Yesterday I received my periodic re-supply of CPAP accessories which includes a new hose, facemask, filters, etc. Pretty much everything except the machine. I think I get these refreshed quarterly but I'm not 100% sure. I thought I would use this as an opportunity to do a quick update for how my use of the CPAP machine is going.

I did a one year update this summer where I wrote that I had used the machine 339/365 days for an average of 5.6 hours per night. Since that date I have logged 187/189 days (only 2 nights missed!) for an average of 5.95 hours per night.

I feel so much better when I use the CPAP machine and I'm really happy to see I have only missed a couple of nights over the last 6 months. And almost 6 hours of sleep a night – I know that doesn't seem like enough to most of you, but trust me that is a restful 6 hours (the sheets barely move anymore) and it's FAR FAR better (and healthier) than what I had been getting before being diagnosed with sleep apnea.

Yes, my plan is to lose weight and not need the machine. That sure would be nice. But in the meanwhile it's really helping me feel good and so I'm a happy user.

Think you might have sleep apnea? Get yourself a sleep study now and be sure.

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Mid-Year CPAP Update

I've really done little right this year when it comes to the topic of this blog – my weight loss journey. It's been more like Gulliver's Travels; who the heck knows what I'm going to see or do next. But there is one thing that I have consistently done well that is positively effecting my health and that is sleeping at night with a CPAP machine.

A year ago I wrote about my experience of attending a sleep study in My Visit to a Sleep Clinic. I'm sure the experience varies at each location but I found the sleep study to be a positive experience similar to staying at a nice hotel. A hotel with someone watching your vital signs all night, but a hotel nonetheless. I am sure there are people who could benefit from attending a sleep clinic but who do not because they are afraid for some reason and I would tell them to not worry about a thing.

The results of my sleep study showed that I had severe sleep apnea, having almost 50 apnea episodes an hour, with my blood oxygen levels dipping down to 80%. I was immediately fitted for a CPAP machine.

The first few weeks of using the machine was difficult as I struggled to adjust with this new experience. Over the first few months I probably missed about 20-25 nights for one reason or another. But even in those early days one thing had become apparent very quickly – the machine was allowing me to sleep in my own bed without keeping my wife awake because of snoring like I had been doing and I was no longer tired during the day. It was clear the machine was working and I focused on finding the secret sauce to making it work on a nightly basis.

I completed one year on the CPAP machine today with the following results as measured by my ResMed CPAP machine: 339 our of 365 days for a total of 1902 hours of sleep – an average of 5.60 hours per night. So over the year I did miss 26 days but almost all of those were in the first few months as I adjusted to this new experience. Since then I have been a fervent user. Less than 6 hours of sleep a night probably doesn't sound like much and maybe it isn't even enough, but it is more than I had been getting and more importantly, that is all quality sleep.

I used to be a tosser and turner in bed (if your body is waking you up every minute you would be too) and you could never count on where the sheets and blankets would end up. Now when I get up everything has remained in the same place and I literally just flip back the corner of the blanket and it's like the bed is made again. It's a pretty awesome sign of success.

I'm not going to re-write these tips here but if you are interested in some of the things that have worked for me as I adjusted to using the machine check out the article I wrote called 5 Tips to a Great Night’s Sleep with a CPAP Machine.

I've been able to have this success despite traveling a little bit this year. My CPAP machine has ridden with me on short one night trips to Wisconsin, long vacations to Tokyo and many trips in between both over the road and in the air. 4 Things I Learned While Flying with my CPAP Machine summarizes the tips I've learned along the way.

You can bet I would prefer to lose a ton of weight along with the need for a CPAP machine to treat my sleep apnea but in the interim between now and when I finally figure out what it is going to take to actually lose that weight, I'll be happily sleeping away thanks to a little modern science.

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One Year Using CPAP

It's not the best picture since I took it with my cell phone looking into a mirror, but that's me after getting hooked up for my sleep study a couple of months ago. Shortly after I took this picture I got into bed and they put more monitors on my face and plugged that wiring harness into the wall to monitor every last thing about what was going on as I slept. What you can't see in the picture is that those wires extend down my legs too – I was a regular robot freak.

