On December 30 I saw my PCP for my checkup visit. He went over the results of my blood work which were excellent. He asked me how I was feeling overall and I replied that I wake up every night around 2 am, but otherwise I’m fine. He then asked me if I wanted a sleep study done. He followed that question by saying I would lose weight using a CPAP (Continuous Positive Airway Pressure) mask. I said sign me up!
On January 6, I went to the Sleep Disorders Center for a consultation with Carla, the nurse practitioner. She had me fill out their questionnaire to get a general idea of my symptoms and asked me questions about my sleep patterns. She explained that Obstructive Sleep Apnea (OSA) is a fairly common problem in which air cannot flow normally into the lungs during sleep. It is usually caused by the collapse of the soft tissues in the back of the throat and tongue. Carla said that when you stop breathing, your brain wakes you and you gasp for air, fall back asleep, and the cycle continues. I learned that when this happens you don’t get the restorative sleep your body requires, and that OSA increases your risk for many health problems including high blood pressure, heart disease, stroke, brain damage, depression, type 2 diabetes, obesity and mortality. She then explained what a sleep study involved and scheduled me to return on January 8 at 8 pm for the study.
On January 8 I returned to the Sleep Disorders Center where I met Lisa, my sleep technician. She escorted me to my room which looked like a nice hotel room with an attached bathroom. She explained that during the study my breathing, heart rate, sleep state, and oxygen levels will be monitored. She told me to change into my sleepwear, and at 10 pm she returned and led me to another room where she placed electrodes attached to long wires on my head and two bands on my stomach to monitor my breathing. The study began at 11 pm when Lisa plugged the wires into the wall and I went to bed. She retreated to another room where she monitored my sleep throughout the night. I lay awake tossing and turning for several hours and finally fell asleep. I awoke at 6 am when the study was completed. I felt like a failure, but Lisa assured me that I had slept enough for a successful sleep study.
I returned to see Carla on January 27 to get the results of the study. I was informed that I have moderate Obstructive Sleep Apnea. During the study I slept a total of 268 minutes; during that time my airway was partially or completely blocked off 127 times. I also learned that during one REM (rapid eye movement) episode I stopped breathing 90 times in one hour. That alarmed me.
On January 29 I was back at the Sleep Disorders Center, this time to sleep with a CPAP mask that covered my nose. I was once again fitted with electrodes and stomach bands to monitor my sleep. Lisa retreated to her office to monitor me and make gradual adjustments during the night to the H2O pressure in the machine. This time I fell right asleep, waking only once during the night.
Data collected during every study is reviewed and evaluated by a board-certified Sleep Medicine Specialist MD, who then prescribes a CPAP if determined appropriate. Carla told me during the follow-up visit that their doctor, whom I never did meet, had prescribed CPAP therapy for me.
On February 11 I met with Amy, a registered respiratory therapist. We first discussed the nose-only mask that I had used during the study and how I didn’t like the rush of air I got when I opened my mouth. Based on that feedback, Amy set me up with a full-face mask, tubing to deliver the air, and a CPAP machine with an attached humidifier. She explained that my insurance would cover 80% of the cost and I would be allowed to pay the other 20% over a period of 10 months. My insurance requires that I become compliant with my physician’s orders by using my device a minimum of 4 hours a night, 22 out of 30 days. The machine has a memory card and a transmitter that sends the information collected to the home care agency that Amy works for. The first night that I wore the CPAP was a little awkward, but I gradually got used to it and now I sleep all night with the mask on. Carla had previously told me that people who do well with the mask are determined to make it work because they feel so much better using it.
So now at night I wear my insulin pump, my continuous glucose monitor (CGM), a dental mouth guard to prevent teeth grinding, and the newest device, a CPAP mask. I still wake up when my CGM beeps to alert me of high or low blood sugar, but I return to sleep faster and sleep better. I feel rested, refreshed and more alert in the morning, and my eyes no longer have dark bags under them. And yes, I am losing weight with additional help from My Fitness Pal, a great free app that keeps track of my calories and exercise.
If you are interested in learning more about sleep studies and the decision to use or not use a CPAP machine, please check out Rhonda’s post dated 1/16/14 and another one dated 3/4/14 at her blog Fifteen Wait Fifteen.