Over the years, I’ve slept in some strange places. A year or so back, I spent an uncomfortable night in a sleeping bag behind a partition in a church sanctuary. Last Friday night found me trying and mostly failing to fall asleep in a comfortable bed in a bedroom wedged inside a modern office building.
It can be tough to fall asleep when you are wired head to foot with sensors (including sensors on your eyelids), there is a belt around your chest and waist and air pressure sniffers are slipped inside your nostrils. How are you supposed to turn over comfortably in bed when all those wires are tethered to a device on the side of the bed? How are you supposed to even sleep with a video camera always watching you?
It’s unnatural, but maybe it will improve my health. All I knew is that my sleep for the last few decades has felt very restless. The problem was one I assumed was familiar to most middle-aged men: the need to pee in the middle of the night. My bladder wakes me up more times a night than our daughter ever did when she was an infant. There wasn’t much I could do about that so I learned coping mechanisms. It typically took me an hour or more to fall asleep. If I woke around four or five in the morning, I could likely count on the rest of my sleep being restless as well.
In fact, I felt like I hardly slept at all except on weekends. I’d hear my wife doze off fifteen minutes or so after the lights went out while I just lay there in the dark hoping for an elusive knock out sort of sleep. Not true, my wife told me. I was often snoring shortly after going to bed. That’s impossible, I told her, because I hear you snoring and I am not asleep. No, you are snoring, she said, and moreover you need to get checked. Sometimes at night you stop breathing altogether, then resume breathing with a start.
That’s how I ended up at the Comprehensive Sleep Care Center in Chantilly, Virginia last Friday night. I needed to be wired up and monitored while I slept, or didn’t sleep, so a doctor of sleep medicine could determine what if anything was going on with me. The likely cause is a rather common condition, particularly among the middle aged, called sleep apnea. Sleep apnea is a potentially dangerous form of interrupted sleep characterized by abnormal breathing while sleeping. I have many of the classic symptoms including what I assumed was a natural condition of middle age: difficulty in staying awake in the afternoon, particularly in a conference rooms with bright overhead lights.
At any age you should be able to sleep well enough so you can get through the whole day without feeling sleepy. Granted, many Americans deliberately choose to deprive themselves of needed sleep. That was not my case. I usually spend eight hours a night in bed. I can only guess how much of that time is productive sleep. Lately, I guess it averages four to six hours a night.
In any event, I have a brother with sleep apnea, so with my wife’s prodding I reluctantly decided I should get tested, but punted until my annual physical. My primary care physician all too happily signed the referral form and within a couple weeks I found myself in a sleep lab mostly not sleeping. There is nothing natural about sleeping while tethered with dozens of wires. As unnatural as going to the bathroom in the middle of the night is, it’s even more unnatural when you have to summon help to do so, and carry your instrumentation with you.
I could not complain about the high platform bed, comfy mattress and pillows, but I could complain about my sleep study neighbors, one of who brought her mother with her. There was much nervous and frequently shrill laughing from the room next to me. I thought her mother would never leave and she would never shut up. The guy next to me was more polite. He dropped off right away and I soon heard his snores coming through the wall. Meanwhile, I lay there and tried desperately to sleep. Unsurprisingly, sleep seemed to elude me.
Sometime after midnight, feeling a bit desperate, I tried one of my recipes for insomnia. It doesn’t always work but it involves concentrating on a past memory and then concentrating on the random links my brain makes from it to other images. It must have worked for a few hours until around three a.m. when my ever-thoughtful bladder decided to wake me up. When I finally shuffled back to bed the trick would not work. Instead, my mind was counting the minutes until 5:30 a.m. when they woke you and sent you home.
After that interruption, I did not feel like I had slept at all, but the technician said I had, just not a deep sleep. He removed many sensors from my body, including some that snaked down my shirt and pants and attached to my legs. My scalp was covered in splotches of white sensor glue, glue the technician told me that would come out with a hot shower.
Shortly after 5:30 a.m. I was pulling out of my parking space and forcing extra vigilance on my drive home. The drive felt as surreal as the sleep study, with hardly a car on the road so early this Christmas Eve, but one perhaps insomniac runner dutifully running down the street. The cat greeted me on my arrival, but seemed puzzled as I headed to bed at 6 a.m. instead of coming out to greet him. I stumbled through a hot shower, and shortly thereafter crawled into my bed to the only real sleep I felt I got that night, which began right around dawn.
Tomorrow I get the verdict. It’s not hard to infer I have sleep apnea; the only question is to what degree and then what to do about it. Most likely I will be sleeping better soon, and won’t suffer the embarrassment of falling asleep during afternoon meetings. However, I will likely have to wear a CPAP (continuous positive airway pressure) device while I sleep, which itself means a machine will be needed to push air into my mouth all night. It sounds uncomfortable, but is probably better than the alternative of doing nothing. While relatively rare, complications from sleep apnea can be dangerous.