'Ello, My Name Is Bruce and I Am a Hose Head

'Ello Bruce...

I mentioned last week that had to strap a CPAP contraption on my head before I went to sleep and I promised I'd explain.

I have Obstructive Sleep Apnea (OSA). Sleep apnea in general is defined as a condition characterized by episodes of stopped breathing during sleep. Obstructive sleep apnea occurs when the soft tissues in your throat relax and close off your airway. Sounds like a lot of fun doesn't it? It's a shame I'm asleep and missing it.

It all started out with snoring. It was occasional (I think) and not terribly loud. Then it progressively got worse. I wasn't quite keeping my wife from falling asleep but if she woke up for some reason and I was sawing wood, well, let's say she had a hard time going back to sleep. Then it got to the point where she started wearing earplugs to bed. Eventually she told me she was (sort of) getting used to the snoring but it was the absence of snoring that was really starting to bother her. WHAT? I can't win. She explained that I'd be snoring along for a while then all of a sudden I would stop breathing. There would be silence for a long time then I'd gasp for air and start breathing again. I told her maybe she should stop holding that pillow over my face. She wasn't amused. I asked how long she waited and watched before I started breathing and if she considered maybe, I don't know, shaking me or something. She was even less amused. I had a medical appoint scheduled for another issue and I promised I would bring it up.

I mentioned the situation to the doctor and he gave me a referral to a sleep specialist. The sleep specialist had me go for a sleep study. For those of you that don't know what a sleep study is, it's when you go to a strange place where strange people you've never met show you to a strange room and tell you to change into a hospital gown. Then they take you to a room and glue electrodes all over your head, chest and legs, they stick a couple probes up your nose, wrap a band around your chest, and clip a pulse-ox meter to your finger. Then they take you back to the room where they hook all the electrodes and wires to a box on the wall. They tell you to get into bed, which is about the time you notice the video camera on the wall pointing at the bed, and they say "make yourself comfortable and have a good night's sleep, I'll be in around 5:30 AM to wake you up". Then you spend the rest of the night tangled in wires feeling like Frodo after Shelob got him in the spiderweb.

The sleep study found that I had moderate sleep apnea. I stopped breathing an average of 23 times an hour. The doctor discussed treatment options and we decided on using CPAP which stands for Continuous Positive Airway Pressure. Then he sent me for another sleep study. Oh for Chrissakes! This time the study is called a Titration. It's when they determine the optimal flow rate of air that will keep your airway open. I don't know how it was possible but the second time was far worse than the first. The results of the study indicated that I slept three hours out of the eight that I was there but somehow they managed to get enough data. Then I got to take the doctor's prescription to a Durable Medical Equipment (DME) supplier to get my CPAP equipment and instructions for use.

I was fitted for a CPAP interface, more commonly referred to as a mask, that is strapped to my head and connected by a hose to the CPAP machine which supplies air to the mask.

Here's my machine being modeled by little Mikey:

Here's the interface I've been using since I started therapy six months ago as modeled by Wayne:

And this is what it felt like during the first couple of weeks of treatment:

Eventually, I did begin to get used to it and really did start to sleep more or less normally. Some nights are better than others but I have started to feel better during the day. It's not a dramatic difference but I really noticed on the mornings after the one or two times I slept without the CPAP. I woke up feeling hungover - and I hadn't been drinking. The hardest part is getting used to it because you spend your whole life just going to bed. Now you have to get all this crap ready and don your gear before you can settle in. It sort of kills spontaneity and it makes you look really really sexy. It's also rather daunting to think that this is a condition that's not going away and that the CPAP is a treatment, not a cure. There are mornings, like today, when you get up after a particularly bad night and think that you just can't do this another night. But you do. It's not the best treatment to have to live with, in fact I frequently think that it involves smoke and mirrors and black magic. The whole education, patient information, doctor, DME, and insurance situation is more often than not extremely frustrating and is set up to prevent the patient from having control over their own treatment. Right now, it's the best thing available.

Talking to others that are dealing with this condition really helps and there is a discussion forum that has been particularly supportive. The people at CPAPTALK.COM have been absolutely amazing and I honestly don't know that I would still be doing this without them. All joking aside, Sleep Apnea is a very serious condition that can lead to high blood pressure and other cardiovascular disease such as stroke and heart attack, memory problems, weight gain, impotency, and headaches as well as job impairment and motor vehicle crashes.

Information can be found at the American Sleep Apnea Association and by search the internet. I'd also be happy to answer questions if I can.