As you might have read in the V-Day post, during my last yearly check-up I told my doctor that I thought I might have sleep apnea. Sleep apnea is classified as a disorder that occurs when a person’s breathing is interrupted during sleep. My wife suggested that I speak with my doctor because there have been many nights where she would hear me gasping for breath and wondered if I would start breathing again.
Initial Consult – Primary Physician
My doctor asked me some questions about why I thought I might have sleep apnea, including; after waking up do I still feel tired [yes], do I have trouble falling asleep [no]. I explained that I am often tired, but I have a long commute, I get up at 5:30 to exercise in the morning, and have young children, so I am not sure if I would be refreshed even if I slept well, he laughed. I also explained that my wife hears me gasping for breath while I sleep, that sealed the deal, I got a referral to an Ear Nose & Throat doctor. And some preliminary things to try to do to help the apnea abate – exercise and lose weight, avoid alcohol and sleeping pills, change sleeping positions (avoid sleeping on your back). I told him I was exercising and losing weight at that point I had lost 10 lbs already, I drink in moderation and I sleep on my stomach and my side.
Secondary Consult – Ear Nose & Throat (ENT) Doctor
My ENT and I went through some of the similar questions and then he did a physical exam of my nose and throat and took my height and weight (6’4, 230). He mentioned that the first thing I needed to do is keep working on losing the weight, the more weight you carry, especially on your throat and face, the easier it is for your throat to close as it naturally relaxes while you sleep. He also told me that the structure of my mouth may be a factor in why apnea would present in me, my mouth is somewhat narrow and crowded and the top of my mouth (palate) runs far back. I also told him about what my wife had reported and I got referred to take a sleep study at our local hospital and spoke about the potential next steps that we could try after the results came back from the study, which were the following:
First Sleep Study
I went for my first part of my study at my local hospital, I arrived at 9:30, I was not allowed to have any coffee after noon that day, not a habit for me, but every once in a while I like a nice cup of coffee in the afternoon, I also needed to shower and shave so that the electrodes would be able to stick easily. The technician asked me to change into my sleepwear and then began the process of putting the electrodes on my chest, legs, head, and neck. I needed to lay on my back and try to fall asleep, I will admit I had a hard time, I am a side or stomach sleeper. I felt funny and limited in my motion with the electrodes on, but I was able to fall asleep, eventually. I woke up in the morning and I’ll be honest I felt awful, I thought I had slept for all of about 5 minutes, I was flat out exhausted.
I got the results about 7 days later, the doctor let me know that the minimum number of incidents per hour one needs to be classified with sleep apnea is 5 per hour (a incident is classified as being woken up for 10 or more seconds), my number is 42. Basically I was waking up (not physically) once every 75 seconds. The apnea was not allowing me to get into REM sleep, or true rest. Needless to say I was not surprised, especially after the way I felt the morning after the study. The doctor asked how I wanted to proceed, I asked if he could consult with my ENT, but I wanted to try the CPAP mask first rather than the surgery, and after conferring with my ENT they both agreed. I was scheduled for a follow-up study with the CPAP mask the next week.
Second Sleep Study & Mask Fitting
I went through the routine like I had for the first study, but this time I was fitted with the CPAP mask and lied down to sleep. It was somewhat strange to have something on my face as I tried to fall asleep and the machine makes has a steady hum to it, but after a while I got used to the mask and the rhythmic sound of my breathing started to put me into a sleep. I again was on my back, but this time I didn’t feel nearly as constrained for some reason and I woke up without an alarm at 5:30 am (that never happens) refreshed and ready to get my day going.
The morning after the study, I had another follow-up with my ENT. He commended me on my weight loss, I am down to 220 and encouraged me to stay on the exercise and diet plan, another post for that one, and we spoke about next steps. I would get the formal results of the follow-up study in 7 to 10 days and at that time I would also get the physical machine that creates the airflow to the mask as I sleep. My doctors hoped that after a few more months of diet and exercise and better sleep with the mask, the apnea incidents will be reduced, at that point we will have another follow-up study done to confirm is the apnea has been reduced and we can start to discuss if a surgery can help reduce the number of incidents even further.
In my next post I will give you the update on getting the mask and machine at home, what my wife thought of sleeping next to Darth Vader, and a progress report.