But the sleep study was well worth it because it showed that I had severe sleep apnea and it resulted in hooking me up with a CPAP machine, which I am beginning to really feel the effects of. My CPAP machine has some basic usage statistics that I can see and what it is telling me this morning is that i have used it 66/75 days for a total of 315 hours. Most of those 9 days that I missed came in the first month – I had a follow-up checkup a month ago were they made some minor adjustments to the pressure (they increased it) and since then I don't think I have missed a day, and that includes 4 or 5 nights in a hotel.

For you math geniuses out there I'm sure you noticed that I am averaging less than 5 hours a night with it. For the first month I was averaging about 3 hours a night, since I have had the pressure adjusted I would say I am probably averaging more like 6 now. Many nights I do sleep through the night with it, other times I find that once I wake up in the middle of the night I have a hard time getting back to sleep fussing with it and so I won't. This is part of the "getting used to it" process that I am still going through.

So does it make a difference? Hell, yes! I have to admit it's not super obvious at first glance, but it is making a difference. First of all, the results of my sleep study showed empirically that it was making a huge difference in terms of my blood oxygen levels and my ability to get to REM sleep. The scientists looking at my charts would say it is making a huge difference in my health. But of course I never really knew about those problems – when you have sleep apnea you think you are sleeping just fine but you really aren't. The symptoms of sleep apnea like being dog tired all day, stifling huge yawns not just after a filling meal but literally any time during the day from the first thing in the morning to late in the afternoon – those are all gone. I feel much more alert throughout the day, not to mention the odd hours of the morning and night that I sometimes find myself driving long distances – I feel safer on the road.

Life with the mask is a definite pain but I am not snoring at night, I feel rested during the day and my doctors are happy. Sounds like good news to me!

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CPAP Update – Life with the Mask

As I wrote about in my last post, My Visit to a Sleep Clinic – Overnight Sleep Study, I recently participated in a sleep study to determine whether I had sleep apnea. I ended that post in the morning waiting for the doctor to discuss the results. If you want to know a little more about participating in a sleep study you should check it out.

Despite having only 3 patients in the sleep clinic that night it took the doctor awhile to get to me. I wiled away the time in the morning watching a little television while propped up in a wonderful Sleep Number bed that moves into all sorts of positions. It also had a head and foot massager but I didn't like how much noise it made so I didn't use it.

Finally, the doctor came in and introduced herself. She told me that the detailed report of my stay would take a day or two to compile but she had preliminary results that she could share with me.

She started by saying that the technician had observed "moderate snoring" which was really no surprise to me – actually if there was a surprise it is that it was characterized as "moderate." Then she proceeded to explain what an apnea episode is, which I will summarize by pulling from this article:

People with OSA experience recurrent episodes during sleep when their throat closes and they cannot suck air into their lungs (apnea). This happens because the muscles that normally hold the throat open during wakefulness relax during sleep and allow it to narrow. When the throat is partially closed and/or the muscles relax too much, trying to inhale will suck the throat completely closed and air cannot pass at all. This is an obstructive sleep apnea episode.

A cessation of breathing must last 10 seconds or more to be called an apnea. Obstructive apnea episodes can last as long as two minutes and are almost always associated with a reduction in the level of oxygen in the blood. When an individual is in the midst of an obstructive sleep apnea episode, as long as sleep continues, the apnea continues. It is only terminated and the victim's life is saved by waking up. This arousal instantly increases the activity of the muscles of the tongue and throat muscles that enlarge the airway. The victim will be able to breathe and to once again fill the lungs with life-giving oxygen. This cycle may be repeated hundreds of times a night while the sufferer has no idea it is happening.

And then came the verdict. According to my doctor I was observed as having more than 35 apnea episodes in the first hour I was asleep, and if they hadn't started with the CPAP machine at that time she said I probably would have had 45 or 50. 35 apnea episodes is the number they use to classify it as being severe sleep apnea, so clearly when you don't even finish an hour of sleep before you can be classified with serious sleep apnea that you have a major problem.

The second point my doctor made after telling me that charming news was that during the apnea episodes my blood oxygen levels were going down to 80%, which apparently is just as bad for you as it sounds.

The good news is that she said that after getting on the CPAP machines I no longer was snoring, I no longer was having apnea episodes and my blood oxygen levels stabilized to wherever they are supposed to be. In effect, I had a restful night of sleep after using the machine. Well, restful as long as you don't include the technician coming in and adjusting the sensors periodically!

