I had my second round of sleep clinic exams last weekend, and I’ve been meaning to post a little about the overall experience.  But then I read this guy in the New York Times (registration required), and I see an experience eerily similar to my own…

Lights out. During the night, as I traveled between wakefulness and sleep, sending back streams of data like a space probe, the technician appeared and disappeared, adjusting my wires, and exiting my consciousness in a ring of light — the door to the corridor — like a spectral visitor, a goblin that only the sixth-sensed see. He monitored my voyage from a desk somewhere in the clinic, taking notes as I sped through the blackness.

The next morning, miles from a cup of coffee, my head damp with mist and dotted with what looked like old toothpaste, I filled out another form, asking, among other things, what I had dreamed about.

"I dreamed I was wired to a bunch of wires, in a threatening tangle, that pulled me back to a wall every time I tried to escape," I wrote, truthfully.

"Perhaps it was not a dream," the technician said, reviewing my responses, with a graveyard humor that was also chilly and serious. Working nights will do it to you.

Yeah…something like that.  After a second miserable night in the sleep clinic I began to wonder if they aren’t measuring how well I sleep, so much as how well I sleep with a lot of wires attached to me.  Going in I was assured that they had the wiring down to an art now, and it would not disturb me in the least.  Well, that might be true if you sleep like you’re in a coffin, but I turn this way and that all night long and you just can’t do that with wires attached to several different spots on your head, and on both legs.

You go in bearing a little overnight bag.  They lead you to a room that looks half like a cheap motel room but with a (way too) narrow hospital bed in the middle, that has lots of plugs and gizmos in the headboard.  I sleep like a cat, sprawled all over the bed.  I took one look at that sleep clinic bed and just knew it was going to be a bad night, even before they put the wires on.  Hamilton in the Times describes a similar room to mine, so I reckon they’re all doing it the same now…

Try this sometime.

Plaster about two dozen electrodes to your face and head and tape some more to your chest and legs. Give yourself two to three feet of wire on each, and attach the other ends to the wall next to a bed, so they tug tightly when you move. Make sure the bed is in a room that you’ve never seen before, something that looks like a hospital room disguised as a hotel room. A kind of Soviet-era bugged spy box for information gathering, with a video camera, pointed at the bed, blinking silently from the ceiling.

Then turn out the lights and go to sleep.

At least they didn’t need to cut any of my hair to get the head leads on.  They use a paste that’s conductive and which comes out easily in the shower with just a little soap and water (really).  They didn’t bother misting my head at Johns Hopkins to get the leads off…just pulled gently.  I was given pretty much the same questionnaire that Hamilton was, but nobody reviewed it with me.  The first time I did the sleep study I dreamed that a technician woke me up and led me into the Hopkins Director’s office, where the Director sadly informed me that they probably couldn’t cure my sleeping problems, but if I wanted to I could finish the night sleeping on his office sofa. 

This second visit was to calibrate a CPAP machine for me.  They got a small nose mask that fit me very well, and after a time I hardly noticed it was on me.  Putting it on though caused a weird sensation because they had the machine on when they did it.  CPAP stands for Controlled Positive Air Pressure…it’s supposed to keep your post nasal breathing passages pressurized just enough that they don’t collapse (which is what causes snoring) and make it hard for you to breath while sleeping.  They tell you to close your mouth when they put the mask on, but it’s instinctual to open it when your nose is being closed off by something, and for an instant I had air going in my nose and coming back out my mouth.  Felt…very funky.  My brother, who scuba dives, would probably have seen it coming.  But I sleep with my mouth closed normally, and once you close your mouth you don’t notice the pressurization. 

But I noticed the effect it had on my breathing immediately.  My sleep problem has been developing over a period of about a decade now, and I hadn’t realized how hard it had become for me to breath at night with my head on the pillow, until it was suddenly effortless again.  I’m actually starting to think now that I may get this problem licked after all.

And in researching my problem I’ve discovered that sleeplessness is no joking matter.  The consequences of chronic sleeplessness that I’m digging up out there, are actually starting to scare me a bit…

The mortality rate is significantly higher in patients with untreated OSAS [obstructive sleep apnea syndrome] than in patients who have received adequate treatment or who experience primary snoring. Several studies have shown that there is a positive relationship between OSAS and cardiovascular morbidity, including myocardial infarctions and stroke. Patients with coronary artery disease may experience myocardial ischemia during episodes of apnea.

Systemic hypertension is found in 70% to 90% of patients with OSAS, and 30% to 35% of patients with essential hypertension also have OSAS. Cardiac arrhythmias are another serious complication of OSAS. The most common pattern consists of repeated cycles of bradycardia during apnea followed by tachycardia with arousal that terminates the apnea. Other arrhythmias include sinus arrest, second- or third-degree heart block, premature ventricular contractions, and potentially lethal tachyarrhythmias.

Automobile accidents caused by sleepiness or degraded perception and response, or both, are another cause of morbidity and death. In addition to higher mortality and morbidity rates, patients with OSAS have more cognitive impairment and a poorer overall quality of life than people without OSAS. Other complications include peripheral neuropathy, gastroesophageal reflux, increased intracranial pressure, optic neuropathy, glaucoma, recurrent delirium, and exacerbation of cluster headaches.

Fuck! 

Okay…this explains why my HMO isn’t bellyaching about paying for all this.  Supposedly they got enough data from me at the sleep clinic last weekend to know how much pressure my CPAP machine will need.  Too little and the breathing problems come back.  Too much and I’ll keep popping awake like I always do now anyway.  I’m supposed to be contacted by someone about getting my machine this week.  If it works for me I’ll look into my surgical options, because I don’t want to be tied to a machine for the rest of my life.  Especially one that requires a visit to the sleep clinic every time it needs adjusting.  These sleep clinic visits are running about two grand a pop.  And I’m not ready to have my house, and especially my bedroom, invaded by a lot of weird looking medical equipment.

And how the hell am I going to attract a boyfriend if I have to sleep next to him looking and sounding like Darth Vader?  No…if this works, I’ll have the surgery.