A CPAP is a Girl’s Best Friend
Navigating A Medical Diagnosis When You Don’t Fit The Description
“It causes breathing to repeatedly stop and start during sleep. There are several types of sleep apnea, but the most common is obstructive sleep apnea. This type of apnea occurs when your throat muscles intermittently relax and block your airway during sleep. A noticeable sign of obstructive sleep apnea is snoring.”- The Mayo Clinic, on Sleep Apnea
Part 1: The Referral
The ENT, Dr. Cohen, peered at me over my chart and informed me that it was very rare for women my age to have sleep apnea, but he understood why I wanted to rule it out before pursuing other options for my snoring.
“Have you gained weight recently?” He asked, visually scanning my body for signs of indulgence.
“I don’t weigh myself. I have always snored like this. I snored like this when I had a stomach parasite and was underweight. I snored like this when I was 12. I will consider weight-loss if we can’t find another answer but I don’t want to start there.” My tone was dry and abrupt because I had already explained this to the nurse practitioner who was responsible for granting me the ENT referral in the first place.
I had no interest in waiting for him to ask the rest of the probing questions that he could use in order to determine to what degree I might be wasting his time. I was finally in that room after years of medical professionals nodding politely when I brought up my concerns about my snoring and offering no proactive advice. I decided that I needed a referral for a sleep apnea study on my own and I wasn’t about to let him derail the process because I was a little bit fleshy.
His eyes widened as I spoke, as if it had not previously occurred to him that he might need to listen to more than a one-word answer.
“I can understand that.” he said with a look on his face that suggested he did not understand why I or any other woman wouldn’t jump at the opportunity to discuss weight loss with a doctor.
“So I guess we’ll set you up with a sleep study and go from there. They’ll call you to schedule, then you’ll come back here and we’ll review the results together. Ok?”
“Ok. Sounds good!” I chirped, trying to force a pleasant demeanor. No good can come from being disliked by the person taking notes about your insides.
I already knew that I needed a sleep study. I already knew that whatever the problem turned out to be it wouldn’t be something that could be fixed with a pill or a simple procedure. It was going to either mean sleeping with a machine or knowing that my future happiness would be tied up in a surgery I might never be able to afford.
I removed the robe that I had been given and slipped back into my t-shirt. I hadn’t removed my bra. I never know whether I need to do that for appointments that don’t directly involve my breasts. Up until that point, a month a month before my 30th birthday, most of my time in a doctor’s office had been for annual physicals that I only really needed to get my birth control renewed.
The last time was to have an IUD implanted, which was an admittedly hasty decision in the wake of Trump’s election, but one I do not regret. On that day the gynecologist I had made an appointment with was training someone in the procedure, so I had two people peering at my cervix and making comments about its strength while they cranked in open with a hand wrench and somehow that felt less invasive than the process of obtaining a diagnosis for a serious condition.
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Sleep apnea is a serious medical condition. Complications can include:
Daytime fatigue, high blood pressure or heart problems, type 2 diabetes, metabolic syndrome, complications with medications and surgery, liver problems and sleep-deprived partners.
-The Mayo Clinic
In high school, I avoided falling asleep on our sometimes very long van rides to athletic events, because I snored.
In college, though they never explicitly said this was why they left, I never had the same roommate for more than a semester in the dorms, because I snored.
I wasn’t as conscious of it then, so I boldly entered into relationships where I would sleep in the other person’s small bed or they in mine. Those relationships fell apart for more than one reason, but the snoring didn’t help.
One stuck it out for a full six years, though we didn’t live together for the entire time. The first time I visited him at his parents’ apartment in New York City when we were both 19, he got up in the middle of the night to go to the living room while I was sleeping and didn’t tell me why.
Even though he was just in the next room, and I knew he wasn’t LEAVING me, the sense of abandonment I felt in the moment was surprising and acute and too much to ignore. Tears welled up as I shuffled into the other room to see what he was doing. This was a pattern we would often repeat as the relationship progressed. The only difference was that eventually he stopped worrying about hurting my feelings, and would make sure that I knew it was because I snored.
Those moments were hard to reconcile because he knew that I couldn’t control it, and I knew that it was reasonable for him to be bothered, but knowing those things didn’t make it any less frustrating for both of us.
It is hard to be kind when your sleep has been interrupted.
