Studying sleep

By | 2012/02/21

Me: “Oh, and supper was sandwiches, like I expected. Four little triangles.”

Darren: “Were they sandwiches of indeterminate content?”

And so began Darren and my conversation about the sleep study I had this week.

I’ve known I’ve had sleep apnoea for years, and of course, I’ve done the dumb man-thing for ages and left it untreated. The symptoms are pretty obvious – I’ve always been a terribly loud snorer, but I usually wake up groggy and barely able to function, hit particular times of the day when I’m completely exhausted, frequently wake up with my chest dripping in sweat, and fight the tiredness daily with high amounts of caffeine. And on those nights where we do sleep together, Darren has at times been acutely aware of times when I’ve stopped breathing.

So many people though think of sleep as a gentle, caressing lover. I honestly think part of what delayed me doing anything about my sleep apnoea was that I’ve always seen sleep as a foe – something to be battled against. Part of that was nightmare based, of course, as I’ve written about in the past, but I was always a reluctant sleeper, even as a kid. I used to be put down to go to sleep as a baby/young child, and I’d apparently scream myself to sleep every night. My parents still insist that the first time I had an uninterrupted night of sleep it was when I was around 7, and they woke up in the wee hours of the morning needing to check because they were panicked I may have been dead.

You couldn’t say that I’d been apprehensive about the study though. Well, I wasn’t until I got the letter explaining the process, and I saw this section:

Sleep study details

“My beard! NOOOOOOOOOOOO!” was my first reaction. I’ve now had facial hair of some variety since around 1994, and my face has not been completely bare since 1998 (there was an unfortunate situation with electric clippers being used before being fully awake, once). Even more though, I’ve now been growing the goatee part of my beard for some time, and I wasn’t willing to trim or get rid of that just for a damn sleep study:

Long beard

To be sure, there are people out there with much longer beards than I – but since I’ve got every intent of going at least twice if not three times as long as it currently is, and I wasn’t going to let a sleep study set me back six months.

The process, as you might imagine, is actually fairly straight forward. You turn up in the evening, get settled, and then you get covered in sensors. Between my head, my shoulders and my legs, there were probably twenty or so sensors all glued on. Once these were all attached to the recording device, and the recording device unplugged so I could move about until I was sleepy, I was like some proto Bear Borg:

Bear Borg

Resistance is futile. You will be discombobulated.

Of course, there was the preliminary questionnaire. The funny question for me was “have you had any coffee today, and how much?” I felt the need to qualify “(this is the quite normal for me)” when I answered “eight Greek coffees” (that seemed easier than explaining “four double Greeks”), but the rest of the questions were to be expected: do I unexpectedly nap? do I feel tired all throughout the day? etc.

The room was setup fairly well, all things considered, being at a private clinic. There was a desk and I could use my laptop until I was ready for bed, so in a lot of senses it was like a hotel room. All the documentation basically said “do what you’d normally do in a hotel room”, but of course since it was still at a hospital and there were cameras in the room, I thought it was probably best to ignore their advice and stay away from Scruff.

Once all the sensors had been attached, they got me to try out four or five CPAP masks – the intent was to do a combined study; they’d monitor until I had one or more sleep apnoea events, then come in and attach a CPAP to me and then monitor and measure how I worked with that. Surprisingly, the masks were quite comfortable, despite having to be attached extra tight due to the facial hair, but thankfully the mask goes just over the nose, rather than the nose and mouth, so this made it pretty straight forward. Despite all those sensors, each time I had a new mask put on and invited to lay down for five minutes I found myself nodding off. If anything, not getting to bed until 4am on Sunday morning may have been quite helpful on that front.

Finally though it was time for “sleep”. I was tired enough that I was willing to lay down, and after my monitoring equipment was turned on, the lights were turned off and I was invited to nod off.

In such situations as that though, as you could well imagine, it’s not really all that comfortable a sleep. For one, I’m used to sleeping alone in a king size bed. Coming down to a single bed (or maybe an oversize single bed) is enough of an odd change in itself. I’d also had some neuromuscular work done on my right arm on Saturday, and I’m still coming down from the lingering discomfort from that. But more so than anything else, all those sensors and wires attached to me, and then subsequently attached to devices on the wall, meant there was only a minimal freedom of movement. I could lay on my back, or I could lay on my left side. Since my left side has been problematic to lay on since a stomach hernia repair in 2007, I think I managed to roll over onto my side about 3 times for maybe 5 minutes apiece each.

Being woken up at 1.30am by a woman wanting to put a mask on me however was certainly a different experience to me.

I’ve got to say, despite all my reservations, I found the actual CPAP mask only a minor inconvenience compared to the actual sensors all over me. It had to be tightened a couple of times in the night – the side effect of having lots of facial hair was needing a closer fit so that as the pressure was increased there wouldn’t be constant air leakage. But surprisingly, each time that happened, I experienced maybe 20 seconds of discomfort before I was used to and fine with the constriction of the bands holding the mask in place.

And so at 5am I woke up, paged the overnight technician and began the laborious process of getting all the sensors removed. There was slight surprise that I didn’t sleep longer – but that resenting of sleep isn’t going to change just because I get the right amount of oxygen overnight, I suspect.

Despite steering away from the process for years, as a one-off situation it was, I have to say, pretty easy going. I was pleased to find out as the sensors were being removed that I most definitely had sleep apnoea; I know that might sound odd, to be pleased about that, but it at least meant that I’d been right – that was the problem, and confirming it meant that the process of fixing it is also now underway.

Oh, and the sandwich triangles did have determinate content, but I’m glad there were only four of them.