Waking up below zero

[rolanni]

Wow, a lot of opinions on yesterday's discussion question!

Speaking as someone who writes books that have been dinged as "too easy," "too hard," "cheesy," "guilty pleasures," "badly written," and "literary masterpieces" (often the same books), the only thing I can add is that every reader brings a different expectation to the table, and that no two reading experiences can be the same, because we all live alone inside our heads.

The qualification and certification processes are fascinating to observe, though.

FWIW, I was raised up by a band of feral newspaper reporters and advertising copywriters. Keeping it simple is one of the basic tenets of both forms. Good reporters must especially excel at being able to communicate sometimes very emotional, and very complex information clearly. So "easy read" in which "easy" stands in for "clear" and "accessible" is sorta the Grail.


Yesterday became All About Doctors. Not only did Steve have an appointment, but I got a lightning appointment with my doctor, too. Nope, not jealous, but. . .Steve reports that I sometimes stop breathing when I'm asleep, and then start up again, noisily. And I have for a couple years now woken up from time to time with a "recurring dream" that I'm not breathing, and start gasping for air. Which, yanno, I figured was Just Stress.

Turns out that it might be sleep apnea, and the gasping thing is my brain yelling, "Hey dummy; you're not breathing! Wake up!"

So -- a sleep test in my near future. I'm not worried about getting any of the answers wrong, because I intend to brush up with Mozart, who has a double-doctorate in the Art and also the Science of Sleep.

However! I think that some of you on the FL have had this test? What can I expect?

For today -- a couple hours at the day-job, then a drive to Bangor in the maybe-snow, for -- wait for it -- a doctor's appointment.

Comments

[isabellag.livejournal.com]

I've done the sleep apnea test (twice); try to take as much stuff from home as you can to make sure you're comfortable (pillow, quilt, cat). If you're a light sleeper (like me) it's going to be very difficult in a strange room to reach a deep enough level of sleep for your apnea to register - both times were inconclusive for me because I just wasn't comfortable enough to get right into sleeping. Worth doing though, can save your life. Good luck!

[romsfuulynn.livejournal.com]

Had it done, got the machine - 3 years out, changed my life for the better. (Also Ben's since there is a low whoosh as opposed to snoring.)

They will do a split study because of insurance. If positive (I'm guessing it will be)at 1 am they wake you up and say let's put this mask on.

There had been a video showing it, but I still freaked when I tried to lie back down with it, felt I was smothering.

Ask if you can get there a little early and do "mask desensitization" before the study. Sitting up and awake in a chair getting used to breathing with the mask on - doing that would have saved me $250 in copay for a second night's study.

Bring your own pillows if you care about them although a good place will have an assortment.

They attach a boatload of wires to legs, torso, scalp, etc, and if/when you get up to use pot, they all go to a single sensor connection that goes with you. Stuff in scalp is sticky - like a sugar paste - you will want to shower there if offered.

Tell them you read in bed before sleeping, and with glasses if you need them - this affects long term mask selection

This is the kind I use:
http://www.cpap.com/productpage/resmed-swift-fx-nasal-pillow-cpap-mask-headgear.html

[jhetley.livejournal.com]

Snow is not supposed to be significant. "Flurries" -- none of which have yet accrued. Which means, watch out for the hidden road-grease . . .

[angrill.livejournal.com]

Nearly 8 years ago I had the test after my wife told me I stopped breathing sometimes for up to 30 seconds and she could not sleep when I was not breathing. They hook up wires everywhere and then tell you to lie down and go to sleep...right. Eventually I got to sleep and then they woke me up to put on a mask. Now there are different types of masks and the first one they tried on me fit over my nose only. I am not normally claustrophobic, but that type of mask nearly drove me crazy. After about 30 minutes I asked to try a full face mask. I fell asleep in about 2 minutes and slept fine the rest of the night. I ended up with a CPAP machine and the full face mask. My wife is much happier now since my loud snoring has changed to a gentle whoosh from the machine.

[drammar.livejournal.com]

I've had the test a couple of times -- apparently my sleep apnea is not bad enough yet to require the mask.

I'll add one caveat to the that romsfuulyn gave above -- bring your own shampoo. The facility that I used offered a shower and soap but no shampoo! And I'd advise that if you are due a haircut that you get it done before rather than soon after.

Oh -- and the prep the skin before attaching the wires, which means they use a light sandpaper on it. Sensors also located on your face, and of course a pulse oximeter on your finger.

Best of luck.

