What is Sleep Apnea?
Literally this means without breathe. People with sleep apnea stop breathing in their sleep hundreds of times during the night and are usually not aware of it until someone tells them they are snoring or they gasp for air in the night. Just because you snore doesn’t mean you have sleep apnea. There are three types of apnea that should be treated to avoid illness, and possibly death. These types are obstructive, central and mixed. Obstructive, is where the tissues in the back of your throat (the little hanging piece of flesh) actually blocks your airway. Central, is where the brain does not trigger the reaction to actually breathe. Mixed, is combination of the two, where you are actually awakened gasping for air or a breathe.
What Damage Does This Disorder Actually Cause?
“Untreated, sleep apnea can cause high blood pressure and other cardiovascular disease, memory problems, weight gain, impotency, and headaches. Moreover, untreated sleep apnea may be responsible for job impairment and motor vehicle crashes.”
The ASAA is a non-profit organization dedicated to reducing injury, disability, and death from sleep apnea and to enhancing the well-being of those affected by this common disorder.
How is Sleep Apnea Actually Diagnosed?
Ironically, most people aren’t aware of apnea unless someone else says that they snore or they gasp for air enough to cause alarm. Recently, while on vacation, my daughter woke me up several times in the night, yelling “mom breathe!”
At first I was confused because when I do fall asleep I am usually out like a light for many hours. My daughter is a research coordinator, for a sleep study, and with her experience she felt I should look into the problem.
I looked back on my sleeping patterns and realized that I stay up quite late, fall asleep while working and usually wake up exhausted everyday. I had gained weight this year and attributed the insomnia to a high carb, high sugar intake in the evenings.
On a routine visit to my doctor, I mentioned that I was always tired, my memory was diminishing, and I had gained a lot of weight. She ordered the standard blood tests and all came out well. I told her that my daughter had mentioned that I snore and gasp a lot in my sleep. She immediately said, let’s do a sleep study. This may be the cause of your lack of energy, but more importantly if you are not sleeping, and breathing correctly you can do damage to your heart, brain, and body organs.
Your First Visit to A Sleep Study:
There is nothing more frightening than the unknown. I wish I had read an article about the study written by someone who actually went through one before I went. Hence, why I am writing this article. I can say that the second visit was much less frightening. I would like to make your visit as easy as it can be by telling you exactly what happens.
1. You are asked to arrive to the Sleep Clinic at 9:00 p.m.. Most clinics are not set up like posh hotels as you may read. Most are in the hospital on a floor that has 2 rooms marked off as sleep study rooms. Your room is furnished with a king size bed, a tv, and regular furniture so you don’t feel like you are in a hospital. It is like staying in a motel room, and is bearable.
2. At 9:00 you are given paperwork to fill out describing your day. You will receive this paperwork again in the morning evaluating your night. So far all seems fine. If you are like me, you are ready to sit and work on the computer, or watch tv. I brought my books etc. plus the toiletries they suggested. I figured that I would fall asleep at my usual time of 2 a.m. or so. First thing you really should know: You will be hooked up to machines, and lights are out by 10:00 p.m. So don’t bother with all the extras, you will not be able to do much productively.
3. Around 10:00 p.m., your nurse will come in to hook you to the machines. This is not the way people describe it too you. First of all you should wear very comfortable clothing. There are a series of wires attached to your body and head. These wires all are attached to a box which stays with you in bed. Two wires go down to the muscles on your calves, several on your chin, jaw, nose,and head. Bands are wrapped around your chest and abdomen. These wires are attached by a water soluble puddy that is globed on your body to hold the wires into place. You will have 10 quarter size clumps in your hair holding the wires to your head. More on your jaw, chin, legs etc. None of this hurts, it is just a very odd feeling. There are also two wires that sit in your nose.
