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My Sleep Apnea: The Beginning

It's time for a new occasional feature! Rejoice! In this column, I'll talk about my personal experience being diagnosed with sleep apnea, what treatments are available, the science behind the condition, and (hopefully) my miraculous improvement after being treated. For this first entry, I'll talk about the experience leading up to my sleep study. In future columns I'll reveal the diagnosis and treatment, and you can follow along as I try to catch some sleep. Before we begin the narrative, let's get a quick definition of "sleep apnea" from Wikipedia (slightly edited for clarity by me):

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea, lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. The standard definition of any apneic event includes a minimum 10 second interval between breaths, with either a neurological arousal, a blood oxygen desaturation of 3-4% or greater, or both arousal and desaturation. Sleep apnea is diagnosed with an overnight sleep test called a polysomnogram, or a "Sleep Study" which is often conducted by a pulmonologist.

...the individual with sleep apnea is rarely aware of having difficulty breathing, even upon awakening. Sleep apnea is recognized as a problem by others witnessing the individual during episodes or is suspected because of its effects on the body. Symptoms may be present for years (or even decades) without identification, during which time the sufferer may become conditioned to the daytime sleepiness and fatigue associated with significant levels of sleep disturbance.

My sleep problems started probably ten years ago, during college, when I became aware that my snoring was really loud. And let me dwell on this a moment -- we're talking sawing logs with industrial machinery loud. The term "epic" was used to characterize my snoring, and neighbors in my college apartment building actually complained. I tried using several nose-opening devices, nasal sprays (disgusting!), sleeping with my mouth closed, and different sleeping positions, but nothing seemed to help. Eventually I ended up in a corner apartment where my neighbors couldn't hear me: problem solved?

Rewinding a few years...at some point during my teenage years, my father had been diagnosed with obstructive sleep apnea. He and I have very similar body types, including a predisposition for charming plumpness as well as a relatively narrow airway in the throat. I have a small mouth (at least relative to my neck), and I still have my tonsils. So it stood to reason that I might develop obstructive sleep apnea as well.

In the time since my snoring became an issue and my recent diagnosis, I really didn't do anything about my sleep problems. I've always been a very sleep-positive person, often sleeping in until noon (and beyond) on weekends. Over the last year or two, I found myself even sleepier: spending entire weekend days asleep, and ultimately not feeling refreshed. Something was wrong. I went to my doctor, who did a bunch of blood tests and ultimately referred me to the Sleep Disorders Program at a local medical institution.

The sleep specialist had me fill out extensive questionnaires about my sleep history and habits, and did some physical tests and a complete interview before prescribing a sleep study. Now, let me back up a little bit here: I actually had a sleep study before. Three years ago, in a similar bout of sleeplessness, I had been sent off to a somewhat lower-rent sleep clinic for a study (which was not preceded by a consultation with a sleep specialist). That experience was a disaster: I spent the night covered in wires and surgical tape, vaguely panicked, and ultimately unable to sleep. After ten hours, they finally discharged me without having slept at all. The study was inconclusive, and my insurance paid handsomely for the ordeal. So when I was prescribed another sleep study, I was wary. Well, let's just say it: I hated the idea. The previous study was awful, lying in the dark for ten hours struggling to sleep while connected to various machines, occasionally being interrupted by lab techs over a speaker asking me why I wasn't sleeping. I didn't want to go through that again to end up with nothing.

This time, things would be different, the sleep specialist said. For one thing, the new sleep study would be carried out in a modified hotel suite, rather than a hospital room. In the new study, I was encouraged to bring my own pillows from home (this actually was a real problem at the old study -- their pillows were awful). For another thing, my doctor prescribed Ambien as a sleep aid during the study, and suggested I get used to taking it prior to that night. Finally, being aware of my previous experience, the staff was extra-nice and accommodated my one odd request: I wanted the room to be as cold as possible, to get as close to my home situation as possible. (I sleep in a fortress of solitude in the frozen North.) With the air conditioning set at 64, I was all set.

Next entry: I'll talk about the sleep study -- what was involved, what they were looking for, and how it went. Do you have sleep apnea? Share your experiences in the comments!

(Image courtesy of American Academy of Family Physicians.)

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Health
How Promoting Handwashing Got One 19th Century Doctor Institutionalized
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Regardless of how often we actually do it, it's common knowledge that washing our hands before eating, after coughing, and after using the bathroom is good for us. But the connection between handwashing and health wasn't always accepted as fact. As Danielle Bainbridge explains in the PBS web series Origin of Everything, the first doctor to campaign for cleanliness in hospitals was not only shunned by other medical professionals, but ended up in an insane asylum.

Prior to the 19th century, handwashing primarily existed in the context of religious ceremonies and practices. It plays a role in Christianity, Islam, Judaism, Sikhism, and Buddhism in some form or another. But washing up to stop the spread of disease wasn't really a thing for most of history. People weren't aware of germs, so instead of microbes, they blamed illness on everything from demons to bad air.

Then, in 1846, a Hungarian doctor named Ignaz Semmelweis made a breakthrough observation. He noticed that women giving birth with the help of midwives were less likely to die than those treated by doctors. He determined that because doctors were also performing autopsies on victims of puerperal fever (a bacterial infection also known as childbed fever), they were somehow spreading the disease to their other patients. Semmelweis started promoting handwashing and instrument sterilization in his clinic, and the spread of puerperal fever dropped as a result.

Despite the evidence to support his theory, his peers in the medical community weren't keen on the idea of blaming patient deaths on doctors. Partly due to his commitment to the controversial theory, Semmelweis was shunned from his field. He suffered a mental breakdown and ended up in a mental hospital, where he died a few weeks later.

Germ theory did eventually become more mainstream as the century progressed, and washing hands as a way to kill unseen pathogens started gaining popularity. Even so, it wasn't until the 1980s that the CDC released the first official guidelines instructing people on best handwashing practices.

If this story suddenly has you in the mood to practice good hygiene, here's the best way to wash your hands, according to experts.

[h/t Origin of Everything]

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Inhaling Cleaning Product Fumes Can Be as Bad for You as a Pack-a-Day Smoking Habit, Study Finds
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People who use spray cleaners on a regular basis may want to reconsider how they tackle their spring cleaning. A new study published in the American Journal of Respiratory and Critical Care Medicine [PDF] offers strong evidence that inhalation of these sterilizing and polishing chemicals may be as bad for their lungs as smoking one pack of cigarettes per day, as Newsweek highlights.

A team of scientists led by Cecile Svanes, Ph.D. at Norway’s University of Bergen tracked 6230 study subjects for two decades, looking for a correlation between diminished lung capacity and use of cleaning products. Those who regularly used chemicals for cleaning, like housekeepers, displayed worsening lung function when researchers asked them to blow air into a tube. Even using cleaners once per week was associated with reduced lung capacity.

Those who reported use of the products also had increased rates of asthma when compared to those who did not use cleaners. It’s believed the particles of the abrasive chemicals are damaging the mucus membranes, leading to steady and progressive changes. The results applied to both occupational cleaners as well as those who were responsible for cleaning at home. The study also demonstrated that women were more susceptible to the effects of the chemicals than men, although a comparatively smaller number of men took part.

What can you do to mitigate the risk? Oistein Svanes, a doctoral student who worked on the project, recommends cleaning with a damp microfiber cloth using only water. If you feel you must use a chemical agent, it's better to pour it into a bucket instead of relying on a spray nozzle—the latter is what causes the chemicals to become airborne and respirable.

[h/t Newsweek]

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