to opther who love it. The Mirage Swift II Nasal Pillow System. It is not a full face mask it looks more like a oversized oxygen tube with a strap that looks like it came off of the headgear that goes along with braces.

I picked it because it was the least scary looking on and I have a 2yr old and a 4 yr old. Also because I didn't like the big bulky thing on my face.

Anyway good luck. If you end up with a CPAP it takes a while to get used to but stick with it. Mine has to go everywhere with me. I have problems falling asleep with out it.

Muck like the languange and OS religions yu will tend to find that many users of this type of equipment become quite religious about their preference in equipment but it all comes down to what is most comfortable and works best for you. Afterall if your not comfortable wearing and sleeping with it then you will probably quit using it. Then no matter what you choose it has no benefit.
Patrick Keating
Friday, May 25, 2007 4:17:06 AM (Pacific Daylight Time, UTC-07:00)
How much did this cost you? Did insurance cover any of it?
Dave
Monday, May 28, 2007 12:58:37 PM (Pacific Daylight Time, UTC-07:00)
Hey Greg,

I am glad they were able to diagnose your sleep apnea. I was diagnosed about 3 or 4 years ago and having the CPAP definitely makes a difference. There are some nights I fall asleep without it on and if it happens to be more than one night in a row, I can really tell in the second day. Word of experience, don't forget to wear it.

I agree with Patrick, find a mask that works for you so that you are willing to wear it during the night. There are not beauty contests while you sleep - unless you are sleeping beauty - so whatever is comfortable should be the winner for your mask.

If you have any questions or concerns about sleep apnea, I would be happy to share with you.

-Phillip
Saturday, October 13, 2007 1:16:19 AM (Pacific Daylight Time, UTC-07:00)
Hi
I've been exhausted now for weeks . Went to do a sleep study and got diagnosed with severe OSA and then had to wait another 3 weeks to get into a second sleep study to do the CPAP thing. That was last night...wow what an experience. Unfortunately not good for me. I tried one mask going over the face and nose (not full face) and had a panic attack and ripped it off as I felt i couldn't breath. Then tried a nasal prong type thing which was better, but I still had elements of panic and had real. trouble getting to sleep as I listened to each breath. Eventually got to sleep but woke up and then felt panic again. Over the night the tech said it fixed my problem WHEN I was asleep but wow what a problem. Maybe the zillion wires and strange uncomfortable environment, but now I'm so down about whether it can help. Have others got past this very poor beginning? Contact me on mholloway2@bigpond.com if you have any comments that may make me feel better.
Michael
Sunday, October 14, 2007 8:47:22 AM (Pacific Daylight Time, UTC-07:00)
My insurance covered it, yes.

Michael - I understand your anxiety with the masks. A couple of things for you to know below, but first of all: It gets better, and for many people it's all the wires and stuff that gets them. They bugged me wuite a bit on my second visit, and I got the whole panic feeling as well. But now I sleep great and no anxiety. In fact, it's quite the opposite. I feel good when I wake up.

A few things to talk to you doc about:

1. There are medications that can be used for a time to reduce the anxiety, as well as to help you sleep. I know my doc prescribes them as needed, and many of the medications available now don't have the dependency issues of the older medications.

2. There are - literally - hundreds of masks out there. I have two. One is the type of mask I think you are describing, which covers the nose and mouth. Mine has a neoprene (soft) head strp thing, which is worth it, and works great. At first it was weird for me, it leaked and makde me crazy, but I found I had it too tight, actually. Once I loosened up the head strap adjustments it felt better and sealed much better. It has a hos that can pivot 360 degrees, and I can sleep on my side with it. I also have another mask that is cool but I have a harder time getting a good seal with. It has just hose pillows, and a strap to help hold the jaw/mouth shut. Since I am a bit of a mouth breather, I sometimes find myself waking up with a very dry mouth, which means the mask is blowing all the air out my mouth. Other times it works fine. I plan to try a mask that is a cross between the two next - nose pillows with a mouth cover. That would let me wear my glasses to read and keep the mouth sealed.

3. Try a BiPAP machine if you are able to. These are CPAP machines that vary the pressure when you inhale (full pressure) and exhale (decreased pressure), which makes them quite confortable. They cost a little more but are great. Insurance generally covers them.

I hope that helps. Let me know if you have more questions.

4. Whatever machineyou use, get the humidifier. Just trust me on this one.
Thursday, February 14, 2008 7:13:08 PM (Pacific Standard Time, UTC-08:00)
I was wondering what the time frame is for other sleep study people in getting their results. It has taken me a month for the results to return and I still havent talked to the doctor about picking up the CPAP machine!
Im feeling 4 months is a long time to wait for results.
Karen
Thursday, February 14, 2008 8:07:55 PM (Pacific Standard Time, UTC-08:00)
Karen - that's a ridiculously long time to wait. In reality it's not a complicated thing for the doc, and my doc sat down with me the next morning before I went home. I literally had a CPAP machine the same day. I can see where acouple days might go by, but seriously you need to call and raise hell with the doc's office.

greg
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