Saturday, November 03, 2007

Let's talk about sleep apnea.

As I'm sure the love of my life and my former roommate will gladly attest, for a relatively little guy (5'9", 175#), I sure do make a lot of noise while I sleep. My snoring was first brought to my attention when I was 12 and my darling brother made a tape of me snoring while we were at a family reunion and played it for everyone.

It wasn't until my mid-20's, having heard the complaints of numerous roommates and bed partners, that I finally decided to talk to my doctor about it. This was the first time I ever heard the term "Obstructive Sleep Apnea". Essentially, the throat relaxes and collapses on itself while you sleep, preventing air from getting into your system. It looks a little something like this:

The most definitive way of diagnosing sleep apnea is through a sleep test. You spend the night sleeping in a doctor's office- the nice ones are set up like bedrooms, but there are others that are like sleeping in a hospital room. Your legs, chest, head and face have leads attached to them, which are connected back to a central computer to measure your brain waves, breathing and movement. The resulting effect is something akin to a Borg who still has a few surgeries left to go.

After my first sleep test (thought I use the word sleep loosely, since it's difficult at best to sleep when you're that wired for sound), it was discovered that I did indeed, have obstructive sleep apnea. During the test, the lack of oxygen woke me up an average of 40 times per hour. The waking epsiodes are not enough that you would remember having woken up, but enough to keep you out of the realm of restful sleep.

There are still only a few options available to those who suffer from sleep apnea. You can make lifestyle changes, such as losing weight, quitting smoking, or cutting back on alcohol. Sometimes though, as in my case, the problem is purely structural. My tongue is too big, and the opening at the back of my throat was too small. The two options open in these cases are surgery or a CPAP (Continuous Positive Airway Pressure) machine. The goal of surgery is to create a more open airway, and the CPAP provides, as its name indicates, a continuous stream of air down the airway to prevent the throat from closing.

I began with CPAP therapy and had amazing results- I actually felt rested, I had a ton more energy, and just generally felt great. But the machine is pretty inconvenient. I met with my ENT, and we discussed the surgery options, settling on Uvulopalatopharyngoplasty, also known by its more tongue friendly name, UP3. This could theoretically be a permanent solution, or it could be a waste of time.

I'll spare you the details; let' just say it didn't work very well. The whole experience soured me on the idea of treating my sleep apnea at all for several years. But, thanks to a persistent partner, a forceful doctor, constant fatigue, and a high blood pressure reading during a physical, I've decided to try to treat this beast again. I had a sleep test a couple of weeks ago to establish a baseline, and at the beginning of December, I'll have a second test, this time wearing a CPAP mask for the whole night. After that, I'll be attached to a machine every night for the rest of my life.

Why did I post all this? I'm not sure. I'm a little freaked out by the permanence of the CPAP, and admitting that you have something that will never really be cured isn't easy. But on the other hand, I hope that no one else is as stubborn as I am with this. Side effects like hypertension and heart disease are serious enough that whatever qualms you have with getting checked out are weak excuses. So not to get all after school special, but if you are constantly being told about your snoring, or that you stop breathing while you're sleeping, go see your doctor. And if someone you're sharing a bed with has these issues, push them to go see the doctor. It's weel worth it in the end.

The American Sleep Apnea Association website is an excellent resource if you're not sure, and also has links to support groups and an online community for those who are dealing with this.


yarnho said...


Thanks for posting this. I feel your pain, I really do. I understand. I know people who unlike me, can tolerate the machine and it changes their lives in amazing ways.

mishka said...

wow, Steve. I appreciate you posting this. I guess accepting the mask is like someone accepting that they'll be on medication the rest of their lives. Not an easy to swallow prospect. But the sacrifice will make the rest of your life that much easier. I wish you the best of luck and I think you're pretty brave for trying it again.

Anonymous said...

As the wife of a newly diagnosed Sleep Apniac (is that the term?)...I can appreciate what the patient is going through, but there has to be something for those of us who are the innocent victims of the disease. I am feeling totally selfish in hating this mask and machine that has taken my husband's face away from me...and guilt ridden and overwhelmed at the prospect of life without it and the damage and danger it can put him in. Surely there is a better solution to this problem than some device that looks like it is right out of a torture chamber? I would rather hear the snoring than the machine, I would rather have to nudge than to touch the mask. The intimacy of sleeping with my husband has been destroyed by this mask. Snuggling, reaching over and patting his face in the night, even giving a good-night kiss are now things of the past. Our 25 year marriage has been reduced to a separate bedroom/roommate situation.
How can anyone sleep with this contraption?