Strike Three, But I'm Still in the Game

About a week ago, I received a not unexpected diagnosis of severe obstructive sleep apnea. This form of apnea (Greek for "without sleep") means that many times an hour, I stop breathing because of relaxed soft tissue in my throat. In yesterday's New York Times, by coincidence, Jane Brody's regular column was devoted to sleep apnea, so I learned that as many as 18 million people in the US have apnea and only 10 percent are diagnosed.

This is the third major health problem I've had in my short thirty-four years. The first, well, despite my well-known openness, I'd rather not discuss, but it involved minor surgery and a long uncomfortable recovery. The second was Hodgkin's Disease, which I've documented all over my site. Sleep apnea may be one of the easiest and most annoying, because there's a simple cure: a continuous positive airway pressure (CPAP) machine.

The CPAP pushes a very small amount of positive pressure through a mask you wear just over your nose and that small pressure--8 cm in my case--makes sure that even when you lose all tonality in your muscles in deep sleep that your soft tissue doesn't obstruct your ability to breath.

The medical technician who advised me and my wife Lynn on the equipment said that insurance companies won't pay for outright purchase, but insist on a 30-day lease, followed by a purchase. Why? Because even though a CPAP machine works for almost everyone--surgery is painful, not a complete solution, and often not successful--it takes some adjustment. Twenty percent of people who get a CPAP return it, even though they're signing off on a reduction in their lifespan by 15 or 20 years or more, as well as a declining quality of life as they approach that shorter end.

The machine isn't hard to use, and after a night in the hospital's sleep study area on Monday night to get the titration--the amount of pressure I needed--I used it for the first time on my own last night. It felt a little strange, mostly good. I got to sleep right away, and slept better than what my sleep experts tell me has probably been 15 years. Who knew?

Friends ask me how I diagnosed, and I credit two people: my wife and my doctor. My wife was somewhat fed up with my snoring, but also worried about how severe it sounded. My doctor listened to symptoms and sent me home with a portable sleep tester: an oxymeter that measured my blood oxygen level over two nights. The sleep clinic analyzed this, found a few disturbing but small signs, and sent me off to a full night sleep study.

During the sleep study, they cover you with from head to toe with electrodes and sensors: polysomnography! They monitor you while you sleep to see whether you wake, what level of sleep you descend into, and your body movements. Apparently, when on my left side, I have virtually no apnea, but it's impossible to always sleep on one side, as nicely as that might solve the problem.

The sleep study was interpreted by a sleep doctor, and I met with an APRN (advanced practice registered nurse, otherwise known as a nurse practitioner) who went over the results and recommendations.

It was a good process, and I recommend it highly to anyone who has been unable to get a good night's sleep, has snoring reported (a symptom but not exclusive to those with apnea), and has frequent problems with alertness during the day. Apnea can also cause memory loss or disorientation.