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My Sleep Apnea: The Beginning

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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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Scientists Think They Know What Causes Trypophobia
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Picture a boat hull covered with barnacles, a dried lotus seed pod, milk bubbles on a latte, or a honeycomb. Images of these objects are harmless—unless you're one of the millions of people suffering from trypophobia. Then they're likely to induce intense disgust, nausea, and fear, and make your skin crawl.

Coined fairly recently, the term trypophobia describes the fear of clusters of holes. The phobia isn’t recognized by the Diagnostic and Statistical Manual of Mental Disorders, but its visibility on the internet suggests that for many, it’s very real. Now, scientists in the UK think they've pinpointed the evolutionary mechanism behind the reaction.

Tom Kupfer of the University of Kent and An T. D. Le of the University of Essex shared their findings in the journal Cognition and Emotion. According to their research, trypophobia evolved as a way to avoid infectious disease. Thousands of years ago, if you saw a person covered in boils or a body covered in flies, a natural aversion to the sight would have helped you avoid catching whatever they had.

But being disgusted by skin riddled with pathogens or parasites alone doesn't mean you're trypophobic; after all, keeping your distance from potential infection is smart. But trypophobia seems to misplace that reaction, as the authors write: "Trypophobia may be an exaggerated and overgeneralized version of this normally adaptive response."

Lotus pod.
Lotus seed pods are a common trigger of trypophobia.

This explanation is not entirely new, but until now little research has been done into whether it's accurate. To test their hypothesis, the scientists recruited 376 self-described trypophobes from online forums, and another 304 college students who didn't claim to have the affliction. Both groups were shown two sets of images: The first depicted clusters of circle-shaped marks on animals and human body parts (the "disease-relevant cluster images"); the second showed clusters of holes on inanimate objects like bricks and flower pods ("disease-irrelevant cluster images"). While both groups reported feeling repulsed by the first collection of photographs, only the trypophobes felt the same about the pictures that had nothing to do with infection.

Another takeaway from the study is that trypophobia is more related to sensations of disgust than fear. This sets it apart from more common phobias like arachnophobia (fear of spiders) or acrophobia (fear of heights). And you don't have to be trypophobic to be disgusted by a video of Suriname toadlets being born through holes in their mother's back. We can all be grossed out by that.

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Researchers Say You’re Exercising More Than You Think
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They say a journey of a thousand miles starts with a single step. If the thought of a thousand-mile journey makes you tired, we've got some great news for you: You've probably already completed one.* A new study published in the journal Health Psychology [PDF] finds that people underestimate the amount of exercise they're getting—and that this underestimation could be harmful.

Psychologists at Stanford University pulled data on 61,141 American adults from two huge studies conducted in the 1990s and the early 2000s: the National Health Interview Survey and the National Health and Nutrition Examination Survey. Participants answered questionnaires about their lifestyles, health, and exercise habits, and some wore accelerometers to track their movement. Everybody was asked one key question: "Would you say that you are physically more active, less active, or about as active as other persons your age?"

The researchers then tapped into the National Death Index through 2011 to find out which of the participants were still alive 10 to 20 years later.

Combining these three studies yielded two interesting facts. First, that many participants believed themselves to be less active than they actually were. Second, and more surprisingly, they found that people who rated themselves as "less active" were more likely to die—even when their actual activity rates told a different story. The reverse was also true: People who overestimated their exercise had lower mortality rates.

There are many reasons this could be the case. Depression and other mental illnesses can certainly influence both our self-perception and our overall health. The researchers attempted to control for this variable by checking participants' stress levels and asking if they'd seen a mental health professional in the last year. But not everybody who needs help can get it, and many people could have slipped through the cracks.

Paper authors Octavia Zahrt and Alia Crum have a different hypothesis. They say our beliefs about exercise could actually affect our risk of death. "Placebo effects are very robust in medicine," Crum said in a statement. "It is only logical to expect that they would play a role in shaping the benefits of behavioral health as well."

The data suggest that our ideas about exercise and exercise itself are two very different things. If all your friends are marathoners and mountain climbers, you might feel like a sloth—even if you regularly spend your lunch hour in yoga class.

Crum and Zahrt say we could all benefit from relaxing our definition of "exercise."

"Many people think that the only healthy physical activity is vigorous exercise in a gym or on a track," Zahrt told Mental Floss in an email. "They underestimate the importance of just walking to the store, taking the stairs, cleaning the house, or carrying the kids."
 
*The average American takes about 5000 steps per day, or roughly 2.5 miles. At that pace, it would take just a little over a year to walk 1000 miles.

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