It is also hard to be understanding when someone has woken you up to (unkindly) inform you that you have interrupted their sleep with something that you can’t control.
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Part 2: The Study
My sleep study was conducted on-site at a facility in downtown Manhattan overnight on a weekday when I had work in the morning. I arrived at 8 PM, having deprived myself of caffeine in anticipation of what I knew would be a less than relaxing environment. I filled out paperwork and was sent to the room to wait for the technician.
The room was quiet and comfortable and had a view of the Empire State Building. It mostly resembled a hotel room aside from the plastic box filled with wires and probes on the nightstand and the cameras in the corner. There was a TV but I didn’t try to use it. I didn’t want to trick myself into thinking this would be a pleasurable evening. I wondered briefly how many people had masturbated in this room before realizing that everything is monitored.
After about an hour of waiting, the technician popped in to let me know that one of her other patients was taking longer than expected and that she would get to me at around 11. “Don’t worry though. Because of the delay, we’ll wake you up at 6 instead of 5:30.” She was too nice to be annoyed at but I really didn’t want to fall asleep before I was hooked into all of the machines. I have a hard enough time adjusting to reality when I’m yanked out a dream so I can only imagine how I’d feel if I were woken up by someone clutching a handful of wires and cooing “It’s tiiiiime!”.
It took about 45 minutes to get sensors placed on my scalp, face, neck, chest, arms, and fingers. She pointed to the speakers and cameras and let me know that she and another technician would be monitoring both the output from the machine and my actual sleeping body. If certain probes came unstuck they would have to come in, wake me up, and fix them. Luckily this only happened once. It was exactly as disconcerting as it sounds.
They woke me up in the morning by saying my name into the speaker until they watched me sit up. There was a bathroom where I could change in privacy but no shower so I stumbled past the reception desk (which I was probably supposed to stop at) and onto 14th street, blinking into the late winter morning haze.
Part 3: The Machine
Continuous positive airway pressure (CPAP) therapy is a common treatment for obstructive sleep apnea. A CPAP machine uses a hose and mask or nosepiece to deliver constant and steady air pressure. — The Mayo Clinic
Please visit my Instagram for an exclusive “unboxing” of my Cpap: https://www.instagram.com/p/Bf4LzADhOFm/?utm_source=ig_web_button_share_sheet
Two weeks later I was back at the ENT, examining my fingernails and saying “mmmmhmmmm” as he told me things that I already knew.
“So you have Severe Obstructed Sleep Apnea. During your study, you stopped breathing 38 times.” He said, and then continued to gravely explain that situation as though I hadn’t spent hours of my life reading about it and was only here because I already knew that it was a likely outcome.
I had the option of going back in for another sleep study where they would check to make sure the CPAP would work for me, or they would send one directly to me and I could check back in if there was a problem.
I opted for the latter not because I hated the sleep study but because I was tired of waiting. In the back of my mind, I believed that somehow, even though it was the solution, getting the CPAP would be accepting that I might be destined to sleep alone forever, and I might as well hammer that nail before I had time to rethink it. Snoring is an excellent thing to blame for being alone, after all.
Part 4: Aftermath
Of course I met someone almost immediately after getting my CPAP, and of course it was a relationship in which my snoring was treated as a non-issue. It’s nice to be able to casually drift off in someone’s presence. That’s something I wasn’t sure I ever would be able to do again and knowing I have a solution makes all the difference.
They might feel like they’re snuggling a shop vac either way but at least they have the option.
There are nights when I am on the couch watching TV with my partner and I look at my CPAP in the corner and consider the steps required for me to have a healthy night of sleep that doesn’t damage my heart, and I think to myself “dying early seems easier” and then I fall asleep. I’m still adjusting of course, but it’s a step in the right direction from when I used to think “dying early and alone seems easier” in reference to looking into treatment.
I’m proud of myself because this is something that no one else was ever going to make me face. While they might mention that I was making troubling noises, most “nice” people would rather ignore you forever than admit that they would rather sleep in a bathtub than sleep in the same room as you. And that’s fine. My health is no one’s responsibility but my own, and doctors are not wizards whose job it is to know how I’m feeling. I had to make people give me the help I needed, just as I know I have to make myself follow through. Now if you’ll excuse me, I have to go actively lubricate my sinuses because having pressurized air shot directly up your nose for 7 hours is not without its drawbacks.