4. When you get into bed you basically feel like you are bound with wire and “glue”. What was not told to me, which may help you to understand, is that each wire reads a different part of your body’s reaction to your breathing pattern throughout the night. If you are claustrophobic, make sure your nurse explains how much you can move, and the whole process to you. I believe it will help more than going in cold turkey. So now you are in bed. You lay on your back. Your covers can not come up above your collarbone. You are allowed two pillows. For many this is a very different way then they usually sleep. Wear comfortable pajamas, set your bedroom temperature before you get in bed. Wear socks if your feet get cold. Bring your own pillow. If you suffer from back problems when you sleep ask for a back support pillow. Once you are in bed, it is hard to take care of anything you need normally during the night. Most importantly, use the bathroom. Each time you wake in the night to go you must and call the nurse and be unattached to the machine .
5. Lights out, you lay on the bed on your back. There are two red lights on the ceiling and the room is dark. You are asked to do a series of tests so the nurse can register your reactions under awake conditions. Eyes blinking, eyes open, legs muscles bending, holding your breath, moving your stomach muscles in and out, rolling your eyes, gritting your teeth and making a snoring sound. This process takes about 15 minutes. If you normally take night-time sleeping medication, you will not be allowed to take these most of the time. So here you lay, waiting to fall asleep. You can turn on your side but your hands need to be above your waist and it is not comfortable. Eventually, hopefully you will fall asleep. Every move is registered and taped during the night. There are certain time line that are followed where markers are taken by the nurse. In fact, if you do fall asleep early enough and they feel you may benefit from the air mask they may ask you then to try it. If not, plan on coming back.
6. At 6:00 a.m. you are awakened by the nurse on the speaker and you are immediately asked to go through the series of tests as you had the night before. Shortly after, the nurse will remove the wires. The putty stays on! You will need to shower and wash your hair several times when you get home. Don’t plan on going directly to work. You are told you may leave after the paperwork. You will not be given any information that day from the nurse.
7. After the doctor’s have read all your reports they conclude you do or do not have a sleeping disorder. Then they decide your next step. The next step is usually to study if the air mask will help during the night based on the type of apnea you may have.
8. Visit two, the same exact routine as above except you are wearing an air mask.
What is an air mask?
Contrary to belief, the air mask has come a long way. Once a hard mask covering your face, it has been modified to provide you with the most possible comfort.
The masks are called CPAP masks. They are available in many sizes and shapes. They fit over your head by a velcro band. The band holds the cup on your nose. There are face masks, nose masks, tubes, many many alternatives. You can usually try several on before your second sleep study. I do have to admit, first that the pillow masks are light and you barely feel like you are wearing them; and secondly, that they whole system is easy to use and portable.
What happens in the Second Study?
This of course may be different for each of us, most likely you are repeating the first study with the apparatus on your face.
1. Try on an assortment of masks, find the one that you think you can sleep and move around in.
2. Have the nurse allow you to try each one on again with the machine on! This will make a big difference.
3. The machine, is a forced air machine. Due to the anatomy, when air is forced through your nose your throat and mouth will close. At first you will feel as if you were choking. Every time you open your mouth to breathe in your mouth will be closed as to avoid the airway being blocked. Once you practice breathing through your nose, you will be able to breathe naturally. Practice before putting the apparatus on so you can control the feeling. Once you fall asleep you will breathe naturally. This is for the nose masks only. They are much smaller and easier to use.
4. Second time around, with the mask, I was asleep by 11:00 p.m. Contrary to the first study where I stared at the red light on the ceiling and tossed and turned, this time I woke up at 6:00 am. I actually felt like I had slept through the night and was rested.
5. You will once again fill out paperwork and wait for your results. Either way, you really do learn a lot about your sleeping patterns. Sleep is essential part of the body’s functioning. It isn’t just 8 hours where you lay until morning. It actually affects every body system.
6. Wether you have apnea or don’t, it is essential to chose a specific time to stop tv, games, work, and get in your bed. Turn off the lights the same time every night and sleep.
I hope this article helped bring a few things to light before you go into a sleep study. Be sure to bring your favorite pillow and best of luck.
Some additional resources:
http://www.sleepapnea.org