We don’t often post articles here written in first person, but for this piece, it seems most appropriate. It’s about denial, as in “being in denial.” People often don’t want to accept unwelcome news about their job performance, the status of a relationship or—often enough, their health.
I had an experience with the last meaning—in my case, about sleep apnea. You’ve heard of it. You may know people with it. You, like me, may not think you have it or resist the notion—not wanting to be hooked up to a machine with the acronym, “CPAP.” I certainly didn’t. Denial, especially when it can increase risk of other serious problems, is not a good thing when it comes to one’s health.
I already posted my experience with it on my blog, Views from Eagle Peak. It seemed worthwhile enough to share again, in an edited form and with additional information. The extra info includes more about sleep apnea—its causes, its treatment and its risks if left untreated. If you think someone close to you has it (I’ll offer some clues about that), urge them to find out. Or if you too are in denial, I recommend you get beyond it.
Before we get to my story, let’s get to the facts. Most of these can be found in a simple search on the internet on multiple sites. One of the best sources is an excellent article on the Mayo Clinic site. The article has many helpful links to more data than I can post here without permission from them.
If the facts are too boring, move on down to the story. Or if the facts are enough, just skip the story—your call.
What is sleep apnea? Your breathing stops momentarily. Your brain senses that and wakes you up and in brain speak, tells you to “breath!” If that happened only once or twice a night, this wouldn’t be a big problem. Unfortunately, it may be happening 25, 30 or more times an hour. You don’t remember any of this, but you suffer because of it.
What clues suggest sleep apnea?
- Morning headache–Check, I had them (they could be from a need for caffeine or a hangover, but you probably don’t have the latter most days and I don’t either)
- Loud snoring–Check, see my story (Note: you can have apnea without that symptom)
- Stoppage of breathing witnessed by someone else (or their complaints about your snoring)
- Daytime sleepiness–Check, see my story (This can be high risk—like falling asleep while driving or operating machinery)
- Lack of focus or attention–Again, check
Types of sleep apnea
- Most common is obstructive sleep apnea, that stems from relaxed throat muscles—why? See below.
- Central apnea—the brain fails to send the autonomic signals to breathe; it’s less common (for more information on this, see the Mayo Clinic article).
- Mixed apnea—a combination of obstructive and central apnea–Yes, I have that too
What causes obstructive sleep apnea?
- Being male or older increases the odds
- Alcohol, sedatives and other things can contribute
- Being overweight or having a larger neck circumference—fatty deposits around the airway make it more likely (Note: trim people can have it too)
- Having a genetic predisposition to apnea
- Narrowing of the airway due to enlarged tonsils, adenoids, sinus or nasal tissues
- Smoking makes it more likely
What consequences flow from untreated sleep apnea?
- A higher risk of heart problems
- A higher risk of strokes
- A higher risk of vehicle accidents due to drowsiness or falling asleep while driving
- Problems with anesthesia during surgery (if you have it, you need to tell them!)
- A higher risk of diabetes and metabolic syndrome—among other diseases
- An unhappy partner kept awake by your snoring—no small thing!
- Or—things like glaucoma; see my story
How to combat or treat sleep apnea?
- Lose weight (didn’t help for me—I’d already done that when diagnosed)
- Stop smoking, taking sedatives, sleep aids, etc. (no longer applied to me either)
- Have surgery to remove obstructions (not always possible and not necessarily as effective as a CPAP)
- Get a CPAP—the most effective. They come with a variety of masks—under the nose or nose and mouth combinations. Some have automatic settings to determine the correct air pressure to overcome obstruction yet allow exhaling. Some can transmit each night’s results to an app on your phone or computer (or to a provider). Insurance will generally pay for them—provided that you use them as prescribed, i.e., no slacking.
I’d been tired during the day for quite a while—maybe a couple years, off and on. Tired enough to take naps. Tired enough to have difficulty focusing and concentrating on creative tasks–like working on blog posts, short stories, articles for my quarterly web magazine and–most importantly, a novel that I had put a deadline on to get out this fall.
It couldn’t be sleep apnea, despite the snoring that caused my wife to sleep with ear plugs. I didn’t want to have to use a CPAP device (that well-known acronym for a continuous positive air pressure machine that forces air into your lungs past airway obstructions). It must be metabolic or hormonal. Hypoglycemia maybe. Adrenal glands not working right. Side effects from prescription drugs. None of those, it turned out.
All the lab tests were normal at my annual “wellness visit” with my primary care physician in early May. He had no explanation for the fatigue, but suggested I do a test for sleep apnea. I told him I didn’t think I had it, but already had a referral from my eye doctor.
The ophthalmologist found glaucoma—damage to the optic nerve, despite my eye pressure being normal. (Excess fluid in the eye, causing higher pressure, is the most common cause of glaucoma—but it’s not the only one). reducing peripheral vision in one quadrant of one eye. He said I might have low night-time blood pressure OR sleep apnea. Huh? Yes, it turns out that the oxygen shortage caused by obstructive sleep apnea is associated with glaucoma.
Sure enough, the sleep study confirmed that I have severe sleep apnea. Bad enough to need not only a CPAP device but supplemental oxygen while I sleep. Thankfully, the oxygen doesn’t have to come from a bottle or tank but a concentrator. Unfortunately, that machine is the size of carry-on luggage and a lot noisier than the CPAP. But it does have a 15-foot tube that means it doesn’t have to be next to my head.
In less than the three weeks I’ve been using the device at night (and during occasional afternoon naps), I’ve become accustomed to it. It feels nearly natural now. I have yet to feel a burst of intellectual energy but some of the fog has cleared and the headaches are mostly gone. I expect creative capacity soon will return to normal.