So this is truly a good news, bad news scenario. The bad news is that I have a potentially life threatening problem. The good news is that I was able to diagnose that I thought I had it, and then followed through to treatment by getting a doctor referral and a visit to a sleep clinic. The bad news is this mask is not the funnest thing to be wearing every night. The good news is that it is possible that if I can get into shape that I may not have to wear it anymore.

So while I have always had good reasons to get in shape that I have apparently ignored perhaps this one will be it – the realization that if I want to live as long as possible that I either need to wear a CPAP mask for the rest of my life or get into good enough shape that I possibly won't need it any more. Of course if I don't get into shape the CPAP machine is only going to help with my apnea, things like heart disease, diabetes, etc are all waiting out there for me if I stay obese.

One of the things I have found is that it is easy to get off the path you have set yourself on. Perhaps the daily reminder of the CPAP review will be enough to help me stay on course.

If you have any of the symptoms of sleep apnea, the primary ones which are fatigue and tiredness during the day and loud snoring repeatedly punctuated by brief periods of silence or choking sounds, then I urge you to contact your doctor and get a referral to a sleep clinic.

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Results of my Sleep Study

I don't recall being a snorer when I was a normal weight. As I gained weight my snoring got worse and to the point where it really has effected my quality of life the last couple of years. It's not just the snoring, it's the tossing and turning, the waking in the middle of the night and the overall impact all of that had on my wife's sleep – not to mention the wear and tear on the couch!

Over the last couple of years I have been reading a little about sleep apnea and have taken a few online quizzes that ask question likes "do you ever feel yourself unable to breath at night", "are you sleepy during the day even after a long night sleep", etc. Almost invariably my answers to these questions were YES, YES and YES.

I started thinking about it a little more last year when someone who worked for me went through a sleep study and was diagnosed with sleep apnea. He spoke highly of how much better he felt once he was put on a continuous positive airway pressure (CPAP) machine that allows for a restful sleep.

Lately I've been hearing ads on the radio for a sleep center and I finally bit the bullet during my annual physical, and talked to my doctor about what I thought I had. He concurred and referred me to a specialist.

Yesterday afternoon I met with the specialist, which really amounted to nothing more than watching a little video on sleep apnea and what I could expect by visiting a sleep clinic for an overnight observation, and going over a survey that I completed. At the conclusion of that meeting we setup an overnight sleep study, where coincidentally enough the first opening was that night!

So last night I packed up an overnight bag and headed over to the sleep clinic, which was a nice new building with what appeared to be pretty good security. I met the technician at the front desk, went through some paperwork and then was shown to my room, which was a very nice hotel-style room with private toilet and shower, tv and a wonderful Sleep Number bed. It also had a bedside CPAP machine all setup.

Once I got into my PJs (they don't allow just undergarments so I just wore shorts and a t-shirt) she started to get me all wired up. She must have applied 20 sensors to various parts of my body. I counted 12 on my head alone. Once I got all wired up we went back to the room and she tested the CPAP machine on me but we started off without it. She would put that on me in the middle of the night if I needed it.

I had to wait for awhile until she got another patient wired up and I started to get pretty sleepy just reading a book. Finally, just when I thought I might fall asleep before it was time, she came in to finish her work, which was to get all my sensors and wires hooked up to the machine and test from her control station (there was a camera videotaping me) that all the sensors were working.

Once everything was working she wished me good night and I no doubt fell asleep right away, which is another sleep apnea M.O.

I didn't see her again until sometime in the middle of the night when she put the CPAP nosepiece on me so that I was getting oxygen from the machine. She had to come in a couple of times during the night to adjust some sensors but that's all I really remember.

In the morning we had to walk through all the tests again, I guess to make sure the equipment was working normally, and then I got unwired, cleaned off, fed, and waited for the doctor to talk to me about the initial results.

All in all it was a pretty uneventful night, and not much different than staying at a nice clean hotel, albeit without most of the amenities. If you are nervous about going to a sleep study, don't be – it was a piece of cake and it could save your life!

Want to know how it turned out? You'll have to tune in tomorrow – I'm saving that up for another post. (and here it is: Results of my Sleep Study)

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My Visit to a Sleep Clinic – Overnight Sleep Study