On a summer night in 1974 a 10-year old kid was trying to fall asleep on his back. That sleep typically didn't come easy, and was often punctuated by a snore so loud that it woke him up. Knowing the stories about his own Grandpa, who snored loudly until his death at 91, the boy figured it was just something that happened to people in his family. He finally was able to settle in, roll over, and fall asleep on his stomach.
By 1980, the same kid was a sophomore in high school and had difficulty concentrating or remembering details in class. He also fell asleep easily at his desk on a number of occasions during the afternoon classes. "Boring class," he thought, "and nothing I would want to know anyway." A 20-minute nap most every afternoon was enough to take the edge off his sleepiness before he went to work. He also continued to snore at night, like his Grandpa, and sometimes when he was on his stomach. A good night's sleep was rarely a good night's sleep, and he tended to wake up worn out and tired. "I'm not a morning person," he thought. "I just need to sleep more." But most of the time that didn't help either. He began drinking black 7-eleven coffee as a junior in high school, to get himself started in the morning. Sitting in one place and reading a text book would typically put him to sleep in 10 minutes. "I'm just not a strong reader I guess," he told himself. He graduated from high school in 1982 with barely enough credits to pass.
By 1990, while in college, the man had become adept at maintaining himself through a tough study schedule despite his constant need for sleep. Naps before study hours would take the edge off his sleepiness and he was able to write papers and do research well into the night - finishing the session with a two or three hour catnap before classes started. He continued to snore, which his new wife was happy to remind him of, but he tended not to believe her as she woke him up numerous times with her own snoring. "It's probably her and she doesn't know it," he thought to himself. "Not my problem...I'm thin and in great shape. Can't be me." He was frustrated at how easy the college course material seemed to come to most of his classmates, while he struggled with a lot of the details and had difficulty remembering much of what the instructor said. He was a horrible note-taker, which only compounded the problem. Yet, through hard work and putting as much concentration as he could into his course load, he prevailed and completed his bachelor's degree in 1991 with a grade point average well above what he expected.
By 1997 the man was in a new career and in the best physical condition he had ever been in. But he continued struggling to get enough sleep; that part of his daily routine seemed to get tougher and tougher to pin down, and he was more tired than ever. "You still snore," his wife would tell him. "It keeps us all up at night." Sometimes he would need two naps during the day, as he just seemed to drag from his main job to his side job that he worked 3 evenings a week. "I'm getting enough exercise," he said to himself. "Maybe I'm overdoing it." He toned down the amount of exercise he was getting, but sound sleep continued to elude him. As time went on he got heavier. Then the problem got worse. The snoring became so bad that nobody could sleep nearby. He was tired every morning after 8 hours of sleep, and was never able to "catch up" from afternoon naps or on the weekends. Having children only highlighted the growing problem, as he now tended to their varied needs during the night. What little sleep he was getting before now became even more fractured.
By 2005 the man was overweight and fighting high blood pressure. His sleep patterns were worse than ever, and he tended to grab shut-eye whenever there was an opportunity. Black coffee was a constant companion, morning to night, as he drank seven to nine cups per day. He started wondering if his problem was more than just being overweight and middle-aged, as he remembered always snoring at one time or another.
After falling asleep during a meeting at work in early 2006, he sought help from his doctor - who quickly referred him to a sleep center at a large hospital. After the initial consultation with another doctor, he was given an appointment for a sleep study. This test would not only determine if he slept, but also how well.