CPAP Masks

[psw456.livejournal.com]

My husband has sleep apnea and uses a CPAP machine. His first mask forced him to sleep on his back. Then he got a much smaller one that fits in his nose (mostly)allowing him to sleep on his side which he prefers. So please know that your preferred sleep position can be accommodated by a different type of mask if using a CPAP machine ends up as the verdict.

Best of luck falling asleep for the test!

[katmoonshaker.livejournal.com]

I have had one already and will be having another. The first one they hooked me up to oxygen which weirded me out. Seriously, how can they tell if I'm not getting enough oxygen at night if they're supplying me with oxygen?? So I'm having another done at Vanderbilt sometime this spring or summer. It's simply a matter of having a zillion wires attached to you and then going (or trying) to sleep. They did find out that I don't reach Delta and prescribed some medication which costs me a $100 copay. HA! Given our finances I no longer sleep. If it turns out that you have sleep apnea they'll hook you up (literally) with a CPAP machine. I have several friends who use them and said they made a major difference in their lives.

Best of luck!

[maddoxa.livejournal.com]

My husband had the test and got the CPAP a couple of years ago. Without it he stops breathing every 45 seconds for 10-15 seconds. With it - actually, he still stops breathing, but no wrenching gasps to start up again; he just starts breathing again.
The problem is, he hates the facemask, so he doesn't wear it until the tiredness catches up with him. His does feel a bit like having the alien on your face.

and the air is blown over a water supply before it gets to you, so you have to keep filtered water on hand.

[queenmaggie.livejournal.com]

says everything I would have. Plus, now when I put my mask on, I immediately fall asleep and stay asleep until morning. It's actually Pavlovian. And I had been thinking I had a bladder problem, because I'd been waking up to go to the bathroom two or three times a night. It was just that I was waking due to not breathing, and thinking, "gee I must need to use the bathroom...."
Find the right mask, make sure you can adjust it to fit you, use a humidifier if your area is dry (I'm in Florida, so I don't seem to need one, which cuts down on extra cleaning issues) I'm so much more energetic and less sleepy now!

[(Anonymous)]

My husband has had the sleep test on several occasions. (Apparently they do follow-ups every few years.) The above comments appear to be right on track, except that in his case he came home to shower and change clothes before going to work. He wears the most comfortable things he can to do the sleep test - comfy cotton shorts and a loose T. He also has his doctor supply a sleep aide - luckily one time he was able to get a sample packet. I think it was ambien - nothing heavy just something to help him relax.

The thing to remember is that there are MANY types and styles of masks and accessories available. If you don't like one - it makes you claustrophobic, you can't get into a comfortable sleep position, or it causes skin irritation - you have many options. Try to give the recommending person as much information as you can to help find the best mask. However, don't be afraid to try others. So many people quit or (as someone above mentioned) only wear it when they really get desperate, when it can be a health / life saver.

[(Anonymous)]

Sorry forgot to identify myself,

from Susan in Orlando

[mothadventures.livejournal.com]

I've had the sleep study and do indeed have sleep apnea, but am two interruptions per hour below the point where my insurance will pay for the CPAP. (grrr......)

When you are scheduling the test, be sure to ask for an arrival time an hour or so before your normal bedtime, as there will be lots of prep work (paperwork, attaching those lovely electrodes, getting some baseline measurments, etc). The centers around here seem offer arrival times between 8PM and 11PM, depending on the center.

I second the advice to be sure you bring everything you need to simulate a normal-for-you bedtime routine (although I don't think they will allow a cat), but even so you may not get much sleep at all the night of the study. There comes a point when they wake you up and toss you out, no matter how much or little sleep you have gotten.

I live only a 15 minute drive from the center, but I was so exhausted that I barely made it home safely the morning after the study, collapsed into bed, and slept for four hours. If it had been a longer distance I could not have driven safely and would have to have slept in the car. Hopefully that won't happen to you, but if it's a long drive to the sleep study center you may want to have a contingency plan in place.

[readinggeek451]

Waking up and going to the bathroom multiple times in the night is apparently diagnostic. (As one person I know put it, when you're not sleeping properly, the pump doesn't shut down.)

Sleep study: what everyone else has said. They wire you up and have you go to sleep. If you're fussy about pillows, take your own; I also took my teddy bear. In my case, they did two nights, one diagnostic and the second to calibrate the CPAP. For the diagnostic portion, they insisted that I sleep on my back, because they can get a better picture that way; I sleep very badly on my back! I turn out to have severe sleep apnea; the CPAP machine has made a huge difference to my health, alertness, and general well-being.

