Thursday, February 29, 2024

To Sleep, Perchance to Breathe

Bodies are weird. And living in one as it's aging is annoying, but never dull.

For anyone interested in long overdue updates about my personal health things: The mastitis issue is essentially gone with occasional flare-ups of WHY?! at inconvenient moments. My back is fine after a few years of very not fine, but I think the beginning of the pandemic cured it by making me stop doing things. Plantar fasciitis was fixed with good shoes. There was a glowing spot in my vision that went away, and has been replaced by a couple of dark dots off to my left that I try to ignore. I think I am finally in menopause? Fingers crossed that sticks because periods are the worst. Currently I'm in a game of chicken with my right leg about going to the doctor. For no reason I can pinpoint, it started hurting a couple of weeks ago, but I stuck a brace/sleeve thing on my knee the other day and it's getting better. Good times.

This post is specifically about how I am adjusting to the use of a CPAP machine. It's been a week, and wow, what a difference it makes to be able to sleep!

If you are in a demographic that is blissfully unaware of sleep apnea, it's a condition where you stop breathing in your sleep, and your body snorts you awake to keep you alive. CPAP stands for "continuous positive airway pressure" and it's a machine you essentially strap to your face to keep you breathing through the night.

I have not slept well in years. Certainly not since before I had children. I have counted myself lucky if I got three hours in a row, and in the past year or two I've been up every hour or ninety minutes. It reached a point where I was exhausted and would just sit up in bed and cry, so I finally asked my doctor for help. He referred me to a sleep specialist, who sent me home for two nights with a sleep monitoring kit.

My brother asked me the other day why I didn't do that sooner. An excellent question! The answer, besides the typical mom response of there were too many other things to do for other people first, is that I was still functioning. When I talked to the sleep clinic doctor, he seemed to think I might be able to try a special mouth guard to start, if I even had sleep apnea. He wasn't convinced based on my answers to his questions. I don't fall asleep while driving, or at work, I don't take regular naps, etc. I am not hindered in my daily activities. When things seem to be working, you can put off fixing the few things that aren't.

Now, instead of the meeting with the doctor to discuss the results, he simply put in an order for a CPAP machine. No consultation. The message in MyChart said "Severe sleep apnea, ordering CPAP immediately." It sounded like he was wondering why I wasn't dead.

And then I went to the CPAP orientation. There were four of us there to learn how to operate our machines and to choose which type of mask we wanted, etc. The instructor had us each sit at our assigned places, and told us the number written at the top of the first page in the instruction folder was the average number of times per hour we had stopped breathing during our at home sleep studies. The woman across from me had the number five. The woman next to me had six.

My paper said 46.7.

I stopped breathing an average of 46.7 times AN HOUR every night! The other people in the room looked at me as if I were making a joke.

So now a week or so into CPAP life, I can sleep! I get about four to six hours in a row before I maybe get up to pee and then go back to sleep. I don't yawn all day. I don't wish I could take a nap. I'm awake! I like it.

There's still a lot to get used to, though. The whole thing is weird, and a decidedly unsexy way to go to  bed. The giant tube coming out of my face is surprisingly unnoticeable, but the mask is leaving my skin around my nose and mouth a bit red which I dislike. The machine is much quieter than I was expecting. Honestly, it doesn't sound much different from a person breathing nearby, and I tend to wear earplugs at night and I don't hear the machine at all. Finding a comfortable sleeping position is still strange, but when I'm out I'm actually out, so I don't care. The thrill has not worn off yet that I can shut my eyes and then open them a few hours later and not remember any of the time in between. But it's creepy that the machine is monitoring everything. 

I get the convenience that the doctor can adjust it remotely if something needs to change, and it's interesting to get a report every morning about how I slept. I get an actual score. The first night I got an 86 (out of 100), so a solid B worth of sleep. Once I figured out how to get my mask to seal better and how to lie a different way so I'm less likely to dislodge anything, I started getting all A's. But it records how many times I take my mask off, how well my mask was working, etc. Apparently the number of "incidents" a night is down to an average of about two. I like having all that information, but I don't really like sharing when I'm sleeping with some unknown observer out in the world. It's like worrying about Santa watching me again, only this time the present is insurance coverage. I have to use the machine four hours a night for insurance to help pay for what would otherwise be an expensive service.

There's also lots of care and feeding for the machine that I'm not looking forward to. Emptying the distilled water every morning, washing the tube, wiping things down, changing the filter, etc. I can't keep houseplants alive because I don't like these kinds of chores, but apparently for me, that's the price of sleep.

And sleep is great! I've missed it.

My husband appreciates that I'm not flailing around. Mostly because when I can't sleep all the covers get twisted and he doesn't get to keep his blankets. Now he wakes up with the covers the way they started at the beginning of the night and he's much happier.

The dog was super confused the first night about why I had things strapped to my head, but snuggled me under the covers all the same. That's been the funniest side effect of the whole CPAP thing, is the dog has more energy. She was already Miss No Off-Switch at her doggy daycare, but when I get a full night's sleep, she gets a full night's sleep. And now she's happily running nonstop with her dog pals and the trainers have noticed.

In any case, if you can't stay asleep, and you're literally tired of writing it off as part of perimenopause or stress, couldn't hurt to figure out if it's sleep apnea. I would prefer not to need this machine to breathe at night, but I am glad to have it.