When he arrived for the overnight session, the technician walked him through what was going to occur that night. "We will hook you up to all this equipment," he said, pointing at a cart filled with sensors, wires, and neoprene belts. "Together they will read your brain waves, face movements, leg movements, and the amount of oxygen in your index finger. There is also a microphone above the bed," he said, pointing to the headboard. "All this stuff will tell us what kind of sleep you are getting." The equipment included:
- An neoprene effort belt that would measure breathing by stretching back and forth during inhaling and exhaling
- Nasal cannula to measure temperature of the air coming out of his nose
- Disc-shaped sensors that were attached to his head and arms to measure limb movement during sleep
"We did find something," the doctor said later in the morning while showing the printout results of the overnight study. It turns out that the 40+ years of crummy was occurring for a reason. "See here where the equipment is measuring how much you breath? You stop breathing for between 11 and 15 seconds, and you did a lot of that all night long. That's 41 times per hour where you stopped breathing. The effort belts are telling us here and here -- [he pointed at two lines] -- that your chest and abdomen are still trying to breath, but that effort gets more and more shallow with each breath. Eventually nothing is getting through, and you stop breathing altogether. Something is keeping you from getting oxygen into your body. All the while the existing oxygen levels in your blood are dropping way below normal. Because your oxygen is low, your heart gets stressed out from trying to keep a rhythm; but it has nothing to work with. After a while your brain says 'enough's enough,' and it forces you to inhale - which makes you snort very loud. Once you start breathing again the heart starts beating faster to get more oxygen into your system; that increases your blood pressure. Your brain is waking up all night long, even if you don't know it. There is no doubt in my mind that you have Obstructive Sleep Apnea, and a significant case of it."
Significant Obstructive Sleep Apnea - something blocking air in the throat, and a really big medical problem. It turned out that the man's nightly sleep was no sleep at all. He was waking up tired in the morning because he was engaged in a nightly war for nearly 40 years; his body was fighting the battle for sufficient oxygen all night long, stressing out his heart and starving his brain of the oxygen it needed for concentration and short-term memory. CPAP - Continuous Positive Airway Pressure - was the method his doctor used to clear the man's obstruction, which was likely a mass of soft tissue in his throat that relaxes and flaps down across the airway when he slept. He was told the change would be amazing.
And they were right.
A week later, he was back at the hospital to sleep with a CPAP machine for the first time. The technician once again strapped him into the belts and glued on the sensors. This time he also placed an air mask over the man's nose and mouth, and started a low pressure application of air into the mask. Before he knew it the man was asleep, and didn't wake up all night. He felt a bit groggy in the morning, but not bad at all. A shower and fresh clothes made him feel much better. With an hour before meeting his doctor, he went downstairs to get some pancakes and coffee at the hospital cafeteria. It was then he noticed the true difference in a good night's sleep.
One cup of coffee hyped him up so heavily that he could barely sit still.
It was a stunning moment, one that told him a new way of life might be at his fingertips. Getting the right amount of oxygen in his system overnight made a huge difference, huge enough that caffeinated coffee no longer had to do the dirty work of waking him up. The doctor's review of the results proved that the CPAP machine was exactly what the man needed to get a good night's sleep. He was issued a machine that day and has been using it ever since. Within a year he noticed that his alertness level had increased, because his body was no longer struggling for the oxygen levels it needed merely to survive. A good night's sleep now was almost a universal experience.
I'm writing this to say that man was me.
This story is from personal experience; the first time I shared it as a speech with coworkers I could barely get through it without crying. Why? Because CPAP changed my life. I am more conscious of the world and my surroundings. My ability to make quick decisions increased. Even six hours of sleep now is more restful than the 8-10 I got before CPAP. While I still drink coffee, I don't drink near as much as I did in the past. With the machine I'm rested and ready to get up to face the day. Without it I wake up strung out and groggy. I chose a device that only attaches to my nasal openings, rather than the more-common full-facial mask, because of how the bridge of my nose is shaped. As I have lost weight, I find the sleep is becoming even more effective. Between CPAP and weight loss, I feel better in my mid-40s than I did anytime before that.
Like me there are many people who have discovered that they can feel better and function sharper, just by using CPAP. If you snore, are being told you snore, or feel like your sleep at night is worthless, I urge you to get a sleep test. If you have a machine and cannot stand the mask you were issued, try a different style; there are many kinds to choose from.
A satisfying trip to Slumbertown may only be a phone call away.
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Photo courtesy of publicdomainphotos / CC BY 2.0
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