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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September 26, 2008 - 1:53pm
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