Yore Health, or the importance of not dying
Now, I’m no expert and I’m certainly not a doctor, but I am still breathing and that puts me one up on approximately 95% of the people who ever walked the face of the earth.
So, listen up — I was having some fairly significant problems getting enough sleep last year, but I put off going to the doctor because I was busy. I put it off for about six months and by the time I realized it was imperative I set up a doctor’s appointment I was just barely able to get to work on time and my work was not up to the standards I normally set for myself.
I have a couple of co-workers who have sleep apnea and through conversations with them I realized it was likely I had the same condition.
First off Obstructive Sleep Apnea is basically a condition where the throat becomes blocked by soft tissue during sleep. Normally your muscles hold the throat open but during sleep those muscles relax and the throat opening narrows.
For most people that isn’t a problem, but for some of us it is enough of an obstruction that we can’t breathe sufficiently and our blood oxygen level drops. When that happens the brain increases the effort to breathe and generally this wakes you up. After normal breathing resumes you drift back to sleep and the pattern repeats. Sometimes hundreds of times an hour. What this means is that you never really reach the deep level of sleep that your body needs to restore itself. You can find more information about sleep apnea at sleepeducation.co m.
A lot of people who have sleep apnea don’t realize it and consequently they suffer needlessly when there are several treatments that can help. The most common is a CPAP (Constant Positive Air Pressure) machine which is effective for about 70 percent of people with obstructive sleep apnea. For one thing it is a condition that can sneak up on you. Particularly as you get a little older and maybe you put on a few pounds what begins as an occasional restless night can progress to the point that, like me, you literally go months without a full night’s sleep.
You probably won’t know this because you are in bed for eight or nine hours and you are more or less unconscious, but being unconscious and being asleep are two entirely different things. Most of the years that I suffered with sleep apnea I thought I was sleeping normally. I was kind of surprised to find after I got on a CPAP machine that I actually sleep a lot less than I used to. I used to stay in bed at least nine hours. Now it’s more like seven.
When I finally got around to seeing the sleep doctor he set me up to do a sleep study which involved nothing more than showing up at the clinic, letting them wire me up like a Christmas tree and going to sleep. I mean there is really nothing to this. The clinic I went to has rooms which are I would say somewhere between a Best Western and a Holiday Inn. They even have television for you to watch while you drift off to sleep if you want to.
I showed up and got in my sleep clothes which — in this case meant a t shirt and a pair of shorts. They probably wouldn’t throw you out if you showed up in g-string and pasties, but for the sake of modesty they don’t recommend it. After a little while they came in and attached monitors to my chest, legs, face, skull, and finger.
I say there’s nothing to it. I can see where a person with claustrophobia would not like having sensors glued on his skull and face and probes inserted in his nostrils, but considering the alternative, I just didn’t mind.
The probes in the nose are there to monitor the rate you breathe in and out. The sensors on your head and face are to monitor your sleep state. They record your brain waves and the twitching of your face muscles. The chest sensors are for two things; one is they record an EKG of your heart but they also monitor the expansion of your chest. The sensors on your leg are to see if you also have restless leg syndrome, while the one on your finger is to monitor you blood oxygen level. While you are sleeping they are monitoring these readings constantly. I did ask about that.
Right before I went in to the sleep clinic there was a story in the news about a fellow who died during a sleep study. Now, I’m fairly polite, but I’m also fairly direct. Before the fellow got me all wired up I told him about the news story and I asked him, “Have you ever lost one?” He told me he had never had anybody die on him, but he did tell me that recently he had to interrupt a sleep study and send a patient to the emergency room because of what he was seeing on the monitors. That was good enough for me.
I thought I would go to sleep immediately but after about an hour I was still tossing and turning (despite the fact that I had gotten up early for several days in a row and was completely exhausted). They gave me a sleeping pill and I guess it put me out pretty good. When I woke up I felt like I had slept better than normal and since I hadn’t woken up during the night I thought I had wasted everybody’s time. As it turns out I put on quite a show. I guess the sleeping pill had me more zonked out than I realized, but when we went over my results it was evident that I snored up a storm.
