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My Experience with Obstructive Sleep Apnea

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Obstructive Sleep Apnea (OSA)

Before we get into my experience with obstructive sleep apnea (OSA), here's a general definition: OSA and its cousin central sleep apnea are breathing problems that people have while sleeping. Together, they constitute a huge and growing health problem for millions of Americans.

That image to the left is the model of CPAP and nasal pillows that I now use. I'll explain what those terms are down the road a bit.

Sleep Apnea

Varieties and Flavors

The term Sleep Apnea (often just "apnea" in conversation) is applied to a general pattern of interrupted breathing during sleep. That doesn't sound too bad, does it? But for people who experience it, and for their partners who listen to them, it's scary stuff.

Wikipedia says that apnea is the suspension of breathing - holding your breath is apnea, as is being choked. Sleep apnea is specifically the suspension of breathing during sleep (lasting for longer than 10 seconds and having a blood oxygen drop or an arousal from sleep).

Sleep apnea can be of "Central", "Obstructive" or "Complex" (a combination of the two). Central sleep apnea is where the normal trigger to breath doesn't work all that well. Obstructive sleep apnea is caused by some part of your airway collapsing and preventing you from breathing for just a bit.

Dangers of OSA

Those descriptions don't really do justice to the reality. For starters, people die from it. OSA causes higher risk of heart disease, stroke, and traffic accidents, among other things.

Also, not only does your spouse have to live with the snoring but also with laying awake at night making sure that you are still breathing. As someone who's been on both sides of that experience, I can tell you that it is a very scary thing indeed to wake up in the night and find that your partner has stopped breathing, sometimes for as much as a minute. And just as you relax toward sleep, your partner stops breathing again. So neither of you get much sleep.

However, you, the sleeper, never really wake up all the way, so you don't know that you almost woke up over and over. You may not even believe it when your partner tells you about it. You will notice, however, that you're tired all the time and no matter how many hours you slept it wasn't enough.

Meetings and movies may find you zoning out and jerking awake. Driving is hard and white-line hypnosis is easy. You may find yourself boosting with caffeine and sugar just to get through the day. That's somewhat ironic since being overweight is one of the big contributors to OSA and adding a lot of junk food will make things worse in the long run. I was up to 5 cans of Mountain Dew a day at one point, just to get through to quitting time.

The OSA Pattern

For OSA, what happens is generally this: The brain goes toward normal sleep patterns. As it does, the muscles in the throat, mouth, jaw and so forth relax. This allows a collapse of the airway. When the lungs expand to suck in air, the obstruction doesn't allow the air in. In fact, in some cases the suction from the lungs increases the blockage. The brain gets the message that oxygen levels are dropping and something is wrong, so you start to wake up. At some point, the muscles involved come back on to normal wakeful tension and the obstruction clears (often with a sucking gasp) and you can breathe normally. After a few seconds of catching up to get the oxygen back in your blood, the whole cycle repeats.

My Experience

My experience with Obstructive Sleep Apnea (OSA) started a long time before I ever knew there was such a thing. I started, as do many people, with snoring. Loud, obnoxious, wife-with-pillow-over-head snoring.

At first, that was all we thought it was - just a lot of racket keeping my wife awake. However, as time passed, I started having more problems functioning at work and (very scary) while driving. I was tired all of the time and having trouble focusing. As the problem progressed, I became a danger if I had to drive more than a half-hour or so.

Finally, the classic symptoms of sleep apnea appeared so clearly that my wife could tell there was a problem. For the kind of apnea I have, the pattern is to start to sleep snoring, then to stop breathing, then after a few seconds to gasp loudly. After that I would slowly go from quiet breathing back into the same pattern - snore, apnea, gasp, breath, and repeat.

We went to the doctor, who immediately ordered a sleep study. Sleep studies are done at hospitals and clinics and are just what it sounds like: You go in during the evening, change into sleepwear, get wired up and go to bed. If you have sleep apnea, the testing can show what kind and how badly you have it.

This picture, from Wikipedia, shows all the fun wires that are attached. Missing are the tubes that they stick in your nostrils to measure your breathing. You might think that this would disturb your sleep, and for some people it probably does. For me, I was so tired that I went out like a light.



If you have a clearly established pattern of OSA, the technicians may be able to start calibrating the positive air pressure needed to keep you from having apnea. In my case, they stopped the test by midnight or so and started doing the calibrations using a mask over just my nose. For some people who sleep with their mouth open, a full face mask is needed.

About 6 AM the technicians woke me up and told me that they had completed the study and the calibration. Here's the odd thing: Even though I'd been wired up and sleeping in a hospital bed and had a mask on my nose, I had the best night's sleep I'd had in ages! That was enough all by itself to convince me that I had OSA.

