Showing posts with label sleep apnea. Show all posts
Showing posts with label sleep apnea. Show all posts

Saturday, May 23, 2009

Restful sleep

It's been a while since my sleep study revealed that I had indeed gone from a bad case of sleep apnea to a moderate one. And it's been a little less than that since I had my CPAP adjusted.

And it's been nice. The airflow is much less overwhelming and much more manageable. Now, I don't usually get eight hours of sleep... in fact, I don't usually get six hours of sleep. Unfortunately, my time to work is best at night, after the girls have gone down for the count. That means several hours of unmolested time to work but it eats into my sleep time. It's not uncommon for me to stay up past midnight, and I always get up at 4:45 a.m. when the alarm goes off.

Yeah, it's a fun schedule.

Still, it would be more stressful if my CPAP was still on the wrong setting. I can feel the difference too. It feels like it did when I first got it, not overpowering, just the right pressure. The noise level is better too - Mrs. LB says it sounds like a ceiling fan.

Sleep apnea is not fun but it's much more manageable now. And it helps now that my equipment is on the right page too.

Saturday, April 11, 2009

From severe to mild/moderate

After my recent sleep study, I was wondering when I would receive the results. I was tempted to call the doctor's office later that same week but figured I'd just wait for them to call me, which they did earlier this week. On Friday, I had my doctor's visit and got the lo-down.

In short, my sleep apnea is gone from severe to mild/moderate. In the doctor's words:

I'm very happy you lost all that weight. It's a good thing you lost weight but the sleep apnea didn't go away.

So while the impact of my sleep apnea has lessened, it hasn't completely gone away. And my body will attest to that. I haven't worn my CPAP with regularity, okay, I haven't worn it at all, since my sleep study and most days I need to lie down for a bit of a nap. But last night I wore it and right now I feel great.

I got a copy of my sleep study and it has some statistics on it. Only thing is, I'm not sure what's good or not. According to the sleep study, I had 462.0 minutes of total bed time, which seems like an awful lot. That's just under eight hours, which honestly to me is a lot. Rare is the time I get in eight hours. It took me 14 minutes to fall asleep, took me 209 minutes to get to my first REM period (normal is 90 minutes) and my sleep efficiency was 88.7 percent... whatever that last number means. Sounds like an important stat.

Before I continue, a quick refresher course on stages of sleep:

Stage 1 Awake: this means you are not asleep
Stage 2 Light Sleep: you're out but your right at the surface
Stage 3/4 Slow Wave Sleep: also referred to as deep sleep
Stage REM: for some people, an earthquake or some other act of God couldn't jar them out from this stage. Your eyes move and flutter during this stage, and about 20-25 percent of the night is spent here.

Now, during the sleep study I slept some time without a CPAP and some time with the CPAP.

Without the CPAP

Stage 1: 5.0
Stage 2: 63.0
Stage 3/4: 23.3
Stage REM: 8.7

At 2:55, the sleep tech woke me up, put my CPAP on and let me fall back asleep. That stats (which I think might look a little distorted because I was already asleep)

Stage 1: 9.0
Stage 2: 39.5
Stage 3/4: 0.0
Stage REM: 51.5

So I slept good that last two hours (she woke me up for got at 5:09:14 am, apparently). There loads of other stats but I don't know what means what (I had 37 PML arousals, hey now). But all in all, looks encouraging.

Anyway, one other good thing. My blood pressure the previous time I'd gone to the doctor's was 144/70-something but on Friday it was at 122/68. I guess it means I wasn't as stressed as the first time, which is strange because that time I went alone and on Friday my daughters went with me.

But the kicker, last time I weighed at 189.8 or so, just under 190, and Friday I weighed 185.9. Sweet!

Tuesday, March 31, 2009

The sleep study

I'll have to await the doctor's determination about the final results but preliminary feedback indicated both positives and negatives from the sleep study.

Long story short, my OSA (obstructive sleep apnea) has been substantially reduced by my weight loss. The technician told me that, even at my worst, on my back and in deep REM sleep, I was barely registering much of anything. Initially when I fell asleep, I showed some signs of the OSA but with or without my CPAP I wasn't showing much.

This is good news. I was worried that it would have gotten worse or changed somehow for the worse since my weight loss, since I haven't done well to wear it regularly in the last 8-12 months. But that doesn't seem to be the case. Instead, my weight loss has positively affected the OSA.

