To Sleep Perchance To Be Diagnosed With Sleep Apnea

This has all happened a little too quickly. It has also taken forever.

In February my doctor recommended I see a sleep doctor. But, this was mostly on a hunch, as I’d not given him any information to suggest this was necessary. It was based mostly on the fact that my throat seemed a bit on the small/constricted side to him and the fact that I still had my tonsils and they were, apparently, huge. I’ve never been one to sleep a lot. I could usually run pretty happily on six hours. But it had gotten harder to get up in the morning. I attributed that to the fact maybe I was getting older and needed more sleep or some mild depression with my current job. And, those could have been factors, too.

But as I talked to the specialist, all the signs that I was not getting a very good night’s sleep became painfully, blindingly obvious. Even if I slept more, I’d not always feel more rested. Sometimes I’d come home and feel like if I didn’t go to sleep or take a nap right away, my critical functions might just stop, like some robot who’d pushed his batteries too far. It was harder to concentrate. I couldn’t start reading a book without drifting off (very annoying) or I’d even fall asleep in the middle of a TV show or movie (also annoying.)

So, an appointment was made to conduct a sleep study… four months later. It was, seriously, the first time the sleep lab could get me in. Fast forward a few months. I lost my job and my insurance along with it. The day for the sleep study came, and I simply could not go. I got another job (well, a different job at the same place I had been working) and got my insurance back! Wahoo! Sadly, I had to start the process over with the specialist for insurance reasons. After my second appointment with the specialist, I lazily played phone tag with the sleep lab to try to schedule the study. To be honest, I wasn’t putting a ton of effort into it because I was expecting to wait 3-4 months to get into the sleep lab anyway. So the very nice woman making the appointment ended up shocking me as she perused their appointment calendar.

“Actually, we had a cancellation for tonight. Would tonight work?” she asked.

“Oh. Well. Yes, yes that sounds great,” I managed to stammer out. Perhaps sensing the hesitancy in my tone the woman replied with something friendly and light in tone, but that also carried some unintended menace.

“That way you don’t have time to think about it, right?”

I simply laughed nervously in reply.

I went home and followed the instructions given to me. I took a shower, but did not put any product in my hair or on my body. I dressed in comfortable shorts and a t-shirt. They were very explicit that just underwear was NOT an acceptable amount of clothing to wear for the study. This was one of those warnings that made me bemused and frightened at the same time. Because, you know that someone somewhere along the way (perhaps several someones) had shown up to a sleep study expecting to sleep in their underwear. Perhaps even less than that! Which meant that the hospital had to be quite emphatic in their very common-sense rule. The thought of someone watching me twist and turn in my sleep was creepy enough, let alone in nothing but my underwear.  In any case, this was not my best look.

When I got to the hospital and made my way up to the sleep lab, I’ll admit to being a little disappointed. In my mind’s eye I had imagined something more futuristic. Little sleep pods embedded into the walls, I suppose. Actually, since my mind was thoroughly infected by sci-fi at a very young age, I think the exact thing I was imagining was the little alcove that Sarah Jane Smith accidentally stumbled into in the Doctor Who story, Ark in Space.

(Screencap from shillpages: http://www.shillpages.com/dw/story/d4/story-4c.shtml )

As is so often the case, the sleep clinic in real life was much more prosaic. My technician showed me my room, gave me a clipboard with a short questionnaire (because no hospital visit is complete without filling out paper on a clipboard) and said she’d be back in a few minutes. Which gave me plenty of time to take in my decidedly less sci-fi surroundings.

Just out of sight is the webcam, the TV and the fan. The paperwork didn’t take long to fill out. So I used the restroom. And then I sat. And sat. And sat. After twenty minutes I had really started to feel forgotten. I took my shoes off. I sat my wallet and keys on the end table along with my phone. Then I decided that seemed weirdly far away so I sat them in the alcove above the pillow. Then I broke down and browsed Facebook on my phone a bit, something I was trying to avoid fearing the “blue light” would keep me awake. I had been trying desperately to think sleepy thoughts so I could go to sleep a full two hours before I usually do. Finally, a half hour has passed and I truly think I’ve been forgotten. So I open the door just as my technician is passing by.

“Do you need anything?” she asks.

