Healthy Manhattan: The Night Stalker

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I’m not sure what I was expecting, but the modern sleep lab looks strangely like a hair salon. I arrive fashionably late for my 9:30 p.m. appointment and see women in aprons hovering over men, using hair dryers to dry the glue that holds electrodes to the guys’ heads. Once prepped myself, I am escorted to a private room with surveillance equipment on the ceiling. My attendant, Brenda, asks me to lie down. The electrodes on my head are plugged into a white box. I drift off by 11:30 p.m. For the next several hours, my breathing, blood oxygen levels, eye movements and brain waves are measured.

At 2 a.m., Julia Roberts, in a pink negligee— ah, damn, it’s Brenda—flips on the overhead light. She informs me that, yes, I have obstructive sleep apnea.

What that means is that tissues in my mouth and throat slacken at night, resulting in airway blockage. After 10 to 20 seconds without oxygen, my brain jolts me from deep sleep to semiwakefulness so that I don’t suffocate. I am experiencing an average of 18 such “apneic events” each hour. Like most people with apnea, I still dream, still wake up with bedhead and still remember nada in the morning. But I have to hit the snooze button multiple times, and by noon I’m ready for a nap. Although it can strike anyone, apnea is primarily an affliction of middle-aged men. You probably know someone who has it. According to a recent University of Michigan study, 5 to 10 percent of all men ages 30 to 60 could unknowingly be in need of treatment. And for some groups, the chances are greater. “If you’re a middle-aged man with a 17-inch collar or bigger who snores, your odds are one in three,” says Dr. Safwan Badr, a professor at Wayne State University, in Detroit, and president of the American Sleep Apnea Association. The reason? A large neck has more windpipe-blocking soft tissue, which frequently sounds like an electric grouter as it’s being blown out of the way. Though my former wife confirms that I’m a snorer, I’m thin, with a chicken-like 15-inch neck. Even so, my 140 mini-awakenings a night mean I have a fairly serious case of apnea. They also mean that the response adopted by many apneics—drinking lots of coffee and hoping they don’t fall asleep behind the wheel—would be even less prudent for me than it is for some. As Badr explains, every time you stop breathing in the middle of the night, the fight-or-flight response kicks in. “It’s almost the physiological equivalent of getting pissed off,” he says. As a result, a large percentage of apneics end up with high blood pressure and other cardiovascular problems to go along with their fatigue and snoring.

Two months after my night with Brenda, I undergo treatment. The form I’ve chosen is a cinder-block-sized pump connected to a mask that forces air into my nose while I sleep. Apparently, some men find this continuous positive airway pressure (CPAP) machine very effective. “It’s changed my life,” enthuses a friend of mine who has sleep apnea. “I love it!” Love, however, is not the word I would use.

Maybe it’s the strange contour of my nose, but I’ve been through four styles of CPAP masks now, and they’ve all left me with tender, irritated skin. They blow air into my eyes. My mouth periodically puffs up with air and makes a farting sound as it escapes.

Unfortunately, the alternatives don’t seem any better. I could try a new retainer-like device that seems to be mildly promising. Or I guess I could try surgery, but most of the surgeons bat less than .500, a lower average than I usually like for my trips under the knife. So I’ve gotten some Duoderm strips to prevent the irritation, and I’m trying to get used to my CPAP. With all of the medical advances today, it’s easy to believe that doctors have a neat solution for almost everything. Then you come down with sleep apnea, for which the best they have to offer is a mask. “Right now, for most people, the CPAP is the way to go,” says Badr. “If in 15 years some genius finds a cure, then you can toss your CPAP into the garbage.” Sounds good to me.

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