Still, for me it leaves me a bit of a question - if my OSA is not as bad as it was, why am I so tired lately? I didnt' wear my CPAP on Sunday night, forgot to put it on, and on Monday afternoon I had to lie down for a nap. It was only a 20-minute nap but I desperately needed to lie down. I guess that's a question for my pulmonologist.

The tech, however, said my CPAP was probably too high. It's at a setting of a 10 and it ranges from 4-6 all the way up to 20, for the severe cases. So, the higher the number the more pressure is going into keeping your airwaves opened to allow you to breath normally during the night. Apparently since my OSA is not as bad as it has been, I don't need the extra pressure. Maybe that's it. And maybe it's just something with my irregularity. Sometimes I go to bed at 9-10, while other times I'm burning the midnight oil. I rarely get more than seven hours of sleep, and am usually sporadic in what time I hit the sack and what time I wake up. That might be part of the problem.

Anyway, the sleep study itself was interesting. I was all wired up as the instruments recorded everything in my body, from heart rate, sleep level, movements, sounds, vibrations, pretty much everything coming from my body.

And it also made me look hot.

In the words of the immortal Human League, "Don't you want me baby?"

No. Oh. Don't blame ya.

I actually sent this picture to my wife. She confirmed that I looked hot.

Wednesday, March 25, 2009

Sleep apnea

Ever slept for five hours and not felt rested? How about seven? Nine?

No way, right? Once you get right around the amount of uninterrupted sleep your body needs - seven to nine hours is about right - there's no chance you cannot feel rested. Right?

Not exactly. For most people I would venture to say this is true. But for me, this is not true. At all.

Last night I slept from about 10:45 p.m. until the alarm went off at 5 a.m.

(Not-so-quick side story: we have the alarm set to go off on some random soft-music-playing radio station and lately that station has been playing the Star Spangled Banner so this morning when I heard the anthem I was so confused, I thought I was watching an old TV show in the middle of the night and the anthem was playing, like in the movie Poltergeist)

Anyway that's, what?, a little more than six hours of sleep. Not great but more than twice of the time I slept on Monday (I got in a whopping three hours of sleep on Monday night... actually, it was Tuesday morning at 2 a.m. to be precise when I finally went off to bed, and woke up three hours later).

So I've been a bit sleep-deprived I suppose. And my sleep apnea does not help things.

I just got back from the gym and I'm glad I went, but I really had to fight through sleep in order to go. Now, when I saw my pulmonologist, I told him about being tired and running and he said that if you are sleepy, you can work out fine because once you start exercising your sleep center is repressed or something like that but if you are physically tired it's different. So I was sleepy tired and once I was on the bike and then the treadmill I was fine. But now that I'm back home, all I want to do is lie down. I can't because I have to blog, I mean, I have to go get my daughters from school.

I really need some coffee, anyway that's what my mind keeps saying. I'm tired, want coffee, want to lie down, have been like that since about 8 a.m.

Hello, my name is Sleep Apnea
.

Sleep apnea keeps me from getting into a deep sleep. So, let's say sleep is like a swimming pool. Your body needs to get down deep in the deep end to get fully rested and stay there. So if it lingers about seven feet deep in the deep end, that's perfect. Now, sometimes you are kind of just floating around under the surface and that's when you can easily come up for air. But that's when you're first falling asleep. After a while, your body gets down into some deep sleep, down in the seven-foot-deep part of the pool.

Because of my sleep apnea, I don't ever get down into the seven-foot-deep part of the pool. The most I get is maybe a foot or two below the surface. So I'm always near the surface, never allowing my body to get fully rested. And it doesn't matter if I'm in the pool for 7-9 hours, or 12 for that matter, because I'm never going to get full deep rest anyway.

See, my windpipe closes in on itself. And every time this happens, I get jarred awake. Well, not really awake, but that's when I come up close to the surface. My head's still underwater but my hair is sticking out of the pool. Then I start to sink back down underneath when BAM! up I come close to the surface. Whenever my windpipe closes in on itself, I get jarred out of sleep even though I won't remember any of it.

How often does this happen? Well, since I don't have your average run-of-the-mill regular boring old sleep apnea but rather the deluxe model Severe Obstructive Sleep Apnea it happens about once a minute, 60 times and hour, hundreds of times a night.

Could you imagine someone jamming you on the side of your body once a minute, 60 times an hour, hundreds of times a night? How could you possibly get any rest?

