WHY I’M JEALOUS OF MY CATS….Andrew Sullivan has been blogging and writing recently about his recently diagnosed sleep disorders, and it occurs to me that a fair number of people might be interested in a different perspective on this. So here’s my story.
I’ve slept poorly pretty much my entire adult life: I generally get to sleep OK, but it doesn’t do much good and I usually wake up tired. Several years ago, after reading a book called The Promise of Sleep, by one of the country’s foremost sleep specialists, I decided to see if I could do something about it.
So I asked my doctor for a reference to a sleep specialist ? and she looked at me as if I’d proposed consulting an African shaman. After she recovered she said she didn’t think their medical group had a sleep clinic anyway. A couple of days later the office called to confirm this.
I decided to visit one anyway, and called up a local hospital that did have a sleep clinic. By good fortune ? or perhaps bad fortune, as will become clear later ? the receptionist I talked to was concerned about how much this would cost me and asked me what medical group I belonged to. I told her. “Oh, they have a sleep clinic,” she told me. “I used to work there until a week ago.”
Hmmm. Back to my doctor. This time she admitted that such a clinic existed, and a week later gave me a referral. I called, and a couple of weeks later went in for a sleep study.
A sleep study is a simple thing. Basically, you come in, they spend about an hour wiring you up like a Christmas tree, turn a video camera on, and then tell you to relax and sleep normally. This doesn’t work all that well, but it does work eventually. The next morning they rousted me out of bed and told me they’d be in touch.
A week or so later I went back in to get my results ? and this is where things got weird. It turned out I had mild sleep apnea, a disease that causes your upper airway to become obstructed during sleep. In other words, you stop breathing several times an hour ? 10-15 times an hour in my case and 40 times an hour or more in severe cases. When this happens, your brain goes into panic mode, wakes you up, and you start breathing again. You’re awake for such a short time that you don’t remember it, but the end result is that the quality of your sleep is severely impaired. My father had sleep apnea too.
It took me a while to learn all this, though. The sleep specialist was oddly reticent when I asked for advice. That’s up to your doctor, she said. My doctor, of course, knew next to nothing about sleep disorders and seemingly considered them to be on a par with religious stigmata in any case. I made another appointment with the sleep specialist. No dice: she couldn’t give me advice, she said.
Eventually, I figured out what was going on: the sleep specialist was a PhD, not an MD, and was legally prohibited from dispensing medical advice. So in the end, I had a sleep specialist who couldn’t talk to me and a medical doctor who knew nothing about sleep disorders. This was not a recipe for success.
Still, between the two of them they ordered up a CPAP machine for me to see if it would help. Basically, a CPAP blows air into your nose through a mask that you wear at night. The air pressure keeps your airways unobstructed so that you don’t stop breathing.
It’s also a royal pain in the ass, and many people are unable to tolerate it. For example, me. I used it for several weeks, and even got a humidifying attachment for it, but I could never wear it for more than few hours. Around 2 or 3 in the morning, I’d wake up and couldn’t get back to sleep as long as I had it on.
What’s more, even the three or four hours of CPAP wear per night, which should have had some effect, didn’t help. I got a deviated septum repaired and tried again. No difference. I asked about further surgical options, but no one was very enthusiastic about them.
The end result is that it was all for nought. The CPAP didn’t work, the nasal surgery didn’t help, and I still sleep poorly. Bummer.
And the lesson for anyone who thinks they might have a sleep disorder is this: don’t be surprised if you run into some roadblocks, but go get a sleep study done anyway. For a lot of people the CPAP works fine, and there are medications available for other disorders. At the same time, I’d recommend that you shop around and try to find a good clinic. Most GPs don’t know much about this, and it’s the sleep specialist who’s going to be able to help you. Good luck.
POSTSCRIPT: Actually, it wasn’t all for nought. After reading the book I understood more about sleep cycles and finally figured out how to beat jet lag. I used to dread flying to Europe because I knew I was in for several days of severe jet lag, but now I have no problems at all. It’s like a miracle.
