The new Hugh, sleeping like a baby.

by Hugh Gilmore

So far: an overnight sleep study said I had mild sleep apnea, in addition to my major complaint: snoring so loud I had to sleep apart from my wife. A CPAP machine was recommended, but I couldn’t get along with the machine, mostly because of the mask. (It had been chosen for me by the delivery truck driver – not my doctor!) When I got no satisfaction from my prescribing doctor (an ENT specialist, but not a sleep medicine specialist), I tried the Chestnut Hill Hospital Center for Sleep Medicine. It was a lucky day for me when Dr. June Fry and her assistant, Kathleen DiLeva, PA, brought me into their office.

Dr. Fry ordered a second sleep study. I hated the thought, but went along. It’s not a painful procedure. It’s just a weird situation, going into an otherwise empty wing of the late-night empty hospital, getting hooked up, via a thick mass of wires, to an all-seeing, all-knowing machine and being told to go to sleep. “Act natural,” they say, attaching a million dollars worth of monitoring disks to your body. The sleep that follows is anything but easy.

However, at a certain level, sleep is sleep, and Dr. Fry, friendly but strict, discussed the results with me a few days later. First, she told me, I have “moderate” apnea (apnea is when you stop breathing for 10 seconds or longer). Second, that is a misleading, overgeneralizing  statement, since that “moderate” label was the measure of the overall number of apnea episodes in a sleep bout.

Third, most of my apnea episodes happened as I entered deep sleep – thus ruining my sleep. I had been trying to overcome that phenomenon by taking a large dose of Ambien every night: two 10 mg tabs. After a nightly sundown cocktail – a bad combination.

So, yes, she said, I should continue to try the CPAP machine – but with a more appropriate mask. She helped me choose one I thought I could live with. Her advice: Keep trying till you get the hang of it, learn to USE the machine, not just passively submit to it. Co-operate with it.

My sleep team also taught me the rules for what is called “sleep hygiene.” Those rules include: avoid stimulation, such as computers, iPads, etc., before trying to sleep. Keep the room dark and cool. Most important: pick a seven-to-eight-hour time period for sleeping and stick to it, even if you have to use an alarm clock to get up. You must do this, I was told, even if it costs you a few days or weeks of feeling lousy. Eventually, my body would come around and my Circadian rhythm and life-style rhythm would become as one. I bought into the program. I chose 12 p.m. to 8 a.m. and I now confine my sleep to those hours. (More or less; I’m not a machine.)

This week marks the one-year anniversary of my new sleep regime. It has worked for me. I no longer snore (when I’m on the CPAP machine), so I’m back sleeping in my bed. My sleep apnea is also in check when I use the machine. I’ve cut cut down to one 10 mg tab of zolpidem, (generic Ambien). It took me six months to do that because I was addicted to them, and they are not easy to withdraw from.

I will try to get rid of that sleeping pill altogether by this time next year. I wake up earlier now, without an alarm, but I feel crisper, more strangely alert, when I get up. The machine and the program have worked for me.

But lest you think is this is a contrived fairy tale, let me tell you this: I hate sleep hygiene. I’m a grownup, dammit, I’ll go to bed when I feel like! And I hate the CPAP masks. I hate the big mask, the medium mask, and the iddy-biddy nosebud mask. I hate admitting I’m handicapped in this way. I hate the unrelenting routineness of this regimen. I’m too young, too filled with vitality to live this way. This machine is for OLD guys. I’m mad as hell and I’m not going to take it anymore.

Except: except, I don’t want to go back to sleeping alone at night on the sofa. And I hate that feeling of just starting to fall asleep and then jerking back to the previous stage of sleep. It’s tormenting. And I hate the feeling that I’m falling into a deep well and about to black out. I hate taking two pills to get to sleep. I hate the feeling of the mask surrounding my nose. I hate seeing mask dents on my cheeks in the morning mirror. But I do it. Because I hate the alternative even more.

I’ll leave you with a few things. First, if you seek sleep-problem treatment, I suggest you go to a place that specializes in sleep medicine. Second, the single biggest impediment to success is failure to find a CPAP mask that suits you. Work on it. Keep trying. Third, even if your insurance won’t pay, CPAP machines are smaller and cheaper now than when I started. Use only with physician advice, however. Fourth, the CPAP is small, quiet, and comes with a travel bag. Fifth, sorry to say this: they don’t work for everyone. I was one of the lucky ones. Sixth, sleep hygiene does work (sometimes). And it’s free.

Good Luck.

P.S. This five-part series is now available as a cheap Kindle e-book.