I got up this morning, did my usual stuff - shower, dressing, cleaning the poop one of our naughty doxies (Brandi!) left on the top stair rug, had my coffee, drove to work - and the draggy, sluggish exhaustion that usually accompanies every move - was gone.
And I owe it all to a little black machine with a long plastic hose and a Hannibal Lecter-looking face mask called CPAP.
CPAP stands for 'Continuous Positive Airway Pressure'. It holds the airway open so air can pass freely to the lungs. It's a treatment for obstructive sleep apnea (OSA), which I suspected I had for literally years, and just confirmed yesterday that I do in fact have it.
What is OSA? Normally when we fall asleep, the muscles in our upper airway relax. In unaffected folks, this isn't a problem because there is enough of an opening for air to pass in and out of the lungs. In patients with OSA, the opening is obstructed due to excess tissue in the airway or anatomical differences in the upper airway. When airflow is restricted, it leads to shallow breathing and episodes of absent breathing (apnea). The body isn't going to let you die from lack of oxygen, so you wake up just enough to restart breathing. These waking episodes prevent you from getting the restful REM (rapid eye movement) sleep so important for rejuvenating your body and mind.
That explains why even when I sleep for 10-12 hours (which I've done lately on the weekends), I *still* feel like sh*t. It's the quality of the sleep, not the quantity, which matters.
I knew about sleep apnea, but resisted getting tested for one reason: I didn't want to have to wear the scary space-age contraption used for therapy. The turning point came when I visited my friend Jeanne and happened to mention my sleeping problem. She told me that her husband had the same problem and slept with a CPAP and now he feels great. I said, "Yuk, he can sleep with that horrid thing on?" She said it was quite small and he acclimated quickly to it. I went upstairs with her to look at it and was surprised to see it was much smaller than I imagined. So I finally made an appointment with my primary care physician (this being Kaiser, everything you do has to go through the 'gatekeeper' of your family doc) and got a referral to the Sleep Disorders Center.
I thought I'd have to wait forever (it is, after all, *Kaiser*) but was pleasantly surprised when the call came a few days later followed by a letter. I had to make two appointments; one for a one-hour class and issuance of diagnostic equipment for a home sleep study, and a second to return the equipment and receive the CPAP if the results are positive. So on Wednesday, I drove to Kaiser for the 4 p.m. class. I joined six others in a training room. First we watched a video on sleep apnea, sleep study, and CPAP. The guy in the video was rhapsodizing about how easily he fell asleep for the sleep study and CPAP use - yeah riiiighhhht, I thought. After the video, a technician named Kim talked to us about apnea and revealed that she uses a CPAP machine and it changed her life. When she doesn't use it, she definitely feels the difference, she said. Kim was followed by Bert, a hilarious tall black tech who made me laugh. He confided that Kim was a real crab when she didn't use her device. He chose me as the test model to hook up the diagnostic equipment we would use that night and to demonstrate the CPAP mask. He must have repeated "if your results are positive" about 100 times when talking about the CPAP device -- because only if one tested positive from the home sleep study, would one receive the CPAP therapy. The therapy consists of a 7-day trial with Kaiser's machine and then your very own machine is ordered for you.
After the instruction, we all left with our little kit containing the diagnostic device. I had to go to my beauty shop to remove the acrylic nail on my left middle finger because the monitor for the finger couldn't read through acrylics. Naturally my nail lady was off, so the eyebrow lady (who hadn't done nails in years) had to wrench it off. Ouchhh.
We were told to put the diagnostic stuff on at 10 p.m. Shortly after 10, after my shower and brushing my teeth, I put on the 3-belt contraption consisting of a meter thingie, finger device and two plastic jobbies that went in the nose. I can't tell you how it works, but what it does is monitor your breathing and oxygen use while you sleep.
The catch: trying to sleep! I felt very uncomfortable with that junk on, and my finger hurt where my nail was sandblasted off. By 1:30 a.m. I was still awake. I got up 3-4 times during the night to pee and drink water. I didn't think I slept much at all, although I do remember snatches of dreams. I awoke at 5 a.m. and again at 6:30 when the alarm went off. I worried that I didn't sleep enough to get a reading.
We were all supposed to report to Kaiser by 8 a.m. I was 15 minutes late due to traffic, having bailed from the 15 freeway and creeping on surface streets to avoid the congestion. One of my classmates was waiting in the outside room; I caught a glimpse of another inside the training room, being shown the CPAP machine. Ah, so he was positive. While waiting, I saw another classmate - a woman - leave with her telltale CPAP bag. The fellow waiting with me told me that his twin brother used a CPAP and he had the same symptoms, so that's why he got tested.
He was called in and emerged with the CPAP bag. "My insurance doesn't cover the machine," he said woefully. Please let my insurance cover it, I prayed. (Later I found out that it does! Thank you, County!)
My diagnostic stuff had been taken away so they could read it. I was called in and the tech told me I was positive. No surprise there. She informed me that I stopped breathing 12 times an hour, which put me in the "mild" category (6-14 times per hour). Moderate was 15-29 and severe was more than 30. However, my oxygen drop rate was 21 times an hour, which placed me in the moderate range. She said it was 'down to as low as 80' which was in the severe range.
She helped me try on the mask from the loaner set and adjust it, and then gave me the kit and sent me on my way.
I spent the day draggy and tired - more so than usual due to NO good sleep the night before - and was more than ready for bed. After shower and toothbrush, I put on the mask. I thought the dogs would bark - they usually do when we look different - but they didn't. Then I turned on the machine and lay down. It felt so weird. The face mask pressed into my nose. I had to adjust it a few times to make it less uncomfortable. I had cruised the Internet for blogs on CPAP and had read it helps to put saline drops in the nose to keep it moist, so I did that.
Falling asleep was hard due to the strangeness of this device on my face. Sleeping on my back was okay - when I broke my rib in 2005, I had to learn to sleep on my back, so it wasn't so unusual. My husband was absent due to a late acting job, so it was just the dogs and me.
I remember hearing the dogs bark and was vaguely aware of my hubby in bed, so I woke up a couple times. Then morning came and I removed the device, discovering a small scrape on the bridge of my nose where the face piece had pressed in too hard. My throat was dry and my nose slightly stuffy. I did my morning routine and that's when I realized - I'm not exhausted!!!I am very excited about this treatment. If I feel this good from the loaner, my own personal machine should be even better. How wonderful to have energy, not feel shattered, and be excited about living again!!
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