My Sleep Apnea Story, Part 1: Diagnosis and Options

I recently went under the knife to take care of a lingering health issue that I’ve been battling for a number of years. The procedure is called an Uvulopalatopharyngoplasty or as it’s more commonly referred to, a UPPP.  The UPPP procedure is done in conjunction with a tonsillectomy, which is the surgical removal of the tonsils, the two oval shaped pads located on both sides at the back of the throat.  I’ll share more about that procedure and the recovery battles in Part 2 of “My Sleep Apnea Story”.  First, let me share with you about my life with obstructive sleep apnea.

 

What is Sleep Apnea?

The health issue I was addressing with the UPPP / Tonsillectomy is obstructive sleep apnea.  I was diagnosed with sleep apnea about 10 years ago. But in reality, I probably have had sleep apnea since I was a teenager. Way back, when I shared a room with my brother, he would complain about my snoring and I laughed it off and basically thought “it sucks to be him” because I’m sleeping fine.  I’m good.  In college, it was the same thing, except this time, my roommate switched out because he couldn’t handle sleeping in the same room with me, especially since any drinking would put my snoring on blast and you could literally hear me two doors down the hall with both doors closed.  He would tape record me and I thought it was hilarious and again also thought “sucks to be you dude.”  I’m good.

 

Later, it became a vanity issue when I started dating and knew that I snored pretty loudly and would be very conscientious about sleeping over with someone and scaring them away while I was sawing logs. Lot’s of very light sleeping in my early days – or so I thought.  When I met my future wife to be, she accepted my snoring as a part of the complete package that I brought to the table.  She thought it was cute that I was so comfortable with her, so soon in our relationship.  Let that be a lesson, love will make you lose your mind and accept any flaw, even ones that are going to keep you up at nights for the next 20+ years.  Sorry hunny!  Sucks to be you, but I’m good – or so I thought, again.

 

Over the years, my snoring has become a real problem for both of us.  For her, because she would wake exhausted from me snoring all night and for me, I’d wake up exhausted from not getting anything close to a real nights sleep and from her waking up pissed off at me each morning for keeping her up all night.  See the circle here?

 

Sleep Apnea Symptoms

Like I mentioned, I was diagnosed with Obstructive Sleep Apnea after doing a sleep study where I was wired for sound, measured for breathing levels, oxygen levels in my blood and also having a video shot of me while I slept. Turns out I had all the classic symptoms:

  • Loud snoring, which is usually more prominent in obstructive sleep apnea
  • Episodes of breathing cessation during sleep witnessed by another person
  • Abrupt awakenings accompanied by shortness of breath, which more likely indicates central sleep apnea
  • Awakening with a dry mouth or sore throat
  • Morning headache
  • Difficulty staying asleep (insomnia)
  • Excessive daytime sleepiness (hypersomnia)
  • Attention problems (ADHD)
  • Irritability

Okay, so now its real and diagnosed and the breathing issues were the real concern, since my heart is working overtime to keep my body alive during sleep and that is the real health risk for those diagnosed with Sleep Apnea – not enough oxygen to the brain and heart working overtime all the time.

 

Here is what’s hapening when you have sleep apnea.  The muscles in the back of your neck, including your tongue, tonsils, soft palate, the uvula (I always thought that was the tonsil) all go into a relaxed mode and clog the nasal air passage in your throat or narrows the airway enough so that you can’t get a adequate breath in on a consistent basis. Your brain senses this clogged system and briefly nudges you awake so you don’t choke and die.  This is so brief, that you don’t remember a thing and it was happening to me, according to my sleep study over 25 times per hour, all night long.  So, this prevents me from getting to a deeper level of REM sleep for restorative sleep this is why I am always tired, even after having a “good” night of sleep.  Bottom line is that I do not know what a good night’s sleep is supposed to feel like, since I have never experienced one in my entire adult life.  Crazy!  I also learned that people with sleep apnea are at a higher risk to have a stroke due to the lack of rest, diminished oxygen in the blood and your heart working overtime trying to keep your ass alive.

