For 49 years and change, sleep was something that came naturally.
Lately, though, the nightly ritual involves mechanical help. After my head hits the pillow, I pull a plastic face mask over my mouth and nose before securing the straps around my head. The face mask is attached to a flexible tube that stretches across my pillows and snaps into a device on the nightstand that forces air into my lungs with every inhalation.
Why all the fuss? Because I was recently diagnosed with sleep apnea, a disorder that afflicts an estimated 22 million Americans and nearly 1 billion people worldwide according to medical groups and studies.
Sleep apnea, as defined by the American Sleep Apnea Association, is “an involuntary cessation of breathing that occurs while the patient is asleep.”
These breathing stoppages occur hundreds of times during the night and can last from 10 seconds to a minute, though the person is unaware because they don’t wake up. The result is a situation that doesn’t allow for deep, restorative sleep, which can lead to daytime drowsiness and fatigue. If untreated, there’s an increased risk of high blood pressure that can trigger a heart attack or stroke.
For years I’ve known I was a prolific snorer. However, not everyone who snores has sleep apnea. But a few months ago, after my girlfriend told me I exhibited those telltale stop-start breathing patterns, it was time to see a doctor.
Which is how I found myself in the office of Fresno sleep specialist Arnold Rugama.
The first thing I did was fill out a questionnaire. It asked me to rate, on a zero to five scale, how often I wake up feeling tired or with a dry mouth, take daytime naps or the likelihood of me dozing off at a stoplight.
My answer to each query was zero or one. I wake up feeling refreshed almost every morning, very seldom take naps and have never fallen asleep with a steering wheel in my hand. If these were the indicators of sleep apnea, then perhaps I could breathe easy.
Nor am I obese, have high blood pressure, drink excessively, smoke cigarettes, take sedatives or experience frequent nasal congestion. Each of these factors can lead to obstructive sleep apnea, the disorder’s most common form. Call it denial or foolish pride, but I walked into Rugama’s office thinking this was all a big mistake.
The look on his face when I related my girlfriend’s observations told me something different. Next thing I knew, I was being referred to a treatment facility called SleepQuest, which furnished me with a home diagnostic test.
The home sleep test consisted of a small computer, worn around the wrist, attached to a finger probe that measures oxygen levels. Another sensor, taped to my chest, recorded my breathing patterns.
The results were pretty conclusive. I had an apnea hypopnea index of 38.1 and a respiratory disturbance index of 40.4. (These are measurements of how many times per hour my body responded to breathing stoppages.) Both fall well into the range of severe sleep apnea. To top if off, my oxygen saturation levels were described as “abnormally low.”
Because most people diagnosed with sleep apnea have difficulty staying asleep, wake up tired, feel drowsy throughout the day, require massive caffeine intake to stay alert or are generally irritable – and I don’t or am not – Rugama considers me a fairly unique case. (OK, maybe the irritability part has some merit.)
“You’re one of the two biggest outliers in my 20 years of doing this,” he told me.
Great. What a time to be a statistical oddity.
From here, I could have requested having my sleep monitored overnight at a sleep center or sought a second opinion. But since these expenses were coming out of pocket (hello $2,000 deductible), it seemed best just to seek treatment.
Next thing I knew, I was visiting various medical supply websites to purchase what’s called a BiPAP machine. (My advice to anyone who does this: haggle.) BiPAPs are similar to the more commonly known CPAPs, except that BiPAPs deliver different air pressures when you inhale and exhale.
It took more than a week to get used to sleeping with a face mask while a machine pumps humidified oxygen into my lungs. Kind of makes you feel like a cross between Darth Vader and the Creature from the Black Lagoon.
But if the results are a better quality of life, not to mention a reduced risk of a heart attack or stroke, then the preventive measures are worth the minor hassle.
One thing I’ve learned, both from personal experience and research, is there’s no such thing as a typical sleep apnea patient. This doesn’t just affect overweight, sedentary old dudes. Recent studies have shown major increases among women and young men.
And if the BiPAP machine helps reduce my snoring, my girlfriend will certainly appreciate it. Better to sleep with a face mask than with her hands around my neck.