Originally posted on September 29, 2022
We put a lot of trust in doctors, perhaps too much. I know I certainly have. For that reason, I never knew that the surgery I had undergone to correct my obstructive sleep apnea (OSA) could fail. I believed that the doctor knew best and that he had done everything possible to end the obstructive sleep apnea. I was wrong. The resulting poor sleep was a factor – alongside a yet to be diagnosed mental illness and my introverted personality – that nearly led me to my death by suicide in 2014.
There is no doubt that subsequent treatment for obstructive sleep apnea has been a factor in the healing I have undergone since then. In fact, I believe that the sleep I had at the hospital, made possible by the oxygen I was administered, was akin to using a CPAP machine and that this jump-started my healing.
Over twenty-five years ago, my then-girlfriend complained about my snoring. Although she described it as deafening, it wasn’t the volume that caused her the most concern. It was the gasping for breath, the snorting, the appearance that I was choking that got her upset. I admit I thought she was being overly dramatic: how could all this be going on without me being aware of it? Nonetheless, I spoke of these concerns with my doctor who referred me to a sleep specialist. In turn, the sleep specialist sent me for a sleep study.
The Sleep Study
For me, and for pretty well everyone who has ever had a sleep study, it was an extremely uncomfortable experience. I’m in a strange bed, with a strange pillow, trying to sleep all the while knowing that I am being monitored. I have goop on my legs, chest, and head, within which some fifty or more electrodes are placed. Most of the electrodes and goop are all over my head adding an uncomfortable weight. I feared moving in my sleep because I did not want to displace an electrode thinking that it would invalidate the study results or, worse yet, cause the application of more goop.
Yet the whole point is to sleep, and I did, at least enough for the study to produce an answer.
It revealed that yes, I was gasping for breath, snorting, and choking during my sleep. It was caused by a common illness called Obstructive Sleep Apnea. I was given scant information about the condition and relied entirely on the sleep specialist for guidance. He recommended surgery to repair my septum, remove my uvula, and scrape my sinuses and nasal passages.
I came out of the surgery thinking that the obstructive sleep apnea had been fixed and that I could breathe and sleep normally. The snoring had indeed gone away, the gasping for breath stopped and all seemed healthy.
I admit that I was naive in giving the sleep specialist such license with my care. My naivete extended to not asking the right questions or any questions. I never really asked what obstructive sleep apnea was, nor did I ask much about the surgery. Consequently, what I did not know was that the surgery has about a 25-30% success rate. Or, to put it correctly, a 70-75% failure rate. I just went about my life, unaware that for the next twenty-five years the obstructive sleep apnea was wreaking havoc with my body and my mind.
What is Obstructive Sleep Apnea?
You now know that obstructive sleep apnea is a sleep disorder. While you are asleep, your muscles relax and something (your palate, tongue, uvula, or a combination of all of them) collapses within your throat to create an obstruction in the back of your throat that cuts off your airflow. This causes you to experience an apnea (defined as the cessation of airflow for ten seconds). This can happen dozens or even hundreds of times a night without you ever being aware of it. Airflow resumes when your brain recognizes the cessation of airflow and causes you to snort, shift your body position or, in some cases, wrench yourself awake.
In my case, each apnea lasts for a minimum of eighteen seconds, typically longer, and I experience one hundred or more apneas every hour. Each time I fall asleep I end up choking myself for more than a cumulative thirty minutes of every hour. In theory, for one-half of every hour, my brain receives little to no oxygen. I say “in theory” only because apneas do not happen on a schedule. They can happen individually, or in clusters.
The consequence is that I wake up each morning more tired than I was when I went to bed. Most mornings, I begin my day with a massive headache. Every day is spent in a sluggish haze. My body feels leaden with exhaustion and my thinking is unfocused. My memory is very much hit-and-miss. I am also quite short-tempered and irritable.
Additionally, the frequency of my apneas means that I, and many others who experience this disorder, never enter the deep sleep needed to recharge. I do not dream because I never fall into a deep enough sleep to do so.
Keep in mind that I was not aware that the surgery had failed. After all, I was asleep and could not know what was, or was not, happening while asleep.
The obstructive sleep apnea came back. I thought I was tired because of too much work, or dealing with changing shifts, or too much coffee, or too much stress. What I did not know, was why. Sadly, or fortunately (I truly do not know which it is), it took something quite extreme to answer that why – a suicide attempt and my interaction with the resultant slew of doctors and counsellors. This was, without a doubt, a most extreme cost.
Just as Major Depressive Disorder is more than just sadness, obstructive sleep apnea is more than just a poor night’s sleep. The effects of it are substantial:
- an increased risk of stroke (the risk to men is increased threefold);
- an increased risk of type 2 diabetes (48% of type 2 diabetes sufferers have obstructive sleep apnea);
- you can develop hypertension;
- you will likely become obese;
- an increased risk of heart ailments including arrhythmias and heart attacks; and
- you are at risk of depression (Major Depressive Disorder).
It can, in fact, kill you.
In the United States, the economic cost of undiagnosed obstructive sleep apnea – from medical costs to treat illnesses related to it all the way to automotive and other accidents (when sufferers inadvertently fall asleep at inopportune times) – is estimated to be $100 billion annually.
Against all of this – the low success rate of surgery; the increased medical risks and associated medical costs; the increased economic cost – is a simple solution. The recommended treatment is a CPAP (continuous positive airway pressure) device. You wear a mask that is attached by a hose to a machine that pumps pressurized air. The continuous pressure is calculated to the level needed to keep your airways open. You experience a reduced number of apneas and breathe all night long.
In my case, the pressure needed to counteract the obstruction is extremely variable so I was use an APAP (automatic positive airway pressure) device. Unlike the CPAP, the pressure I receive varies in response to my need with the machine adjusting the air-pressure as needed
I now wear a mask while I sleep and my breathing during sleep may sound Darth Vader-ish. But given the choice of continuing to choke myself, or not, coupled with all the added increased medical risks, I would rather wear the mask.
Ultimately, it is about bettering my health and giving myself the opportunity to enjoy a good night’s sleep, wake up in the morning with no headache, and feel vital throughout the day. And I do.
If someone mentions to you that your snoring is overly loud, please listen to them and speak to your doctor. If necessary, undergo a sleep study, just to be safe. Your health and mind will thank you.
Image by solart from Pixabay