All I Need Is The Air That I Breathe, Rammed Forcibly Down My Throat

Oh hey guys what's up so apparently I get to sleep with a plastic mask strapped to my face for the rest of my life!

It's not that bad, I guess.

For most of what has passed so far as my "adult" life, I've had sleep problems. Like not getting enough, or getting too much (sleeping through entire weekend days, for instance), and snoring myself awake sometimes, and feeling tired during the day. Plus I got depression. And I'm kind of a big, doughy guy with a freakishly large neck that's apparently packed full of fatty tissue.

And people who are in a position to know have told me that I sometimes stop breathing during the night. So, whenever I see a doctor, it usually only takes him a few minutes to bring up the possibility of sleep apnea.

Which I actually got tested for a few years ago -- somebody brought a pulse oximeter over to my place and told me to clip it to my finger and go to sleep and she'd be back to pick it up in the morning. The thinking being that if I stopped breathing, the oximeter (which is a device that measures the amount of oxygen in the blood) would register the resulting lack of oxygen.

That test did not find anything abnormal, but that may have been because I barely slept that night to start with. I'm kind of finicky about the situations in which I can get to sleep, and the big plastic clip on my finger just bugged me. (After I did manage to drop off for a little while, I woke up to find that the clip had somehow migrated to my other hand.)

But that plastic clip is nothing compared to what they do to you for a full polysomnography, which is what I went to my local teaching hospital to have done to me in early January. I know that some of y'all who might be reading this have had this (or a similar procedure) done -- in some cases, multiple times. So I know I don't really have any room to complain. And, I mean, given the broad range of things that can be done to you in a hospital, a sleep study is pretty benign. They don't cut into you or anything. (They just sandpaper your head a little bit.)

But really, there are few things in this world less restful than a clinical sleep study. You've got the pulse oximeter clipped on your finger, plus about 20 electrodes or whatever glued to your head and face, stuff taped to your arms and legs and chest and side, some plastic tubing looped under your nose, and big rubber bands around your chest and abdomen. And everything smells kind of weird. I'll say this for the sleep lab I went to: It didn't look that much like a hospital room. It looked more like a slightly run-down motel room.

I don't remember sleeping at all that night, frankly. But apparently I slept enough to have 99 "respiratory events" (48 obstructive apneas -- stopping breathing entirely due to the airway collapsing, then waking up to breathe -- and 51 hypopneas). Which is a lot, but not as much as some people do. My AHI only indicates "moderate" apnea, which is between "mild" and "severe."

Enough, however, for them to recommend CPAP therapy, which is where the above-mentioned plastic mask enters my life. Apparently, what they do normally is make you do another sleep study so they can determine the optimal pressure of air to pump down your airway to keep it open -- this is called titration (hee). For some reason, they didn't do that to me. Instead, I received a phone call directing me to an office park near the airport, where I picked up an auto-titrating (hee) machine. For the past week or so, it's been gradually cranking up the pressure every night and storing a bunch of information on a card which I have to take back to the office park, and somehow from there my doctor will arrive at the correct air pressure to prescribe, eventually.

I can't really tell if it's helping yet. The mask itself isn't that bad, but I guess I'm still getting used to it. The machine doesn't make much noise once I've got the mask strapped on, and I think it has cut down on my snoring. Plus, it's kind of fun to have a new gadget to play with. But it may take a while before I really reap the benefits. It's funny to think about the fact that I might not have had a proper, full night's sleep for most of my adulthood.

I don't know how I'm going to pay for all this, though. Like the gambler I am, I opted for a comically high deductible on my insurance. And now, sitting next to my humble bed, I've got an apparatus that, all told, is about the price of a used car -- and which also takes more fuss and cleaning than I'm used to providing. (One of the reasons I never got contact lenses was that I just didn't want to fuck with the solutions and cases and stuff. Anybody who's seen the state of my apartment can verify that I do not have the kind of lifestyle that's conducive to keeping up with minuscule, fussy details.) The various elements (mask, filter, humidifier tank, hose) have got to be cleaned frequently, and the humidifier needs fresh (distilled) water every day. It's what I imagine having a small housepet would be like.

I guess I can't complain too much, though. As one of the interviewees on the DVD that came with my mask said, what other disease can you get that can be treated by just wearing a mask every night? I'd rather have sleep apnea than polio, for instance. Or Huntington's chorea. Just to pick two examples.

Interestingly, when I visited my hometown for Christmas, I found out that a few of my relatives have similar problems, and had either had or might soon have their own sleep studies. So, if you're reading this, relatives, this is what happened after my sleep study. Sorry I haven't called to tell you this in person, but I've been busy trying to get to sleep with a plastic mask strapped to my face.

Comments

[stew]

a) my dad has this. b) a friend of mine from college who I had a crush on has this. c) I've also done those sleep studies, but they just made me sleep with a tennis ball strapped onto my back to train me to sleep on my side instead. d) something is wrong with your blog HTML and it's displaying weirdly. e) it's SO GOOD to see a post from you, dear!