One thing that surprised me was the effect it had on my blood pressure. My blood pressure has consistently been a little bit high since I was in high school. It’s never been high enough that anyone ever thought I needed to be on medication, but it has been around 135/90 for a long time. I have a blood pressure cuff and I use it. Normally I use it at the end of the day on the assumption that that is when it would be at its highest, after all of the days stresses.
At the sleep study they took it before I slept and after. Before it was around what I considered typical, 130/87. In the morning — after a full night’s sleep–it was 157/113. I had never thought about taking my blood pressure immediately upon waking, so it came as kind of a shock to see the effect that struggling to breathe all night long had on my blood pressure. Now that I have been on the machine for a few months my blood pressure is running at about 120/80. Much better.
The thing that was most disturbing though was when they showed me how low my oxygen level had dropped. Normally 90 percent or more of your red blood cells should be carrying oxygen. My level dropped below 60 percent. When they told me that is in the range that they consider life threatening and that it puts you in pretty serious risk of heart attack or stroke they really got my attention.
For one thing my father was only forty-nine when he died of a heart attack while he was sleeping, for another a cousin of my who is a few years younger than me had recently had an aneurism in his brain and was still in a pretty critical state (he has since made continual progress towards what we think will be a full recovery, but it is a slow process). The other thing the doctor said was that until they got me on the CPAP machine I shouldn’t drink because a couple of beers could be the difference between waking up and not waking up.
For about six months prior to this the only way I felt like I could get any rest was to have a couple (or three or four) drinks at bedtime. After this I didn’t have as much as a single glass of wine until I got on my machine.
The CPAP machine is a pretty simple idea. I’m sure the engineering is more complicated than it sounds but basically all it does is apply enough air pressure to force you air passages open. What this involves is a mask you wear over your nose that has a tube that runs to a little machine about the size of a toaster that pumps air in you all night long. It is actually sophisticated that it pulses the pressure up and down as you breathe in and out so your breathing feels normal.
Mine has a humidifier attached to it to keep the air moisturized so my nose doesn’t dry out as I sleep. I’ve had a mild cold since I’ve been on the CPAP machine and like a lot of people the pollen hit me pretty hard this year. I was pleasantly surprised to find that the machine seems to alleviate minor nasal congestion pretty handily. Both times I went to bed stopped up and woke up breathing easy.
Now, before I got the machine I had to go back to do a second sleep study so they could set my prescription for the CPAP. While I slept they calibrated it to ensure the pressure was right for me. There is a pretty broad range of pressures that can be effective so they want to be sure they set it at the lowest setting that will work for you personally. Mine is about average, one of my co-workers machines is set almost twice as high as mine. It really is a very individual thing so I understand why they want to go to the trouble of rigging you up for the full monitoring procedure a second time. The night we set my prescription up was the best night’s sleep I think I have ever had.
Now that I’ve been on my machine for a few months I really do feel much more alert and I have a lot fuller day. Instead of waking up feeling hung over and fuzz-brained whether I had anything to drink or not I actually wake up before the alarm goes off on most days. Prior to getting on the CPAP machine I didn’t wake up so much as “come to” and usually I could look at the clock and see that the alarm had been going off for at least half an hour, sometimes more. Sometimes much more.
So in closing, remember that if your wife or husband snores loudly it’s not funny like in a sit-com, and it’s not something they do just to annoy you. It really can indicate a pretty serious health condition (sleep apnea is the most common but there are others) and it’s worth checking it out.
For one thing sleep apnea is one of the few health conditions I can think of that is so readily and effectively treatable. Back when my father died no one had ever heard of such a thing as sleep apnea. It’s possible he could have lived another thirty years if he had just had a CPAP machine. Kind of a sobering thought for a forty year old man and the main reason I haven’t failed to use the machine for even a single night since I got it. If there is the slightest possibility you have sleep apnea you really should get it checked out.
Edwin E. Smith is a poet, heckuva writer and all around swell guy. Send him an email at email@example.com or visit him on the Internet at edwinesmith.com