I have my sleep study five days away now. I'm looking forward to it and will share the data with everyone. Yesterday I got another piece of the puzzle, which I think is equally as important. I got a new mask. See, to combat sleep apnea, you wear a CPAP, a continuous positive airway pressure machine that constantly blows air down your throat. This keeps the windpipe open and allows your body to sink down to the bottom of the deep end of the pool. It sounds complicated and even uncomfortable but the body adapts. It took me a couple of nights to get used to it.

But my mask was giving me problems before, and my body has changed since I first started using my CPAP. I got the first part down with a new mask. It's the Mirage Activa Nasal Mask; basically it's a mask in the true sense of the word. It has straps along the back, a forehead pad that keeps the mask close to my face, cushioning and padding that keeps the plastic from tearing my face up, and a tube that comes out of the mask that blows air from the machine down my throat.

Sounds like a pleasant night of sleep, doesn't it? (If you ask nicely, I might post a picture of me and my mask)

I'll take that though any of the day of the week to sleepwalking through mornings and afternoons.

Now where's the friggin coffee?

Friday, March 13, 2009

Sleep apnea update

I saw my pulmonologist on Thursday for the first time in more than one year. Overall, I'd say the visit was a positive experience and I am very glad I made the appointment. I'm tired a lot, sluggish even, and there's no reason to be tired at 9 a.m. when I've slept six to eight hours the night before unless it's my sleep apnea working its magic.

Here's how the visit went.

"Weight is not everything"

I'm sure my doctor does not remember me, which is fine. He sees, what, dozens? hundreds? of visitors each year and I am just another person passing through. I say this because we had the same conversation Thursday as we did in December 2007, the last time I saw him. He asked me how I lost the weight and I responded through diet and exercise. Then, he said "You didn't have surgery?" and I said no, that I exercised a lot and still do.

He told me that it was great that I had dropped the weight but that my sleep apnea probably did not go away because "weight is not everything." I can attest to this because I'm tired nowadays like I was back in the day before I experienced the wonders of the CPAP.

Sleep Study Soon

I'm supposed to get a call on Friday from a local sleep clinic. I will schedule a sleep study when they call, hopefully sometime early next week. I need to get in and go through with it so the doctor can get the results back quickly and I can get my new CPAP, which I am expecting to happen anyway.

I've had a sleep study done before. If you haven't had one, I'll explain. It's like you are a guinea pig in an experiment. First, you are strapped with all sorts of wires on your forehead, chest, arms, back. Then, you are fitted with a mask. I had to watch a video afterward as well. Finally, you are taken off to your own room, which isn't private though. There are monitors so the medical staff can see you in action. The first half of the night you sleep normally, without any mask. At midnight or thereabouts, you are woken up to put the mask on and then go back to sleep. At around 4 a.m., they wake you up and kick you out... okay, that's harsh but if I wake a guest at my house up at 4 a.m. and ask them to leave, I'd be kicking them out.

Vitals

My blood pressure read 144 over 78. I think the 144 is a bit high and the 78 is good-to-average. Not sure what it means. I weighed in at 189.6. I was happy because it was less than 190. Why was it less than 190? Because I changed out of my jeans and put on some shorts and a light shirt. Had I gone in my jeans, I'd have weighed 191-something and would have freaked. Also, I had lunch about 90 minutes before so I expected the weight to be a bit higher than it was the last time I weighed myself, at the gym recently.

Also, the nurse who took my blood pressure told me my heart rate was 49. I was excited! She said that was kind of low, then measured it with her hand and watch. She confirmed it. As we walked toward the exam room, I told her that I wear a heart rate monitor when I run and that my resting HR is usually at about 60 or so. Then she said "Well, you are in good shape so 49 isn't too low."

Long-Lost... Something

My last name isn't that common. Once, when I substitute taught for a high school class I had a student with the last name Bueno. Another time when I worked as a teller, I had someone come to my window named Bueno. The nurse who admitted me today was named Bueno. She was the third non-family Bueno I've ran into in my life. Strange!

Thursday, March 12, 2009

Airwaves

One of my New Year's Resolutions was to wear my C-PAP more often, but it became clear that I didn't need to just wear it but rather that I needed to try and start over with it.

What the heck is a C-PAP? Well, it's a breathing apparatus that helps sleep apnea sufferers breath at night. It's a Continuous Positive Airway Pressure machine. You wear a mask and the mask sends air continuously down your pipeline.

My problem, I believe, is that my machine needs to be re-calibrated, that because of my weight loss I need a new sleep study done and I need possibly a new machine and a new mask.

