ME and My Sleep Apnea
(The story from the newest member of MEMSA)
by Terri Rogal

Initial Symptoms

        I was just diagnosed with severe obstructive sleep apnea last week.  I had no idea it was that bad.  I thought that perhaps I had a mild case of it because of certain symptoms I displayed.  Initially, these consisted of some snoring and waking up with a start or snorting.  I would also awaken to move or turn over to get more comfortable.  I was always tired, especially in the afternoon at work, in meetings or in front of the computer.  Lastly, I awaken with a headache once in a while. Little did I know how dangerous all these symptoms were.

The Effect

        The effect on me was more embarrassment than anything else.  I would get up on a Saturday morning after “sleeping” seven or eight hours, have coffee, eat breakfast and promptly go back to sleep in my living room chair (continuing to make noises there as well).  I have always been uncomfortable sleeping since I gained most of my weight, always turning over or readjusting myself.  I also do not like to sleep when I am hot.  Not only is that a problem here in Florida, obese people are always a 100 degrees hotter than skinny people (at least it feels that way!).  I was also getting tired in the afternoon at work.  The past two years I have been getting sleepy while driving in my car!  Sometimes I would catch myself going out of my lane or getting too close to the car in front of mewell I did few months ago!  I was one of my long drives over to Tampa to teach and as I was just about to my destination, I was slowing down for a stop light and I must have dozed off for an instant and did not press hard enough on the brake.  The next thing I knew I was bumping into the back end of a pregnant lady in a Volvo.  Luckily, there was only a little tiny indentation from my license plate screw in her rubber bumper.  I kept asking myself:  was it something I ate?  Drank?  My blood sugar?  Now I know the answers.

How I First Learned About Sleep Apnea

        I first learned of sleep apnea from a friend who thought she had it.  While trying to diagnose the many symptoms of fibromyalgia, she got tested for sleep apnea at a local hospital.  As she was filling me in on the test she was about to take, she told me of the symptoms was curious to know why she thought she had it.  My friend listed each and every symptom I displayed which made me wonder if I too could have sleep apnea.  As it turns out, my friend does not have sleep apnea, but I do.  At that time, I just shrugged my shoulders and did not pursue it any further.

Reason for Testing

        As part of my pre-testing and preparation for my upcoming gastric bypass surgery, I was told that I should be tested for sleep apnea.  While filling out the doctor’s admittance form, it said to list all possible illnesses and disorders I thought I may have.  Not only is a person with sleep apnea a higher surgical risk, but having it may also help my insurance company decide favorably to the bypass surgery. 

The Test Itself

        My primary care physician set up the polysomnography (sleep study) with the local hospital’s sleep center, which happened to be three blocks from my house.  I arrived at 8:30 p.m. to check in with a pillow for my head and a small couch cushion for between my knees should I turn on my side during the night.  We had to watch a video on sleep apnea produced by Respironics before we started our test.  I normally do not go the bed until almost midnight, but had to read a book and try to get into sleep mode.  At 10:30 p.m. my sleep technician came in and fitted me with a CPAP (Continuous Positive Air Pressure) machine to be used in the second half of the split study I was doing.  She told me she would be coming into my room in the middle of the night and put this breathing machine on me that would help me keep my airway open and continue the test the rest of the night.  As I sat upright on the bed with the CPAP machine on, it felt fine, albeit a little confining, I was able to handle it. 
        My sleep technician began to wire me up for the test.  I asked her if she had seen The Green Mile, a recent movie depicting execution by the electric chair.  She said she had not seen the movie but wanted to.  I laughed and told her that while watching the movie, be mindful of what she did to her patients each evening.  I wonder if she has seen it yet?  With all the wires around my head and everywhere else, and straps around my chest, I felt as though I was about to be one of those ill-fated prisoners depicted in the movie.  I carefully lay down on the bed, making sure not to disturb the wires by moving too much.  Normally I turn over so many times in the night; I was concerned I would pull out the wires each time.  My other concern was being cool enough to sleep.  Luckily each room was air conditioned nicely, almost chilly the way I like to sleep and wish I could at home.

Too Close for Comfort?

        All was going well until my tech came in to put the CPAP on me early in the a.m.  The two pillows my head was on were so soft that they came up halfway around my ears.  When she put the nose cup on and the straps around my head and I put my head back down, I felt as though I could not breathe because my face was almost totally covered.  I noticed that in the past five years I have gotten a little claustrophobic in elevators, crowds and in the new diving mask I just bought myself for the swimming pool.  Although I kept telling myself to relax and breath through my nose, everything would be OK, my breathing became more shallow and hurried.  I could stand it no longer and pulled the mask off.  The technician came in because she not only heard me, but also saw me on the camera focusing on my every move.  She told me to relax and she would be back in a minute.  She came back very soon with a different kind of nose apparatus that did not have straps on it.  It only covered the nose and had one small plastic piece that went over the top of my head instead of surrounding my face.  I was able to continue the test the rest of the night.  It was a little odd trying to sleep with a constant stream of air blowing in through your nostrils and trying not to open your mouth at all.  If you did, air would blow out that way and not into your lungs.  We were all roused at 5 a.m. to have all our gadgetry removed and get ready to go home.  I arrived at home at precisely 5:55 a.m., made coffee and chatted with my mother for about a half and hour.  As she was talking to me, I realized how tired I still was and decided I could not function at work in that condition let alone drive there, so I decided to take the day off and go to sleep in my own bed.  I did and woke up three hours later a little more rested than when I arrived in the morning.

The Results

        I was shocked to find out that I had a very bad case of sleep apnea from my doctor’s office.  I was given a copy of the test results at my regular appointment the following week.  I was diagnosed as having severe obstructive sleep apnea and should be tested again and fit if a BiPAP machine would be better for me at home.  In the short time I slept without the CPAP I never achieved R.E.M. sleep, the most restful, and had 247 respiratory “events” which consisted of 137 obstructive apneas where I stopped breathing for at least 17 seconds.  The number also consisted of 110 obstructive hypopneas that lasted at least 19 seconds.  My respiratory disturbance index was 96.5 per hour when the normal RDI is less than 5! 
        The remainder of the night with the CPAP machine on proved to be only a little encouraging.  My RDI went down to 64still not great for sleeping restfully.  I do believe I would do better at home with the other machine.  I was rather nervous the second half at the hospital as well. 

The Future Treatment and Hopeful Outcomes

I have not been fitted with a BiPAP machine as of yet.  My surgeon said he would prefer that I had another sleeps study scheduled with a BiPAP machine because he would like for me to have the machine and be comfortable with it before he goes ahead with scheduling my surgery.  I look forward to getting better sleep and night, remaining awake during the day, not falling asleep at meetings, and not bumping into other cars on the road or ending up in a ditch!  Hopefully with the BiPAP and loosing weight, I will not have to consider any surgery to fix the sleep apnea.  I now know how sleep apnea can affect the body, mind, family and your work if not diagnosed and treated.  I caught it before the sleep apnea damaged any more of my life or my heart.  I encourage anyone who sleeps next to someone that snores or stops breathing, is obese, or has a larger neck to get checked out, it could save their life!  Don’t be afraid, it is worth knowing that there is a reason you feel the way you do.