30 March 2018 - So You Got Some Sleep?

Last night, I participated in a sleep study. For a long time, I've had issues with sleep that I considered normal and part of my sleep pattern. As of late, however, some things have gotten worse and I was referred to the sleep study. I won't receive the full results for a week or two, but right now the diagnosis is one of sleep apnea and I will be part of a program that has people use a machine at home that "forces" oxygen into their system to ensure proper sleep.

For this post, however, I want to "debrief" the process that is a sleep study.

When you first sign up for it, you receive an onslaught of paperwork and phone calls which, quite often, overlap with each other. You fill out insurance information and then, when they call, you give them this same information. You fill out surveys on your caffeine habits, sleep habits, and weird things you experience while sleeping.

You also receive a plethora of information. Some of it will contradict itself:

• No caffeine after 11
• No alcohol
• No naps
• Bring all medications with you
• Do not bring water with you. 
• Bring a small bottle to take medication with
• Nothing in your hair or on your skin (make-up, lotion, etc)
• Wear loose fitting pajamas
• Wear button up pajamas 
• Bring slippers and a robe
• No cell phones, pagers, or watches - "time free"
• and so on

Finally, the day will come... 

----

What happened

I was taken up to a floor that was secured by lock and key. Each room as also secured by lock and key to allow for a quiet and undisturbed experience. 

I was let into my room and got into my pajamas while my paperwork was run. Then I filled out more paperwork and signed forms to allow for the study and send copies of my results to my doctor and myself. This took almost an hour and included about 20 minutes of down time where I read. I also had access to a TV if I wanted it, but I don't watch TV while falling asleep, so I opted out. 

After that, I was hooked up to about 20-30 wires. I had about 8 or so wires on my head, secured with a putty type glue and gauze. I had 4 or so wires on my face, 1 on my neck, 1-2 on my chest, 4 on my legs, 1-2 on my back. I also had one hooked up to my finger, 2 wrapped around my chest and stomach, and one-ish (it was multiple that connected to each other) on my nose and mouth. Each measured something different: heartrate at different times, snoring, brain waves, leg movement, breathing in different parts of the body (lungs, diaphragm, nose, mouth), movement of my teeth and mouth, etc. I was also fitted for a mask, should I need oxygen during the night.

Finally, I was told to lay in the bed. It wasn't unbearable, but I was definitely aware of the fact that any small movement could affect my readings. After she left, she came over the loudspeaker and tested her end of the equipment. She asked me to close and open my eyes, move them in all directions, hold my breath, and move my feet individually. 

Finally, I fell asleep and, about two hours after, was woken by the technician who told me I'd stopped breathing. She removed the wires on my nose and mouth and replaced them with the mask which was wrapped around my head (and the wires) and hooked up to a machine that forced oxygen into my airways, ensuring they were kept open. 

I was then left again. I remember going in and out of sleep, having fast, vivid dreams, mostly silent with one in Arabic, and staring at the ceiling. At some point, I woke up and I was awake. I figured it was nearly my waking time (4:30). About half an hour later, she came in and woke me up. She said I'd been awake since four and asked how normal that was. She began to take all the wires off. Those secured with tape were an easy removal. Those secured with glue came off easily, but the paste was stuck all through my hair. I had more paperwork to fill out and was left to shower, get ready, and leave. 

My Experience

For days after making the appointment, I had nightmares about it. I dreamt of a large, pure white room, where the technician led me and left me. In the center was a large bed lit by spotlights and across from it was a large mirror, behind which stood 4 people in white coats with pens and paper. It was terrifying. The thought of someone watching me while I sleep and taking notes left me with high anxiety. My partner spent most of yesterday afternoon walking me through what he knew about the procedure based on his experience in the medical field as a photographer and videographer. 

From about 2:15 Thursday afternoon to the moments I fell asleep, I was hit with high anxiety. My anxiety is both fairly normal and unique. When I get anxious my hands itch. They've done this since I was very little and I remember my doctor prescribing lotion which kept me from scratching when I was young. It helped, but I still do it. I have calluses on my hands from where my nails dig. Often I look like I have a clenched fist when, in reality, it is just me coping with anxiety. 

I also have a very nervous stomach. Prior to visiting the dentist, I can't eat for about 24 hours. Prior to this visit, I ate, but mostly regretted it. I also had clammy hands and was both freezing and sweating. I also got emotionally overwhelmed, which causes me to cry. 

My partner spoke to me on the way down, which helped, and let me get out all my fears. When I finally arrived, I found the people to be very nice and was thankful I had a female technician. I hadn't thought about locked doors and was thankful that we were on a secured floor.

From then through most of the night, thing were okay. I was very aware of the wires and didn't want to disturb them, which did cause some discomfort while sleeping, which has caused some soreness on the day after from trying to lay very still. The room was very private, but had cameras in it, which made me wary about changing.

I began to feel frustrated during the night because I was awake and I wanted to be asleep. At one point, after the machine was turned on, I woke up and became extremely aware of a few things:

1. Every single breath, heartbeat, and movement were being recorded.
2. There were at least two people who would see that and watch my tape.
3. At least one person was watching me, live. 

This caused an anxiety attack. I don't know what the readings were (but I'm hoping to see them in the report), but my heartbeat rose, my breath shallowed, and I felt myself begin to tear up. I did not want to disturb the study, so I tried to calm myself quickly. 

When I was woken in the morning, I was quite grumpy. I do tend to be grumpy if I haven't slept enough, but often my morning routine takes care of that. The technician was very nice, but a bit too positive in her speech: "So, you got some sleep ya?" I found myself increasingly annoyed with her. 

After leaving, I felt a delayed relief of my stress. I spoke to my partner again, who wanted a run down of what happened and the tears that I'd shaken off during the night came back. I was overwhelmed by it all (and I still am a little). 

How do I feel about the diagnosis? 

Sleep apnea can have many causes, but I find myself blaming myself for having it. As I have talked about, I am overweight. I have always been active and I have always had a decent diet, but I have also always been overweight. Since my foot struggles, I have not been active at all. And so, I have spent my morning being overwhelmed by the blame I am putting on myself. The technician pointed out that sleep apnea can actually prevent weight loss itself, so putting blame on myself may be misplaced. The oxygen machine can help, she told me, and I am looking forward to documenting its changes to my life and sleep. 

Ultimately it's all connected. Being overweight can cause sleep apnea. Sleep apnea can cause you to stay overweight and have serious struggles losing weight. Sleep apnea can cause headaches. Having migraines can cause sleep issues. Sleep issues can cause issues with self care. Issues with self care can help maintain or cause one to be overweight. It's all connected. 

----

Current Stats:

Yesterday's water intake - ~60 ounces

Today's goal - 90 ounces

Pain level - 4-5 + discomfort from swelling

Current Mood - overwhelmed

Miriam's Recommendation - Check out the instagram account sukiicat to see a cat who travels and enjoys life.