My Latest Experience

Flying with a CPAP

I recently took my newer CPAP with me when I flew to northern New Mexico from the Phoenix area. The first few nights there were just awful and I couldn't figure out why. I was waking up multiple times a night with a dry throat. At first I thought that it was due to my not having brought distilled water with me as I do when I drive (I had to use tap water the first night) but I finally realized that I'd forgotten a very simple adjustment: CPAPs need to be corrected for altitude. Some auto-adjust, but this one doesn't.

As soon as I changed my setting to the 6,000' level, my sleep was much better.

Another part of flying with a CPAP is going through the security process. I treat the CPAP as if it were a laptop. I remove it from its bag and put it in its own separate tray. So far I've had it pulled out and inspected every time, but other than that it isn't a problem to carry it on. I don't trust the airlines enough to put it in my checked bags. This last time, I think I had 7 trays or loose items to get inspected - CPAP, CPAP bag, laptop, netbook, shoes and other junk, backpack, and a coat. < SIGH > I remember when a plane trip was actually something to look forward to!

Treating OSA

Remember I said that I'd explain about nasal pillows and CPAPs? This is where they come in.

After I had the study, I had to go back to the doctor and get a prescription to get my CPAP. CPAP stands for Constant Positive Air Pressure. A CPAP is a machine that literally blows air up your nostrils all night. The idea is that the obstruction in your breathing passages occurs when your muscles relax in sleep. By blocking the collapse, the CPAP prevents you from starting the OSA cycle.

For me, the CPAP has been addicting - I can't relax enough to fall asleep now unless I have my CPAP going. Technology has advanced and my mask has been replaced by a small tube with two "pillows" that fit into my nostrils. This makes it much easier to wear glasses as well as being a lot more comfortable to wear.

Not everyone has the kind of OSA that responds to a CPAP. For some people, surgical procedures to reconstruct the mouth and throat may be needed. Others may find that a dental appliance is a better choice.

Finally, there are those who have OSA for whom there is no good solution. My wife, as it turns out, is one of those. She had a bout of OSA because she had gained a great deal of weight and was sent to a sleep study. It was an absolute disaster because it turns out that she is also unable to tolerate any pressure being blown up her hose. It made her claustrophobic as hell. Fortunately, she was able to lose enough weight to stop the full-blown (pun intended) OSA.

Tips and Problem Solving

Living with a CPAP

First, let me say that this is my experience. Your mileage may vary.

CPAPs are wonderful when they work. There are times when they don't. Having a cold or allergies can stuff up your nose to the point where the CPAP can't push air through. So make sure that you have the meds and tissues close at hand to keep those passages open!

You may find yourself more susceptible to nose bleeds. The constant wind blowing up your nostrils can dry them out - particularly if you live, as I do, in a desert environment. Making sure that the water reservoir has enough water in it is important. My experience is that you don't have to clean it out or refresh the water every night, but you should follow the instructions until you're comfortable with making your own decisions. The same is true with cleaning the mask.

You should also know that it does take some time to get the habits in sleep necessary to keep the mask in place and the hose un-kinked. They make pillows just for CPAP wearers, but I've never tried those. You may also find that you get a shove from your bed partner when you turn over and blow the mask's exhaust in his or her face.

Another item to consider is taking a CPAP on the road. I actually have two machines. One is older and bulkier, but it has the advantage of allowing me to plug in a 12-volt power source directly. If I am on the road or want to camp for a night, I use that CPAP and a 12-volt marine battery (sealed and it's supposed to be allowed to fly on airliners, though I've never tried that). When I recently had surgery on my shoulder and had to sleep in the recliner, I used that setup too instead of dragging the other one out of the bedroom and hassling with getting an extension cord out to the middle of the room. It's also been handy in older hotel rooms where the only electric socket is a two-prong type, hidden behind the bed and full of lamp cords anyway.

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Comments

Please take a moment to share questions or experiences!

  • sheymyster May 31, 2010 @ 12:27 am | delete
    nice article, I suffer from sleep apnea (but not this badly) but It hasn't gotten bad enough to see a doctor yet. This was very informative and well constructed, nice job!!
    --Mr. Music
  • thewishpearl May 30, 2010 @ 7:18 am | delete
    Great lens! I also suffer from OSA and made a lens about it. I just bought a CPAP but the model is different. My mask is different from yours. It is the one that covers the nose. I'm not sure if it is the right one though, but I will give it a try. This condition is so common! 5*'s
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fortune_smiles

I'm a real-world wage slave working toward independence.
I'm in Arizona, but from the Great Plains. I love to write, read, debate (but not argue), e... more »

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