(edited to fix typo)

sleep apnea

[(Anonymous)]

My husband has sleep apnea. He had no trouble going to sleep (while reading, talking, driving!) but would stop breathing, which made us both wake up. Then I'd stay awake watching to make sure he was still breathing. Exhausting for both of us. The machine was a real benefit except that 1)it didn't fit right and he kept blowing cold air onto my head when we snuggled and 2) the cat ate the cord to it. Sigh. His breathing was actually much better on it's own for months afterwards. Now we need to get him a new one, and put aluminum foil on the cord for the cat, D'art, who at two is not quite as fond of cords as he was as a kitten. I will say we both benefited from him sleeping better with the machine. Kathy in CA

[jilltanith.livejournal.com]

There are actually two kinds of sleep studies now; attended and machine. I actually had the machine one about six weeks ago. You go pick up the machine, they fit the headstrap to you, and take it home. At bedtime, you peel off a strip over a couple of adhesive areas, put the machine over your head with the sensors over your forehead and a cannula in your nose, and press a button on the machine. Lie down on your back until the machine tells you that you can move, then position yourself comfortably and go to sleep. When you wake up, you turn off the machine and take it back to the doctor's office.

My results showed that I had results in the normal range when sleeping on my side, moderate apnea when sleeping on my back. So I'm avoiding sleeping on my back, at least for the moment.

[(Anonymous)]

"Waking up and going to the bathroom multiple times in the night is apparently diagnostic."

This can also be a sign of diabetes.

Susan in Orlando

Re: sleep apnea

[kalimeg.livejournal.com]

I'd say paint the cord with pepper sauce and let it dry. :)

[(Anonymous)]

ditto to everything readinggeek451 added. I blamed it on BP meds before doctor recognized it as indicative of likely sleep apnea.

Doing well with my CPAP machine. Ongoing costs for monthly/quarterly supplies somewhat surprised me, though. There really ought to be a way to deep clean and reuse hose and mask components on long-term basis, IMHO. (Engineer at heart) I keep thinking that surely these components could be carefully cleaned and then run through a Hospital's (or clinic's) autoclave, and then be "good" for another 3 months. This disposable approach (clean daily and dispose at 3 months) seems wasteful.

But now, sleep is GOOD! Don't be afraid...it's worth the initial slight discomfort. And, no, after the test is over you don't ever again have to wear all that ridiculously outdated set of monitoring equipment with wire tails everywhere. Geez! You'd think they'd bring this testing procedure into the 21st century, rather than continuing to rely on best of 1950's technology! ;-)

[martianmooncrab.livejournal.com]

I went through several sleep tests before they did the one with the CPAP itself. I did qualify for the machine, but it turns out that the face sucker and my flesh dont like each other and the skin on my face abrades.

I ended up buying some high end pillows to keep me elevated when I am sleeping.

Re: sleep apnea

[mothadventures.livejournal.com]

When my father was first put on oxygen and used a setup with a long hose that dragged across the floor, we came up with an idea for "murder by cat".

The idea was, smear a little catnip on the line, and the cat would tear it open....

(But for protecting the power cord, I would just get one of the inexpensive cord organizers that looks a bit like a ribbed garden hose with a slit in it, and stick the cord in that. Ikea used to sell them pretty cheap.)

Sleep apnea and the CPAP

[(Anonymous)]

I've had a CPAP for almost 10 years.
I love it, mostly because I can pull the covers up over my head and still breathe. But also there is the white noise. I have a standard mask that covers the nose with a sort of bar on the forehead. I got a lot of weird zits around the silicone at first, but the ones on the side of my nose stopped popping up fairly soon and I use a cotton or linen hankie under the forehead brace to prevent the problem there.

I've found that the more often I clean the plastic/silicone pieces the sooner they discolor and/or fall apart. And the zit around the nose problem is worse. So I just check them for obvious grunge, wipe it off and only if that doesn't work apply soap and water. I usually need a new mask less than once a year.

I sleep on my side with the help of 2 or 3 pillow to prop my head to about shoulder height.

The worst thing about the test was that I was supposed to sleep on a plastic covered mattress covered only by a thin sheet. If I take another test I will bring a futon pad. Also, make sure you know what time you have to leave in the morning. I was booted out shortly after actually got to sleep. I was so glad I had someone to pick me up.

Sue H

Re: sleep apnea

[(Anonymous)]

We tried every kind of pepper, anti-cat spray etc. He just likes cords. Thanks though. Kath of CA

Easy Read

[claire774.livejournal.com]

I'll leave the discussion on sleep apnea to others because I don't know anything about it except ....I have two friends who have taken a test and didn't complain about the test at all so hopefully it isn't that bad.

