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Obstructive Sleep Apnea, Wake me up at the Sleep Clinic!


man sleeping in chair

I’m among the estimated 25% of midlife American men that have Obstructive Sleep Apnea (OSA). I was officially diagnosed in 2007, but I was 90% sure I had it for years; if I had to guess, ever since my mid 20’s. It affected my life in many ways, even back then. I would doze off driving home from work more times than I’d like to admit. I’d fall asleep at movies or even when hanging out playing a game with friends. You can imagine the ribbing I took for this, or maybe you currently catch some of the same grief. I developed the reputation as “the sleepy guy”.

This went on for at least 15 years. Since I was single for so long it never really bothered anyone but me. I just accepted the fact that I snored and would even wake myself up occasionally. I thought that being groggy at work was from staying up too late or crashing from the morning’s coffee buzz wearing off.

It wasn’t long after I married that I was urged by my wife Kathy to have this looked into. She wasn’t really bothered by my snoring; it was what she saw in my waking hours. Now in my 40’s I would wake up, drink a cup of coffee, and doze back off sitting on the couch watching the morning’s weather report. Once I dozed off while she was telling me about her day at work! DOAH! I was also beginning to have to get up multiple times during the night to urinate. I’m thinking, great, do I have a prostate problem now?”

So off to the Doctor I went. I was given a pulse-ox monitor to clip to my finger overnight to test the oxygen content in my blood during sleep. I turned it in the next morning so the data could be analyzed. Later that afternoon, the Doctor called me, not his admin, not a scheduler, the Doctor. He wanted me to come in for a sleep study ASAP. His serious tone punctuated the request, as well as the phrase, YOU COULD HAVE A STOKE. He told me that at times the pulse ox indicated that my breathing stopped over 100 times an hour. I never was going into good sleep, and the reason I kept waking up to urinate was when the body is short on oxygen, it will produce a hormone that will cause an increase in the production of urine, so the bladder fills up faster, triggering one to wake up and empty it; a rouse to wake up enough to breathe. I heeded his request and scheduled the next available sleep study.

Preparing for the sleep study had a great side note for me. I had childhood dreams of being an Astronaut; one of the steps in the study is attaching electronic leads to measure heart rate, brain activity, breathing rate, etc. While the technician was attaching those leads I felt like I was getting ready to suit up for a launch! I also watched a video about Sleep Apnea. It could have been entitled “Devin’s life story”, everything depicted about the main character was part of my life, especially dozing off during a card game with friends.

I was apprehensive about not being able to fall asleep with all of the monitor leads attached to me, but after reading for about 20 minutes or so I dropped right off. The next thing I remember the technician woke me up to so I could try a CPAP mask for the rest of the study. It was certainly a strange feeling, the constant air flow, my ears popped and felt like they had water in them. Will I be able to sleep like this? I was awakened again after about 3 hours. I hadn’t felt that well rested in years.

I arrived at home just as Kathy was getting ready for work. After about 10 minutes she asked me, “What did you do with my Husband?”

She was right, I felt like a different person, well rested and full of energy, it was like stepping out of a time machine back to my 20’s; and that was with only a few hours using a CPAP machine.

Now that the Doctor’s prognosis was confirmed, I was prescribed my very own CPAP machine and mask. The CPAP machine I was prescribed is the BiPAP type, which makes automatic adjustments in pressure during the night. It also has a water tank that humidifies the air. There are many different types of masks; I was able to use what is known as a ‘nasal pillow’ type mask, which leaves my mouth uncovered.

With the testing and examinations over, the work now began. Although I was very enthusiastic about wearing the mask at night, the next four months proved to be problematic. Most CPAPs will start with minimal pressure and ramp up to your prescribed pressure in about 20 minutes or so. Even with that gradual increase, having the air coming in can be very annoying. Your sinus cavities fill with air, and it feels like being in an airplane. Hold your nose, close your mouth and try to breath out, that’s what it feels like. I would unconsciously take the mask off during the night in my sleep. Many times I would wake up and realize it myself or Kathy would hear me snoring and give me a nudge. Fortunately she is a great sleeper and drops right back off. Believe me; I paid for it when I didn’t wear the mask, groggy all day, irritable, it was terrible. To think I lived like that for years, it’s amazing what a person can get used to and accepts as “normal”. As time went on, I became better at wearing the mask for the duration of the night, and now look forward to the airflow.

I won’t kid you or try to gloss over it. It takes time to adjust, you have to just suck it up and work at it. Most of those I have met that have been prescribed with CPAP machines do not wear them. I for one just don’t understand how a person can not heed their Doctor’s warnings. HELLO!..YOU CAN HAVE A STROKE! Pardon the pun, but that is just something you shouldn’t ‘blow off’. Maybe some Doctors do not stress this point as mine did. Maybe it was because a ‘mild’ stroke played a part in the beginning of my Father’s last days, and that was fresh still fresh on my mind. Whatever the reasons, I’ll suffer through a bit of inconvenience and discomfort instead a stroke any day of the week.

A CPAP machine is not the solution to having OSA, it’s the bandage. The key factor in overcoming OSA is weight loss. At the time I was diagnosed, I was at my heaviest. (5’11” @ 235lbs) My doctor described it like this. Imagine a cross-section of a neck, it resembles a doughnut. The ‘doughnut hole’ is your windpipe. People that are prone to Obstructive Sleep Apnea start off with a smaller than average hole. As a person gains weight, the ‘doughnut’ expands on the inside as well as the outside; so the hole gets smaller. While sleeping, neck muscles relax and the hole, or airway, can completely close off. The CPAP machine provides a constant flow of air at a slightly higher pressure, which keeps the airway open. If you can lose the weight, the hole will be larger again, like it was when you were young, and most of the time, a CPAP machine is not needed anymore.

Although I have lost some weight, I’m not at the point where I can stop using my CPAP. I’d have to be less than 190 pounds; at that point my doctor would re-evaluate my status, either with another pulse-ox test or sleep study. I have severe OSA, so I’d probably have to look like a marathon runner to ever kick the machine.

The reality for most of us Americans is that even if we are actively working at it, we are not going to get back to what we weighed in our early twenties. If you are diagnosed with OSA, a CPAP machine may be a sleeping partner for the rest of your days. That maybe a discouraging concept for some people; for the most part I’ve been able to take it in stride. My wife as accepted it, although I have to make a conscious effort not to point the exhaust vents at her when we are sleeping. Getting a consistent, good night’s sleep has made a huge difference in my life. Don’t misunderstand; a CPAP can be a real pain in the rear. Although the airlines have made policy accommodations, you still have the carry it. If you like to camp, make sure you have power nearby and pack extension cords. If you are a ‘road warrior’ or an avid camper; travel size and battery operated machines are available.

If you read other websites like the American Sleep Apnea Association or Mayo Clinic’s Sleep Apnea website; you will see that depending on your situation, there are many therapy and device options. The best thing is to be examined by a physician that specializes in sleep disorders. They will find the best solution for you. It’s been nearly five years since I was diagnosed with Obstructive Sleep Apnea, and I’m using my CPAP machine every night. It’s helping me live a normal, more productive life. OSA was the catalyst that started my quest for a healthy midlife. I’ve made improvements, but have yet to reach my goals. That’s ok; the most rewarding things in life usually take the most time and effort.

Update:

Here’s a video I found while looking at sleep apnea websites.  It’s from the Harvard Medical School’s division of Sleep Medicine. It’s nice to know that my lack of talent at free-throws is not the only thing I have in common with the Shaq!

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