 

Lifestyle Changes to Treat Sleep Apnea

Well, once diagnosed, I did the normal recommended approaches to dealing with this sleeping disorder, which includes:

  • Diet change – basically fat and fast foods are going to make you thick and fat and obese, welcome to your heart attack waiting to happen;
  • Lose weight – the heavier you weigh, your snoring and apnea issues will increase.  My ideal weight for my height of 5′-8″ is 165 lbs.  I recently have been tipping the scales at 189 lbs with a Body Mass Index or BMI reading of 31.  My ideal BMI target is 24-25;
  • Cut back on drinking – yeah, I know see how too much drinking can be a problem;
  • Change how I sleep – I try to sleep with my head elevated (sleep on two or more pillows) or on my side. Unfortunately when I get into too comfortable of a sleeping position, I can literally feel the muscles in the back of my throat re-positioning itself for sleep and not a good night’s sleep at that.

So, although I need to make changes to all the items above and I did, it didn’t help one iota with reducing or eliminating my sleep apnea issues.

 

CPAP – Do Ya Think I’m Sexy!

I progressed to the next level and after doing the sleep study, I was prescribed CPAP therapy.  This is known as Continuous Positive Airway Pressure or CPAP and is a common treatment for obstructive sleep apnea.  The CPAP is a comprised of a small machine that provides constant and steady air pressure, a hose, a mask or nose piece.   You are supposed to use the CPAP device to help you get a steady air stream pumped through the mask to help you overcome your sleep apnea.

 

I know people who swear by their CPAP machine.  Like an American Express card, they won’t leave home without it.  When traveling, they take it along with them as another piece of luggage.  Guys have sworn up and down that they “love” their CPAP machines.  Mind you, all of these guys were much older than me at the time and they’ve gotten to that place in life where quality of life was more valuable to them than trying to always look sexy in bed for your wife.

 

I couldn’t use the machine at all. From the very beginning, I had challenges that include:

  • Trouble getting used to wearing the CPAP mask.  Again, I had to sleep with the aid of a machine and I felt so unattractive and pathetic.  Yep, I know.  It’s vanity and I am a vain son of a bitch.  I am.   But that was an issue I was grappling with.  It didn’t bother my wife, she never joked about it or was cruel in anyway.  It was just me.
  • Difficulty tolerating the forced air.  When you put on the CPAP mask, you are automatically going to have air forced down your throat to keep your airway clear and working and not clogging again.  This requires a crap load of air being blown into your nose all night.
  • Dry, stuffy nose.  With all that air comes a lot of dryness in not only your nose, but also in your throat and around your mouth.  Dry mouth, throat and nose was not comfortable at all.
  • Feeling claustrophobic.  I felt chained like a dog at times.  The hose would always pull the unit off the bedside table, the mask would pull off and eventually, I would just pull the whole mask off and give up.
  • Leaks, pressure marks, etc.  I didn’t make sense to me that I would resolve the sleep apnea with the aid of a device, but that same device would constantly have to be tweaked with each night to work.  Maybe there was a leak and some of the air was escaping through the seams around the nose fitting.  Well, that’s going to make a noise and with the amount of air pressure we were dealing with, it sounded like a damn jet engine at times.  Also, I’d have to keep the mask tight enough to prevent these leaks from happening and this would result in me having a big old pressure line across my forehead and around my nose where the mask was pressed against my skin.  That mark would remain for the entire day.  Vanity kicks in, since I have to meet with clients face-to-face and I knew they were always looking at the deep lines on my forehead and thinking WTF?

 

Needless to say, this wasn’t working.  To add insult to injury, I had to rent the machine at the cost of $60/month and maybe kept it for 10 months the first go around.  Turned in the machine and stopped paying for something I wasn’t using.  Tried it again after a year or so and the same thing happened, paid for 6 months this time, used it for a total of 2 months and resolved to taking this Sleep Apnea issue to the next level.

 

Before taking the surgery step, I tried one last time, a last ditch effort, I ordered the mouthguard via an “as-seen-on-tv” infomerical.  Basically, this is like a protective mouth gear that pushes your jaw forward and keeps the airways open.  Well, I tried that option too, but I couldn’t keep the guard in my mouth, the gag reflex was strong and I’d end up taking that out as well. Another drawback was the amount of saliva that was created and the spit pool on the towel was too much.  Yep, I know. TMI.

 

So, let’s recap.  Diagnosed with Obstructive Sleep Apnea, completed sleep study, tried CPAP Therapy – twice, tried the Mouthguard, none of that worked.  Now what?  Do I go for “the cleanout”? The UPPP/Tonsillectomy procedure.  Go ahead and take the risk and go under the knife? Do I really have a choice? I do want to get better and discover the kind of sleep that I’ve never experienced, so is this really the next step in fixing my sleeping problem? In a word…YES.  That story in detailed in My Sleep Apnea Story, Part 2:  You Down with UPPP?