Sleeping for Medicine

So, after a consultation with a lung specialist, it appears that I am a likely victim of sleep apnea--the condition where one's muscles become so relaxed during sleep that the tongue blocks the breathing passages, and one actually stops breathing, often several times a night. Based on my reported sleep habits, many complaints that I snore, and the apparently small size of my airways, I was recommended for a sleep study.

This is because sleep apnea can really only be diagnosed by watching the patient sleep. And since doctors aren't going to stay up all night just to watch someone else sleep, I got to go to a "Sleep Disorders Center" and get hooked up to all kinds of wires, machinery and cameras, all of which generate data about how I sleep so that the doctors can look at my situation.

So, my appointment was last night at 9 p.m. I was to bring pajamas, toiletries, and my insurance card. Once I was checked in (paperwork! Whoo hoo!) and a name bracelet was stuck on my wrist, I was shown to a sleeping room. At first glance, it looked like a hotel room: highly figured and rather corporately unattractive bedspread, forgettable art overhead, armoire, television, full bath and nightstand. Okay, so the bed was a dinky little single bed--not the size most adults are used to sleeping in, as far as I'm concerned. And there were no curtains, plus some other things were just not quite right. I was instructed to change into my sleepwear, and then I was hooked up.

Sure, I'm an optimistic person. I try to mentally convert medical procedures into spa services. . .as much as is possible. This wasn't really possible. The lack of any light but glaring overhead fluorescents was one characteristic that I couldn't overcome, and the total lack of soothing music and aroma therapy was another. I did ask the technician about it. Don't think I didn't! He laughed, but he thought it was a good idea. He also thought the bed was a bit small. Don't you think some mattress company would donate some decent beds, just to have their name associated with a sleep clinic? If you saw an ad for some mattress that promised better sleep, and said "Used in sleep clinics across the nation" wouldn't you make a point of checking it out?

Anyway, the hooking up process took a good 40 minutes, or maybe longer. At least as long as a good spa service should be. First the technician (Dave--and I refrained from using my HAL voice when using his name) measured my head in three different dimensions, in order to place six nodes in specific places on my skull. I got one by each eye, one behind each ear, several on my chin (I'm not sure why--I'm sure he explained it, but I don't remember. "I'm sorry, DAVE."). I also had two just below my collarbones to check my heartbeat, one on each calf to check for leg motion, and two breathing bands--one across my chest and one across my abdomen. Then the whole mass of wires was attached to a 4"x6" console. The whole process involved several swipes of alcohol cleansers to wipe off any body oil to make sure the adhesives stayed attached all night, and gobs of some sort of gummy goo (I think this is a medical term) were placed in my hair to keep the skull nodes in place.

By the end, I was feeling like I had a major dreadlock 'do going on at the back of my head. Once I was hooked up to all these wires, I had to climb into bed and get an oxygen monitor taped to my right index finger, and then a breathing tube attached below my nose to measure the air coming out of my nostrils. This was possibly the worst part of the whole mess, because it had that unmistakeable scent of newly opened, certified sterile, medical plastic, which stunk up into my nose all night.

"Okay, so when you are ready to go to sleep, you just let me know. I've got a microphone in here and I can hear you when you call." So, I tried to read myself into sleepiness, which isn't easy in a strange room, with a too small bed, where the only light is a screaming overhead fluorescent. . .but I tried. By about 10:15 I was ready to lie down. . .and then we had to do more testing.

"Lie on your back with your hands on your sides. Now with just your eyes, look left and right. Now with just your eyes, look up and down. Take a deep breath and hold it for 10 seconds. Now move your right foot up and down. . .and now your left foot. Take a few deep breaths. . .good. Good night."

GOOD NIGHT, DAVE.

Let me tell you, it isn't easy to fall asleep. And it felt like I was awake for at least 40 minutes until I got any kind of sleep at all, and even at that I was jolting awake quite a bit. Still, I was asleep when Dave came in to ask me to sleep on my back, because he startled me awake. Okay, sleep on back to test the most classic form of apnea. Yeah. Sleep. On my back. Yeah. Right. . .

"Okay, you're doing great. Now we are going to hook you up to the machine." This machine is the CPAP machine: Continuous Positive Air Pressure. You wear a small triangular nose cone attached to an enormous headgear to keep it in place as you sleep. The machine pumps out a continuous stream of gentle air to force your airways to stay open. It isn't too hard to breathe with it, but I gotta tell you it's impossible to talk. The stinky nose thing was untaped, but not removed because it was already tangled up in all the other wires. The CPAP went on, and I was allowed to try to go back to sleep.

Listen--I was already wide awake from the startle reflex, and adding the odd feeling and the weight of the CPAP thing didn't make me any more comfortable. So what did I need? MORE wires, I guess. I plugged in my iPod and listened to a book on tape. Actually, even though I had listened to this particular book before. . .recently. . .I found I wasn't nodding off. I finally gave up and tried to get to sleep without it. I tried to do it while on my back, so Dave wouldn't come back and wake me up. . .AGAIN. . .but it didn't work. Actually, the cone weighed rather heavily on my teeth, squishing my lip against my teeth. But I STILL had to sleep on my back, after Dave came in and woke me up AGAIN.

It wasn't very restful, and the CPAP had a weird effect on my breathing. I felt like it was forcing my sinuses open, and also that because the air was going in, I hardly had to breathe at all. In fact, if you asked me my opinion, I'd say I did less breathing with the machine than without it. I also thought I did less sleeping too, but I guess the data will show if that's true. I was asleep when Dave came in to say it was 6 a.m., and time to go home. I woke up so quickly, though, every time, which is quite unlike my usual sleep, and so until proven otherwise, I believe I didn't sleep as deeply as I usually do.

I was going to just get up, throw on some clothes and come home to shower, but once Dave ripped off all the adhesive and tape (boy, am I glad I shaved my legs!), there were still gobs of that crap in my hair, and residual stickiness around my neck and I just couldn't stand it! I filled out the final paperwork, took a shower, and came home to go back to bed.

I go in to see the doctor on Tuesday, who will read the results of my tests, as well as Dave's report and that of the other sleep disorder specialists on staff. Apparently, although there are several options for sleep apnea, only the CPAP is actually consistently effective. Which I have some trouble with. I mean, I spent years in high school, faithfully wearing the god awful headgear for my orthodonture, and trust me, the CPAP skull cap is worse. It just isn't how I see myself, wearing this big ugly appliance-type headgear and attached by the nose to a bedside machine. I mean, really, did Sleeping Beauty wear a CPAP? How about Meredith Grey, even when she was in a coma after nearly drowning in Puget Sound? NO! They didn't! As for me, it's hard to get over the non-aesthetics of it to confront the medical reality. Apnea is dangerous--it leads to all kinds of serious medical conditions, like increased risk of stroke, high blood pressure, etc. etc.

But it's hard to get over the feeling that it's like being on life support, and I really didn't plan to be on life support until I was a whole lot older, and had a couple of hips replaced, and perhaps had senile dementia, so I wouldn't notice.

We will see what the doctor says, but the odds are generally lined up for the CPAP, and then it's up to me to get over my issues about it. After all, I'm not the one bothered by my snoring, right?