On "easy read". Simple and clear is definitely best in my opinion. Indeed for "easy" one might mean "clear". I happen to like the first sentence of novels or the first paragraph. For your inspection the first paragraph of "the Hobbit" by J.RR. Tolkien. "In a hole in the ground there lived a hobbit. Not a nasty, dirty, wet hole, filled with the ends of worms and an oozy smell, nor yet a dry, bare, sandy hole with nothing in it to sit down on or to eat; it was a hobbit-hole, and that means comfort.".

Notice that most of the words are one syllable. Only one I believe is descended from French which kind of made our language classier. Most good solid English words descended from the Anglo Saxon from before 1066.

First sentence of "the Fellowship of the Ring" "When Mr. Bilbo Baggins of Bag End announced that he would shortly be celebrating his eleventy-first birthday with a party of special magnificence, there was much talk and excitement in Hobbiton." One long sentence with some words descended from French. Perhaps to signal that this is a book for grown ups, not for children.
C.

[paw3pals.livejournal.com]

Roommate refuses to get a sleep test or consider CPAP, even with his doctor saying he has apnea. We found the below mouthpiece works pretty well in preventing the snoring and in feeling better.

http://www.nosnorezone.com/

Got the least expensive one first, to see if it worked. It did, then a dog ate one and another went thru the laundry. Now has the Somnoguard SP and it works much better and feels better.

Additional CPAP comments

[(Anonymous)]

As mentioned above my husband has had the test and uses a CPAP. First for the person that has zit and irritation problem with a full or nasal mask, try looking into a "pillow" mask. Due to skin irritation, Steve finally started using that style. It is a very small plastic "mask" that fits just below the nose. I am not fond of it because it exhaust the air out on the sides, so I often have air blowing on me. However, Steve can wear it without skin problems on a nightly basis and that is what is best.

Second, if you are in an area that has frequent power outages or brownouts, especially at night, purchase an inexpensive UPS to plug the CPAP machine into.

Third, since the CPAP machine is a medical device, it doesn't count toward your carry-on luggage when traveling. Be prepared to take it out of it's bag to have it x-ray'ed and/or swabbed for explosives.

Fourth, pack an extension cord into the CPAP travel bag. It is amazing where and how hotels hide their electrical sockets.

Susan in Orlando

Sleep apnea and body posture

[zoned001.livejournal.com]

First, have had the test 3 times. Have dealt with this since early 90's. It's not difficult as long as you can deal with minor irritations (wires, etc.) and strange bed/bedding when going to sleep. The newer systems are much easier to deal with. Noticed lots of good comments on that. Be aware that there is a fairly large subset of folks who can not use/tolerate CPAP or APAP devices. I've spoken with sleep Dr.'s who estimate 25% to 50% of patient don't long term. As ever, YMMV. The CPAP is a preferred treatment as it's relatively cheap. I'm in the subset that can not use a mask to sleep (35+ types tested). Have gone through multiple surgeries to improve airway. Everything but breaking all the bones in my face apart and restructuring with titanium plates (bi-maximal facial reconstruction). So, been there and wore the t-shirt. Did the dental appliances dance, etc. The bottom line? It doesn't always work. Sleep Apnea can be caused by several different issues, most related to airway closing. I'm not over weight, yet I have severe apnea. Post years of medical intervention I worked on Yoga and the fact that with years of keyboard work my collar bones/chest were bowed inwards. I was fortunate to work with an Iyengar Yoga practitioner who spends time in India at the Iyengar medical clinic. She at least recognized the situation and knew how to compensate. So keep my tale as a cautionary. Sometime the resolution is mechanical - bio-mechanical, that is. As long as I make time to practice and keep the chest and neck muscles relaxed & opened I sleep normally most nights. Would have been a lot cheaper and saved me a lot of surgical recovery time if I'd researched more, sooner. -Robert

[magda-vogelsang.livejournal.com]

My impression is that the exact procedure varies some depending on the sleep center.

I was tested one year ago, with the initial diagnostic test done in December, and a follow up with the mask in January. The first test was done at the hospital sleep lab (University of Michigan Hospital), and involved having dozens of electrodes attached to me (chest, back, legs, face, lots glued to my scalp with sticky red goo, etc.). These all attached to a box on a strap, which in turn plugged into a cable.

After the electrodes were attached (which took longer than you'd think) they did let me read for a while before going to sleep, since that's what I normally do, then they hooked everything up, and told me to at least try to sleep on my back (I'm normally a side sleeper), and if I wanted to switch to my side halfway through I could.