“Oh. No, I mean I haven’t begun yet,” I said. She just smiled politely.

“Oh, I know. I was just finishing up my other patient. You have a remote?”

“Uh, yes. Yes I do,” I say dumbly, before closing the door again. I guess I was supposed to just relax and watch TV? This never occurred to me. For one thing, I was in my typical “obedient patient waiting instructions that could come at any minute” mode. Also, what about the other people sleeping? Would it have been okay to watch TV? I was waiting on further instructions, and no one had instructed me to make myself at home! In any case, the wait after that was short as my technician came in and started attaching wire after wire. This was quite a lengthy process, so I can understand why I had been kept waiting so long. Down the neck-hole of my t-shirt and through my shorts and above my knees they went. They attached to my forehead, behind my ears, by the side of my eyes, on my chest, in my hair at the top of my head, the indentation in my chin and other places besides. There was even a mic that attached to my throat to monitor any possible snoring. Then came the little nasaI monitor that hooked into my nose slightly and then was taped in place on my chins. There was a strap at my chest and just above my belly, also affixed with wires. I was a little too self-conscious to take a picture of myself in full get-up as I laid down in the bed, but it looked something like this:

Time for a lovely night’s sleep, right?

Or… a night spent hovering at this wavering, timeless threshold between sleep and waking. They said I could turn in the night if I needed to, but it was easiest to monitor everything when I was laying on my back. So I tried my best to stay on my back, but could only keep that up so long. My fitful sleep was interrupted on occasion as the technician came back in to reattach the various wires that fell off as I turned. I lost all track of time, until what felt like about an hour into my study (which turned out to be more like three hours in) the technician came in and removed the nasal monitor because it was time to put the mask on my face.

For those of you who have not had to deal with this, the mask coming on means that I did, indeed, have sleep apnea. Sometimes they can’t determine this the first night, and you have to come back in. But if it’s very clear that you DO have sleep apnea, and you stop breathing for ten seconds or more several times at night, they’ll go ahead and try the CPAP machine out on you.

I have a bad history with masks that fit over my mouth and nose. When I was very little, maybe about 3 or 4, my mom took me to the dentist. For whatever reason, they had to put me out through anesthesia. This involved a small green mask that fit over my mouth and nose. I did not, in fact, like this at all and threw quite a fit. I can’t say I’ve loved dentists office since then, but I’m getting better. Even so, there was still that initial wave of claustrophobia as the mask went on. I gulped for air a bit at first, and when I blew the air out too quickly the mask would get backed up with warm air briefly before clearing and letting more of the cool, crisp air in. That part was an unpleasant and strange feeling, more-so than the feeling of the actual mask and straps on my face.

While I can’t say how I’ll react at home (in my own bed and with my own pillows) to having the mask on my face, I can say that for the next three hours I slept like a baby. I did not wake up once. The mask itself was fairly comfortable. I relaxed into a regular breathing pattern and it was all actually quite pleasant, what I remember of it.

Then I woke and I wanted that damn thing off. I can’t say what woke me up or triggered the sudden and intense claustrophobic feeling, but I felt like my mouth was a little dry and I did not want to breathe through this thing any more. I tried to just lift it up, but one of the clasps came undone immediately, and I could not get it back on properly. That, and I was afraid I’d somehow broken the clasp, as the technician had been the one to put it on and I didn’t have a clear idea of how it attached. I called the technician and said I needed a drink of water. The CPAP machine stopped, and she came in, explaining it was 5am and time to wake up anyway. I did manage to capture a quick picture of the morning after.

Remember, your technological and biological distinctiveness WILL be added to our own.

So, a lengthy wire removal process later, I was in the bathroom to wash the glue off my face from the wires, had my order for a CPAP machine, and was off to the parking garage.

Since my doctor first suggested the sleep study, I must admit I’ve been nervous. Not just about the actual study itself and whether I could actually sleep in that sort of environment, but also about the CPAP machine. But I’ve talked to a few other people who have a CPAP and it’s legitimately changed their lives. And after getting over my own preconceived notions and prejudices about the machines and the need for them, I’m pretty excited. I’m sure there will be some struggles to get used to it, but even with the brief usage of it I think it’s going to be a good thing in my life.