I’ll let you in on a little secret: I snore. I’ve always snored, but I’ve only recently been able to admit it publicly.
When I was eight years old, my concerned parents took me to a specialist, who declared my adenoids unfit and scheduled an immediate surgical removal in the hopes of resolving my snoring problem. Normally, the medical team would take the tonsils at the same time, based on the theory that one bad set of vestigial organs may lead to another. Not mine. My doctor left my tonsils intact and when I awoke bewildered from surgery, I was greeted with orange sorbet and a pair of quietly ticking time bombs in my throat.
Why is this important? Fast forward 25 years, past annual bouts of severe tonsillitis and strep throat. Here I am, sitting on an examination table with an Ear, Nose, and Throat specialist shining a light into my mouth with a thoughtful, almost reverent look on his face.
“Your tonsils are huge,” he says, and I’m not sure whether to take it as complement or critique. He sits back in his chair. “Do you snore?” he asks.
I should note here that I’m female. And everyone knows girls don’t snore. We don’t sweat, we don’t curse, and we certainly don’t snore. I’m hesitant to own up to this shameful problem, but he doesn’t wait for my answer. Instead, he shines a light up my nose.
This is when he tells me that he believes my snoring is caused by sleep apnea, due in large part to big tonsils and worsened by a deviated septum. We discuss the health risks of sleep apnea, including hypertension, heart disease, and even stroke. He recommends that I participate in a sleep lab in order to be properly diagnosed and identify treatment options. After much persuasion, I finally agree.
Cozy But Wired
Fast forward again one week. I arrive at the sleep lab at 10 p.m., the only car in a lonely parking lot in the middle of a suburban medical complex. I carry a small bag containing pajamas in one hand and a pillow in the other. Sleep labs frequently recommend that participants bring their own pillows in the hopes of replicating home conditions. It’s something of an absurd goal, since I rarely spend the night flat on my back with wires and leads stuck to my head and a stranger in the next room watching my every move.
The lab technician greets me at the door and takes me to a surprisingly cozy suite. I expected a hospital setting, with blinking lights and monitors and rolling beds with rails. Instead the décor is distinctly hotel-like, with a queen-sized mattress and matched set of heavy oak dressers.
I change into my pajamas and sit obediently in a chair to fill out paperwork while the attendant preps the monitoring equipment. She lays out a complex network of color-coded leads, straps, and gadgets and starts attaching them to my head and body.
The first leads are taped to my shins to monitor for restless legs syndrome. Next, a pair of monitors is taped to my chest and ribs. Then a microphone is taped to my throat, electrodes are stuck to my temples and jaw, and a nasal cannula with two tiny hair-like wires is attached to my nose in order to measure the force and pace of my breathing. Finally, it’s time to adhere the multitude of brain monitors to my scalp.
Prior to this experience, I’d worried that the brain electrodes would be attached with tape, a scary thought for anyone with hair. Instead the leads are mashed into great goopy dollops of gelatinous adhesive jelly and squished onto my head. The goo is the least pleasant part of the experience, having a consistency somewhere between petroleum jelly and all-weather silicone caulk. The technician bluntly tells me to block out my morning for the laborious task of shampooing it all out.
And now it is finally time to get into bed. The technician plugs the wires into a shoebox-sized device and tells me it will be my bedside companion for the night. If I roll over, the box rolls with me. If I get up to use the restroom, the box comes with me. I settle down, say goodnight to the box, and try to sleep.
Sleep at Last
What follows is 7 hours of restless, delirious sleep. My confused, exhausted mind conjures up dreams that I’m actually lying awake the whole time. I am vaguely aware of opening my eyes and apologizing to the technician, and each time she assures me that I have, in fact, been asleep.
At one point I roll over and detach several leads, and three times during the night I kick my way out of the leg monitors. Around 5:30 a.m. I finally fall into a deep, restful sleep where the jumbled worries about lab results can no longer plague me; 15 minutes later, the technician wakes me up and tells me we’re done.
I spend the better part of the next day trying to scrub adhesive jelly out of my hair. The unctuous goop is impervious to soap and every time I think I’m clean I find another deposit behind my ear. It takes all of the hot water, most of my shampoo, and a few healthy rounds of vehement unladylike cursing to wash it all away.
So imagine my dismay when my doctor positively diagnoses me with sleep apnea and recommends that I return to the lab for a second night to try a CPAP (continuous positive airway pressure) device. That's a face or nasal mask that pumps a flow of air into the nasal passages to keep the airway open.
His argument for treatment is simple: I had stopped breathing. In fact, during REM sleep alone I stopped breathing 54 times.
I’m shocked. I recall the number of times I woke up to tell the technician that I couldn’t sleep, or to apologize for not snoring. Every time I awoke I inhaled clearly through an unobstructed airway and was convinced the sleep lab was capturing nothing worthwhile. The doctor then tells me that my blood oxygen level dropped below 85% without my awareness.
This is the danger of sleep apnea. We are asleep when it happens, and as soon as we wake up it goes away. We rarely catch ourselves in the act, and that enables the condition to silently erode our health. Our blood pressure rises, our risk of stroke increases, and our hearts labor, all while we’re sleeping peacefully. Or so we think.
This is the moment when I realize that I have to let go of my snoring denial. I agree to go back for the second night at the lab. I will sit quietly while the technician gobs sticky mounds of adhesive onto my scalp and I will wear a CPAP mask. And hopefully, once the experience is behind me, I can look forward to better rest, less daytime sleepiness, more energy, and a better outlook for my greater health. Right after I scrub the goop out of my hair.