Sunday, February 10, 2008

Sleepyhead

Good heavens, it's been 10 days or more since I last posted! I've been having adventures in the land of medical devices - have you ever had to deal with a CPAP machine??

The short story: last May (10 months ago now) I was diagnosed with possible sleep apnea and took a sleep test. Symptoms? I couldn't drive the 25 minute freeway commute to work without at least 4 or 5 little narcolepsy incidents, where I had to fight desperately to stay awake at the wheel. It took them until July to schedule a review of the test, which meant August since (as we all know) I was in England and Wales in July. (Gloat.)

In the meantime I was sufficiently frightened by my symptoms that I went back to riding BART to work, having discovered that I can now walk the half mile or so to the station in under 20 minutes, my minimum requirement for a transit commute that doesn't take an hour and a half.

So: in August they told me I had "moderate sleep apnea", based on my May test. However, as we also know, between May and August - I retired. My stress level went down by several orders of magnitude; I quit getting up at 5:30 AM; and I quit falling asleep during the day, because I was getting enough sleep at night! I could drive again! I also learned that, with a relatively minor change to my current meds and personal habits, I might be able to deal with this problem without getting a Continuous Positive Airway Pressure machine (in case you wondered what is "CPAP"). So I made the changes.

All was wonderful and lovely (as our chorus director puts it) for several months, and then I started occasionally (like, maybe every other week) waking up at night out of a horrific dream, and finding my heart pounding. Hmm, thinks I - can these be apnea episodes? I usually find myself on my back, the "bad" sleeping position. And if so, should I take some action? Maybe I need the CPAP machine after all?

Well, it didn't work out like that. The purpose of a CPAP machine is to blow enough air into your throat to keep your breathing tube open. All night. You wear a mask that looks like something out of World War II, and you hook it to a little motor, using a plastic hose a bit over an inch in diameter, which trails you around like an IV drip. So, first, if you need to sleep in a (relatively) silent room, fugeddaboudit - the thing whirs constantly in your ear. Second, every time you shift position the mask leaks; you're constantly fiddling with the thing. Third, you will find yourself - I found myself - constantly thinking about breathing, which makes it impossible to disengage the mind and fall asleep. Finally, having one of the world's less efficient breathing systems, I found myself hyperventilating, a state I once spent several tedious months of behavioral therapy trying to get out of...

Some people can't sleep without these machines; in fact, some people's possession of a driver's license depends on their being under treatment with CPAP. I found myself facing two options: either sleep normally, and occasionally wake up with my heart pounding - or use the CPAP machine and never sleep again (but get lots of fresh air). This is probably an exaggeration; but I'm told that it takes up to 2 months for some people to adjust, and I just wonder how they survive 2 months without a full night's sleep.

I'm happy to say I've talked to my doctor and he agrees that first, my apnea (if it still exists) seems to be under control with medication, and second, that I'm not adjusting well to the machine. I'm getting another sleep test, and unless it's much worse than I think, or my old symptoms come back, I won't have to have the machine.

Part of my problem was that my introduction to how to use the thing didn't mention anybody ever having any problems with it, so I went into it expecting everything to be fine, and spent an entire night trying to fall asleep and failing. I suppose they're afraid if they tell you the truth, you'll go in expecting it to fail. If I ever do have to use CPAP, I'll need to approach it very differently than I did this time.
Which God (or the Great Lobster) forbid.

And that's why I haven't posted - I couldn't write because I couldn't get enough sleep to think. I don't know if you missed me but I missed you!

4 comments:

  1. Stephen7:04 AM

    Glad you didn't need the machine. My dad has Sleep Apnia and uses one, you do eventually learn to sleep through it. I use to ride into work with him when I was younger and would watch him fall asleep as he drove. When he went in for his test they said he has a 33% blood oxygen level. Be careful with that.

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  2. Thanks for your concern, Stephen, my test was nowhere near 33%! I was somewhere between 80 and 90%, and not even all of the time. Apparently I have a lot of small incidents.

    I concluded after I got some sleep and calmed down that I could probably learn to sleep through it, but I don't relish the prospect... having been there, you probably understand how terrifying those "falling asleep at the wheel" incidents are! I'm SO relieved those have stopped!

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  3. Some years ago, I had a couple of incidents of severe "narcolepsy" (as you call it) while driving home from work on I-80 (via the Bay Bridge). I'd never had anything like this before: Almost a sense of dizziness, like fainting, which I had to really concentrate to fend off. This went away, and I had no problem with it until the last five years or so, when it's begun to return a little bit. Something about low blood sugar. Then this happened last Fall: I was driving, alone, to Salt Lake on the first leg of a long swing through the Rockies and back to the West Coast, across those dreary straight-as-an-arrow freeways across the Salt Flats, in the fast lane with a big rented SUV, doing about 70 mph, just meditating and staring ahead. Suddently, the car began jumping and skidding--I was on the gravel shoulder on the left side of the tarmac, leaning about 15% to my left, bouncing on the median (at 70!). I had "nodded off" and the car had drifted about one "lane" to the left. I was able to hold the wheel straight while the vehicle slowed, and I stared around sheepishly to see who might have seen me, but there was only a single "semi" going the opposite direction across the way, and no one had been around to notice. Nothing like this had ever happened to me before. It scared the living excelsior out of me, and now I make sure to scarf down a bottle of that cheap sweet Starbuck's stuff at each gas station island I come to. Better to be a little buzzed than dead!

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  4. Yes, it's terrifying, isn't it? I'm not sure the tendency to fall asleep at the wheel on long road trips is the same problem; I was having these uncontrollable urges to nod off while driving between Oakland and Concord. Rolling across the desert, there's almost an excuse for it. Try driving Highway 50 some time, too.

    The trouble with caffeine as a solution is that it wasn't working for me - I drink a full pot of tea, over 20 ounces, every morning, and it wasn't helping. Fortunately this has stopped happening; but like you, I support the Coca Cola Co. on long road trips. We're planning one to Yellowstone this summer, I'll be interested to see how I do. But my mother invariably fell asleep in the car on long road trips, and I've always done so too. Come to think of it, maybe I inherited the apnea from her.

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