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’d undergone to correct my obstructive sleep apnea (OSA) had failed. The resulting poor sleep was a factor – alongside my mental illness and my personality – that nearly led me to my death by suicide in 2014.
There’s 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 being given, was akin to using a CPAP 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, the sleep study was an extremely uncomfortable experience. I’m in a strange bed, with a strange pillow, trying to sleep while knowing that I’m being watched. I have goop on my legs, chest, and head, within which some fifty or more electrodes are placed. The vast majority of the electrodes are all over my head which adds an uncomfortable weight. I feared moving in my sleep because I didn’t want to displace an electrode. If I did that, would it invalidate the study? 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. Apparently, it was caused by a common illness called Obstructive Sleep Apnea (OSA). 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 hopeful that the issue was solved. It was – or so I thought. The snoring went away, the gasping for breath stopped and all seemed good.
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 OSA was, nor did I ask much about the surgery. Consequently, what I didn’t know was that the surgery has about a 25-30% success rate. Or, to put it another way, a 70-75% failure rate. I just went about my life, unaware that for the next 25 years the Obstructive Sleep Apnea was wreaking havoc with my body and my mind.
What is Obstructive Sleep Apnea?
You’ve probably already guessed that Obstructive Sleep Apnea is a sleep disorder. While you’re asleep, your muscles relax and something (your palate, tongue, uvula, or a combination of all of them) collapses to create an obstruction in the back of your throat cutting off your airflow. This causes you to experience an apnea (defined as the cessation of airflow for 10 seconds). This can happen dozens of times a night without you ever being aware of it. Some people have hundreds of apneas a night. Airflow is regained when your brain learns of the obstruction and causes you to snort, shift your position or, in some cases, wrench yourself awake.
In my case, each apnea lasts for 18 seconds or more and I experience 70 or more apneas every hour. In essence, each time I fall asleep I end up choking myself for a cumulative 20 minutes every hour. For one-third of every hour, my brain receives little to no oxygen.
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’m also quite short-tempered and irritable.
Additionally, the frequency of my apneas means that I, and many others who experience this disorder, never enter into the deep sleep needed to recharge. I don’t dream because I never fall into a deep enough sleep to do so.
Keep in mind that I wasn’t aware that the surgery had failed. The progression of OSA came back gradually. 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 didn’t know, was why. Sadly, or fortunately (I truly don’t 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 OSA are substantial. There is an increased risk of stroke (the risk to men is increased threefold); type 2 diabetes (48% of type 2 diabetes sufferers have OSA); hypertension; and other ailments, including depression. It can cause heart attacks or arrhythmias. It can, in fact, kill you.
In the U.S., the economic cost of undiagnosed OSA – from medical costs to treat illnesses related to OSA to related automotive and other accidents – 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. In essence, you wear a mask and inhale mildly pressurized air. The continuous pressure is calculated at the level needed to counteract the effect of relaxation and 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 prescribed an APAP (automatic positive airway pressure) device. Unlike the CPAP, the pressure I receive varies in response to my need.
Yes, I now wear a mask while I sleep and my breathing during sleep may sound Darth Vaderish, but given the choice of continuing to choke myself, or not, coupled with all of the additional increased medical risks, I’d rather wear the mask. Ultimately, I’m looking forward to a good night’s sleep, waking up with no headache, and feeling vital throughout the day. And I do.
Image by solart from Pixabay