Well, I finally FINALLY made a doctor's appointment. I'm seeing a pulmonary specialist today for my annual checkup. I hope he sends me to get a new sleep study done because I've been feeling sluggish for a while. I was falling asleep one day last week while working with my daughter on her homework. At three in the afternoon.

Sleep studies are fun. Okay, fun isn't quite the right word... interesting maybe... but I had one done once, about four years ago and I was hooked up on machines and slept somewhere for a night. At about 4, they woke me up and sent me home. It wasn't comfortable and took me a while to fall asleep soon but I'm looking forward to getting one done.

I could finally get a decent night's rest.

Thursday, January 1, 2009

Resolution No. 1 - Use my CPAP more often

My first and foremost goal, the primordial New Year's Resolution for me, is to wear my CPAP more often. At least six days a week. Seven if possible. That's my goal, a full seven days a week.

What the heck is a CPAP? And why would you wear one?

Well... a little background. Throughout most of my life, I've snored. Loudly. My younger brother and I shared a room for most of our childhood and he is the heaviest sleeper I know. I credit myself for that, for it was because of my loud snores that he forced himself to sleep through anything and everything. The man can sleep through earthquakes...

Anyway, I was a snorer in my teens and early 20s, but it got worse and worse as I got older. My wife was not a fan of my snoring when we first got married and as it worsened, she became a critic and then didn't want to have anything to do with my snores as they kept her up at night. I'd snore her out of sleep and she couldn't get back to bed. We found a solution - we didn't share a bed. We went through a period of about five years where we didn't sleep in the same bed. At all. For anything. During this whole time, of course, my weight was spiraling out of control.

She urged me to see a doctor about the snoring as she feared that it was not just your average run-of-the-mill snoring. Worse, I was getting tired early. And by early, I don't mean at 7 p.m. I'd be so sleepy at 9 a.m. and resorted to taking Vivarin to help me get through the morning. That was the last straw, and after months and months of pleads from my wife I sought out medical help. I saw a pulmonologist and he told me he felt I had sleep apnea. He sent me to a sleep study and I stayed the night at a clinic with wires hooked up on my face and chest and under constant supervision. The results confirmed the doctor's initial diagnosis: I had sleep apnea, but not just your regular sleep apnea, I had it bad. I had severe obstructive sleep apnea.

When you have sleep apnea, the throat closes in on itself during sleep. It blocks air flow down into the lungs and causes you to stop breathing. As I said, I had it bad. I'd stop breathing once every minute or so. When you stop breathing, you sort of wake up but you may not actually come to all your senses. Basically, sleep apnea prevents you from reaching deep sleep.

Because of my sleep apnea, I was tired and sluggish throughout the day. I had a hard time feeling rested because I never got real rest. I never got into deep sleep.

I got a CPAP machine, which is short for Continues Positive Airway Pressure. It's a bulky machine and people can poke fun at it. But I don't care what people say about it. It's helped me massively. The CPAP continuously pumps air in through the mask into your windpipe. It's not enough to make you gag or anything, not like a vacuum or anything either, but it's enough pressure to keep the airway open and allows you to A) reach deep sleep and B) stop snoring.

Now, it wasn't easy to adapt to the CPAP. The first night I was scared of it. But I got used to it, little by little. It looks uncomfortable and it can be but I learned how to sleep with it. The results were night and day. I was no longer tired. I could sleep through the night without waking up, something that hardly ever happened. I felt refreshed, renergized, renewed. I don't think without my CPAP I could have ever lost my weight; I just wouldn't have had the energy to do all the workouts.

But after losing my weight, I learned that I didn't snore any more. At all. I could leave my CPAP off and go through an entire night without snoring. No more middle-of-the-night elbows from my wife to get me to stop snoring, no more raspy snores that would wake myself up, no more restless nights.

So I strayed. I have not worn my CPAP in more than one month and probably wore it for less than 25 percent of the year, maybe on average one or two nights a week.

Not good. Not good at all.

Well, I can change all that. I can start wearing it again. I need to start wearing it again. It's a must. Sleep apnea does not go away. I've noticed too sometimes (like right now) that I get a little tired early in the day. I nap sometimes when I'm home, when I can and if I don't, the phrase "I sure could use a nap" pops into my head often.

So I will start by wearing it tonight. My wife might complain (it makes more noise now than it did when I first got it) but she needs to understand what I also need to understand - the CPAP is important. I must wear it. Every night, without fail.

Am I scared I'll fail with this resolution? Yes, I am. Very scared actually. I've gotten into a routine with it. But I must change for the better, for my sake.