To Sleep, Perchance to Dream
I had a fun appointment with a doctor today – and after the past seven months, that is saying something. This doctor was the ear, nose and throat specialist that told me last October that I had cancer. He arranged for me to see the tumor board at the Stanford Cancer Center the very next day, beginning the odyssey of my winter with cancer. But today, I went to see him about his other area of expertise – sleep apnea.
About fifteen years ago, I was keeping my wife awake with my snoring and mentioned that issue to my doctor. She referred me to a sleep specialist who arranged for me to have a sleep study – which determined that I had sleep apnea. It was no surprise, as apnea runs in my family. The treatment was sleeping with a CPAP (Continuous Positive Air Pressure) machine to keep the airway inflated like a balloon. With the airway inflated, it would not collapse; so I would not stop breathing while sleeping and no snoring.
Back then, the way that CPAP machines delivered air pressure to the airway was via a mask over the mouth and nose. That mask reminded me of what Hannibal Lecter wore in The Silence of the Lambs. It looked something like this:
The problem with the mask was that it leaked air around my nose, and that air blew into my eyes. So, I didn’t snore, but it was more because I could not sleep than because the CPAP was keeping my airway open. After trying for about a month, I gave up using the CPAP and my wife has suffered with my snoring for the past fifteen years.
Fast forward to this past winter. While being treated for my cancer, I lost about 30 pounds and – wonder of wonder – I stopped snoring! Then, when I gained back about twenty of those pounds in recent months, the snoring came back worse than ever. I mentioned this to my brother over Easter weekend, and he said that I should look at CPAP machines again because the technology had been improved a great deal in the past fifteen years – resulting in the appointment that I had this morning.
My doctor did confirm that there is a very strong correlation between apnea effects and weight. When I lost so much weight, I had little or no fatty tissue around the throat, so it was more rigid. He also agreed with my brother, that CPAP technology has advanced significantly since I tried it. He suggested that I NOT use the full mask, but rather a nasal pillow, which inserts the air directly into the nose. A nasal pillow looks like this:
Also, modern CPAP machines have variable pressure and can sense whether or not the airway is open. So, they can regulate themselves to use just the amount of air pressure needed to keep the airway open – a much lower pressure than was used with the machines that I had before. Lower pressure means that the air is more comfortable and it also means that the machines are very quiet. What I had 15 years ago was quite noisy.
So, I expect to be fitted with a new CPAP in about a week – once all of the insurance red tape and paperwork is complete. I’m looking forward to seeing for myself just how much a modern machine helps me get a restful and quiet sleep.