[stew]

and...two seconds later it's displaying perfectly. Yay!

[pinky]

That is really cool, especially if it helps you get a good night's sleep!

I always wonder how anyone gets to sleep during sleep studies - as someone who hasn't slept well in days (because of a bad, evil cold) I need things to be pretty much like X to sleep well. Right now when I daydream, I daydream about sleeping. Maybe today I'll get a good nap in.

[Jerry]

Stew: To paraphrase my man Roast Beef, it sounds more like it would just train me to not wear that shirt. (I don't do nearly enough evangelizing for Achewood in this space, so there's one attempt.) I also wonder, though, if my problem might not have a simpler solution, one not involving expensive durable medical equipment and physicians in several different specialties. Is sleep apnea just a scam dreamed up (ha!) by the powerful CPAP machine manufacturers lobby?

Pinky: I have a cold, too! Maybe I caught it from you when I bumped into you. Or maybe you caught it from me. I plan on napping today, too.

[Elrond Hubbard]

Good luck with all the sleep and other kinds of studies, everyone! Great to see a post from you, Idiom, though I cold always go back through old ones if I miss seeing a new one.

[Rob Rogers]

Sorry to hear you're struggling with it, Jerry. But if it's any consolation, I've been using a CPAP myself for a few years now, and it makes a significant difference in how I sleep. Granted, part of that is Dina not waking me up anymore to tell me I'm snoring, but I'm getting deeper rest, I feel more rested and less cranky, etc.

I hope it works out for you.

[Judy]

I have problems too. Yikes. Sometimes I wake up gasping.
Wavelength. You never let me down.
Well you'll get that or not. So nice to hear from you again.

[suz]

Awesome to see a post from you. Wish it had better news.
I can't even imagine having to deal with this crap. I do, after all, sleep the sleep of the dead and still feel like crap in the morning. (Sorry, feel kinda like I'm gloating or something, sorry, sorry, to you and your readers that seem to have the same issue.) Can't imagine how HORRIBLE it would be to wake up like 48 times in a night because I stopped breathing. Crap. If it's any consolation, like half the people I know have sleep apnea. Sharing a bed with someone with it is absolutely fucking FREAKY. I mean, hell, they just stop breathing. That first night is awful-- do you call 911? Do you shake them, wake them when it's over, tell them that they're dreaming, wake them when it's over?
I hear you have to wait like a year to get into those sleep studies too.
Um, science is a good thing? Hope the mask and forced air thing works. Imagine how awesome you'd feel with one... good... night's... sleep.
You would think that the stupid Big Pharmaceuticals would be developing something to counteract THAT instead of spending gajillions of dollars on anti-restless-leg syndrome drugs (which only like 3% of the population has, but they've created their own market thanks to marketing, but that's another story).
Sorry to ramble. Email me sometime, we can get some drinks to make us happy.

[suz]

Oh, as if I didn't say enough before...
When you said "mask" I imagined Batman. Or Robin. Or even the Riddler. Then I followed the link in your blog. Wow. That really sucks.

I was put through the sleep study brouhaha in 2003, got my gear in 2004, and although it took a while to get used to wearing the mask I sleep soooo much better. However, I stopped doing the cleaning routine on the equipment after about a year. I stopped using the humidifier for the most part (though it's still connected), I don't clean the tubing or mask or chin strap, or filter. Can't tell the difference. When I do add water I don't use distilled water I use tap. The humidifer bottom gets crunchy, but so what? I only get new mask bits every other year or so, partially because my insurance deductible is so hight, but also because it doesn't seem to adversely affect anything. I sleep better, and that's all that matters to me. Good luck with the gear!

[Dr Jonathan Greenburg]

Hi there,

I came across your blog post and wanted to make a comment. My name is Dr. Jonathan Greenburg and I treat sleep apnea and snoring disorders in my clinics in Los Angeles area. (You can just "google" my name and read about me...

Anyway, I commend you on getting treatment. You just added YEARS to your life and reduced your risk of stroke, heart attacks and even the risk of diabetes, which has been linked to sleep apnea.

This word needs to get out. Your experience needs to be told.

I have several examples on my blog that you can read about, however the public needs to be eductated and it's people like you that are in a postion to help.

For those of your readers that are sitting on the fence and perhaps snore, but don't think it's much of a problem, please listen to an interview that I did and get some of your questions answered.

You can hear it at http://www.apnea-treatment.com. Just sign up and get the free download or listen to it online.

It could save your life or the one you love...

[Jerry]

Over a year later, I return to say: thanks, Dr. Jonathan. And everyone else who commented. And also to admit that it took me this long to catch the Four Tops reference in Suz's comment. Awesome.

[medieval clothing]

You have a quite scary condition..