It was one of the worst nights sleep I've ever had. Had trouble going to sleep, what with all the wires, the tubes in my nose, the fact that the guy had taped together a bunch of the wires and caught some of my hair in the tape, etc. And every time I woke up and had to use the bathroom, I had to ask someone to come unhook the O2 and unplug the box from the cable so I could carry it with me.

Apparently while on my back I stopped breathing 107 times an hour--severe obstructive sleep apnea. And I only got about 3 hours sleep total, and felt worse in the morning than I did when I went to bed.

I had to go straight to work afterward (bad idea, even if the building where I work is connected to the hospital), and had to use their medicinal shampoo and no conditioner to wash the goop out of my hair. I'll second the recommendation to bring your own!

The second test was at a satellite lab closer to my house, and the woman there managed to put the electrodes on in a way that was less uncomfortable. I mentioned that I have allergies and can't always breathe well through my nose, and she recommended I still try a nasal mask first, since it's apparently easier to convince the insurance folks to buy you a full face mask when you already have a nasal one than vice-versa.

Again I read for a while, and then got plugged in and went to sleep. And had the best night's sleep I'd had in at least 2 years, despite all the odd paraphernalia.

My CPAP has made a HUGE difference in my quality of life. I no longer have to struggle to get out of bed to get to work, I don't have to fight to stay awake in meetings (any more than anyone else), my energy level is far higher, and I don't have to get up in the night to use the bathroom anymore. I did end up getting a nasal mask, which I use most of the time, and (as my first replacement) a full face mask to use when I have a cold or my allergies are bad.

So in summary:

Bring your own shampoo and anything you need for your normal bedtime routine (though I doubt cats are allowed).

If you bring your own pillow as recommended above, I'd consider using one of their pillowcases on it, unless you want to get goo from the scalp electrodes on yours.

Don't plan to get much sleep, or to go to work the next day, if you can help it.

just a little to add

[(Anonymous)]

Hi,

Good luck with the test, it's not scary at all. It's hard to sleep when you know someone is watching.

I see someone mentioned the travelling/TSA issue. When/If you get a CPAP machine, you'll probably get a carrier for it. They used to just swab the carrier for explosives residue, now they make you take it out of the carrier case. Just slows you down (and adds to the paranoia that someone will steal something whilst you're dealing with all this).

Masks: I've see three kinds. One has a plastic bar with two "pillows" one for each nostril, held in place with a few straps. Easier for sleeping on your side, less feeling of strangling/claustrophobia. Another type there's a nose piece held in place with straps, I like it better for the air flow issues, but I also had the problem with skin reactions. There's a more elaborate one which covers the nose and mouth, more important if you have mouth vs nose breathing issues. They might give you more than one type to try.

It might take a little bit of time to get used to the hose when you're turning over in your sleep.

I never used to be able to sleep with my head under the covers (how do cats do that?), but I can with the CPAP. Sort of like a snorkel. This comes in handy when sleeping in room that isn't dark enough. Glad to see by someone else's comment that I'm not the only one.

Some people have a whole lot more energy during the day after using the CPAP machine. I haven't found that dramatic an energy difference, but I'm much more comfortable when I wake up (hadn't realized how much neck discomfort I'd been dealing with until it stopped) and have a lot less post nasal drip issues. Also fewer headaches.

Angie

Disposable

[wjb3-reads.livejournal.com]

"This disposable approach (clean daily and dispose at 3 months) seems wasteful."

Actually, the sleep study lab *does* clean and reuse between patients.

I am terrible at ordering my consumable supply. Record is 8 monthes on a mask. If you compare my 8 month old mask to my new mask, the new mask is more comfortable and gives a better seal when I roll over on it. The 8 month old mask is uncomfortable and does not seal properly. As far as I can tell, the straps on the headgear lose elastity, the seals lose elastity and grip, the hose loses its seal to the CPAP, the hose's rigid wire support gets repeatly crushed and the humidity tank plastic becomes cloudy.
-=FIN

Individuality

[wjb3-reads.livejournal.com]

My Mom, my wife and I had different experiences at the sleep lab. I guess it depends on the tech on duty.

Because of my goatee, I got one type of mask and my wife another. She hated hers, so she got a dental appliance.

Recently I got a free iPod Touch App and checked, with the dental appliance her snoring has gotten worse lately. At her annual checkup, other things had gotten worse so the doctor is suggesting ditching the dental appliance and trying different masks until she finds one she likes.

I tried turning off my CPAP humidifier for a while since it can run off a marine deep cycle battery without the humidifier . Ended up irritating my tear ducts. After treatment to fix my tear ducts and eyelids, I now have to turn up the humidifier to 3, instead of 2, to keep my eyes moist.
-=FIN