Not all who have sleep apnea snore; not all who snore have sleep apnea.
~ My doctor
I didn't get the 100,000 signatures I needed for White House action on my Port Chicago White House Petition. What I did get in the interim may have saved my life.
I have been tired for a long time. Years. I just assumed this was what middle age felt like -- diminished energy, foggy thinking. I just thought this was menopause or my ferritin deficiency (ferritin is the back-up iron storage in your system) and I had to get used to it. I often wondered to myself and to Black Man Not Blogging (BMNB) how I was going to be able to parent small children when it was all I could do at the end of the day to fall out tired on the sofa after work.
My exhaustion didn't really become an issue until I continued coming in to work late because I was oversleeping. I went to get a doctor's note to verify my ferretin deficiency, and when I described my symptoms, my doctor replied, "That sounds like sleep apnea." I replied, "I DON'T SNORE!"
My doctor, ever her amazing self, said with Yoda-like wisdom, "Not all who have sleep apnea snore; not all who snore have sleep apnea." She referred me to my health care provider's sleep clinic, and after wearing a diagnostic monitor for one night, it was determined that not only did I have sleep apnea, I had moderate to severe sleep apnea.
WTF? I don't snore!
In a later visit with my doctor, I asked about my sleep clinic results and the fact that I had received a call from the sleep clinic for a return visit. She explained then that I had moderate to severe sleep apnea. That return visit to the sleep clinic? She dropped a bomb on me: "You're about to be fitted with a CPAP machine."
I was still pretty much in denial. I had heard about CPAP (Continuous Positive Air Pressure) machines and how uncomfortable they were to sleep with. "What if I don't use the CPAP machine?", I asked.
My doctor, ever the patient person, looked me dead in the eye. "Sleep apnea is serious. It can lead to cardiovascular hypertension. Basically, when you stop breathing while you sleep, the cardiovascular system that supplies your heart and lungs are working overtime to keep them oxygenated with the oxygen left in your system when you don't breathe. That leads to cardiovascular hypertension, which is extremely hard to treat. We don't even want patients to get to the point of having cardiovascular hypertension."
She continued, "Not only does sleep apnea present as cardiovascular hypertension, but it can also present as heart attack and . . . . " She listed a whole host of maladies I didn't want no parts of, and then the last malady stopped me cold: "It can also cause dementia."
Hold the phone. WTF?
It got me thinking hard. My mother, who was a smoker, had her first heart attack at 53. She also had early onset Alzheimer's, or at least that's what they thought it was. She died at age 64 of cancer.
And she snored. A LOT. I can remember my mom basically running on coffee and cigarettes for energy. I used to think she was tired because she had six kids.
Maybe, just maybe, she had sleep apnea, too. Sleep apnea tends to run in families.
I know for a fact that my thinking has been cloudy for the last couple of years. I've always had a facility with words, and I've had to work harder to write correctly and recall arcane vocabulary words that I once used easily and freely. I know for a fact that it takes me longer to read and analyze cases than it used to, that I can't remember names as easily, although I wasn't very good at names to begin with. The idea that this could get even worse for me without some kind of medical intervention? The idea that this silent disease I never thought I could have -- because I don't snore -- could kill me?
Since then, I've been telling everyone I know about sleep apnea, that it could happen to them, too, even if they don't snore.
When I went to the sleep clinic follow-up appointment, it was a sleep apnea class where we were being given a tester CPAP machine in order to calibrate the CPAP machine we would all eventually have to get. I was the only woman in the class. The rest were all men, most of then white, most of them way overweight. Just the kind of folks who, in my uninformed mind, would have sleep apnea: Men who look like Homer Simpson.
I told the class leader, a woman respiratory therapist, that when I was told I had sleep apnea, you could have rolled me over with a feather. "I don't snore. I don't consider myself way overweight. I don't . . . " She cut me off: "You thought sleep apnea was only for fat people who snore? Yeah, we get that a lot."
After being shown how to adjust the CPAP mask, which goes over your nose, use the oxymeter thing on a finger of our non-dominant hands, and set up the machine, we were sent off with tester CPAP machines and told to record our nightime sleeping experiences with it for a seven-day sleep study.
The first night, I almost cried. The CPAP mask and straps made me look like Hannibal Lector's little sister, and the sound of the air being pushed into the mask, although not loud, sounded like Darth Vadar breathing. I couldn't relax, and I couldn't get used to some machine pushing air into me. I knew that my life depended on getting used to this machine. With some adjustments (loosening the mask a bit, sleeping on my side), I got used to it.
It was the best week of sleep I had in years. I didn't feel tired waking up, and I had more energy all day. Even BMNB said I looked noticeably better. I didn't want to return the machine after my seven days were over because I didn't want to be without it, even for the interim period before I get my own.
The day after I returned it, even I could see the difference. I had dark circles under my eyes again, and I didn't have the same level of energy.
Another doctor who was reading my medical chart to me last week over the phone told me that it was shown that I stop breathing while I sleep at night 9.7 times per hour on average. "Basically, you stop breathing just about every time you go to sleep," he responded. "Good thing you were diagnosed."
The last thing he said to me? "We get folks in the emergency room all the time who have had heart attacks due to sleep apnea."
If you find that you are tired all the time, even after a full night's sleep, ask your doctor for a referral to a sleep clinic to be checked for sleep apnea. Don't assume that it's menopause, middle age, or just the way you are. I never, ever thought this would happen to me. Sleep apnea is no joke.