A Journey To Better Sleep

Having kids is tiring. I do not know of a parent out there that would disagree with me. When the kids are young and I mean in the baby and infant stages they typically wake up multiple times in the night which means you and mom need to wake up multiple times in the night to deal with whatever it is they need. When the children grow older, they (hopefully) wake up less and less during the night which means you and mom might get more restful sleep at night.

I know when it comes to our kids there are good nights and bad nights. Typically ‘A’ can sleep from 7am to 7pm which is great! 12 hours of him sleeping sounds almost mythical doesn’t it? ‘W’ on the other hand, being younger, still has 1 to 2 wake ups on average per night. It can be at 11pm or 2am or 4am etc. She does occasionally do a full night without a single wake up, but that is fairly rare. With her waking up, it means one of us gets up and resettles her. Usually we both wake up and then we figure out which one of us will go and see what she wants. Essentially she wakes up screaming like a Banshee. I’m always surprised how loud she is and yet never wakes up ‘A’ as they both sleep in the same room.

My Journey To Better Sleep.

Since having children, for at least what I can remember, I wake up tired every morning. Doesn’t matter if it’s 6 hours of sleep or 8 hours of sleep, I feel exhausted and groggy during the day. At first I thought this was due to the kids and their lack of sleep during the night but recently when my wife took the kids to her mom’s house for 4 days, I was still extremely tired when I woke up. Something else is going on.

When I had a bad bought of Sciatica that I was taken to the hospital via ambulance (they gave me nitrous to be able to get out of bed) the nurses at the hospital noted that my blood pressure was very high. They said it could have been because of the pain I was in and wanted me to keep an eye out for it. Now my family has a long history of heart problems so my wife wanted me to look more into it with our doctor. My wife, being a nurse, also took my blood pressure a few more times after the incident and noted how high it was, in fact she was contemplating sending me back to the hospital because it was so high (ie 160/100).

I made a doctor’s appointment and we went over my family history. I mentioned that my dad has his first heart attack at age 41 which had the doctor send me off to get blood work done and an EKG (aka Electrocardiogram). EKG came back normal, blood work was fairly normal and I am not diabetic. This lead to my doctor setting up a sleep trial to test whether or not I had Sleep Apena as he said this can be a reason for high blood pressure.

What Is Sleep Apnea?

So what is Sleep Apena and why should I care? Off the bat I am not by any means an expert on Sleep Apnea, I am not a Respiratory Therapist (RT) or a Doctor (obviously) or even in the medical industry, so my info is from various readings off the Internet and through friends and family. There are a few forms of Sleep Apnea, with the more common one being Obstructive Sleep Apnea or OSA. This is when the airway is blocked by either the back of your tongue or larger muscle tissues etc. Essentially the flow of air/oxygen to your lungs is restricted during a 10 to 60 second period of time.  For some better explanation check out the Sleep Apnea section over at CoastalSleep.

Common signs or symptoms of Sleep Apnea:

• Excessive daytime sleepiness
• Loud snoring
• Gasping during sleep
• Morning headaches
• Restlessness during the night
• Leg cramps
• Weight gain
• Frequent need to urinate at night
• High blood pressure

When I look over the list, I can say I can relate to almost all of those symptoms. My wife mentions me snoring, I feel like I could fall asleep at work and the big one, the high blood pressure.

Take Home Sleep Test

I wish I got a photo of me wearing the little sleep test setup. It’s not bulky like one might imagine and it was easy to use. I “slept” okay with it too. It consisted of me venturing to a local sleep clinic to pick up the sleep test kit and wearing it for 1 night.

Not me, but this is what it looks like with it on

The kit itself, a ResMed ApneaLink Air, consists of a small rectangular unit attached to a chest strap, nasal prongs (monitors snoring etc) and a finger-tip sensor (heart-rate and oxygen saturation). As you can see in the above photo, it is not too obtrusive. The next day I took the device back to the sleep clinic and we went briefly over my numbers.

The Results Are In: I’m Dying In My Sleep…

Okay, I may not be dying in my sleep each night but on average I am NOT breathing approximately 35 times per HOUR (that’s my Apnea Hypopnea Index or AHI score). Normal/Minimal AHI is 0-5 with Mild being at 5-15, Moderate being 15-30 and Severe being greater than 30. So that 35 puts me at the extreme high end of the scale.

Another value they look at is my Oxygen Saturation. Ideally you want the number to be above 95% or greater. Mine dipped down to 84% which of course causes my heart to pump faster. My heart rate would be 60 bpm and then jump to 120 bpm to compensate for the decrease in oxygen.

The other value they made note of was my snoring events. Now, I forget the actual term for the value but on the extreme side of the scale they typically would see 1,000 to 1,100. I blew that out of the water with a score of 3,400. Which is not a good thing either. I guess the back of my tongue drops down and obstructs my airway causing me to snore which causes the lovely cascade of other things to happen.

Did I mention Sleep Cycle yet? At this point I’ve had my appointment with a Respiratory Therapist (RT). She explained the above numbers better and gave me a whole run down on Sleep Apnea and of course ways to handle it. The one thing we talked about was the Sleep Cycle.

The Sleep Cycle; Or Lack Of It

When you sleep, you start off in a light sleep and throughout the night you (should) go into various stages of sleep eventually into a deep (stage 5) sleep. This is what most people refer to as REM (Rapid Eye Movement) and the stage in which you typically dream and also where the body can start to reset and do repairs needed.  Did I mention I don’t remember dreams? Not very often do I even remember a dream or think I dream, but this could be one reason why it seems I am not going into the deep or REM sleep caused to my Sleep Apnea.

So with our sleep cycle we continuously go between these stages multiple times throughout the night. In my case I seem to rarely ever hit the deeper sleep stages where the body enters its repairing stages. Where your body rests, your heart-rate slows down, your kidneys slow down etc. Because of my Sleep Apnea I bounce around frequently in the lighter stages of sleep and never give my body enough time to rest for the next day. I also toss and turn a lot because of being in a lighter sleep.

What Can Be Done?

What can be done to get my body the rest it needs to not only function better on a daily basis, but be less tired during the day? My tiredness hinders my parenting ability. My kids want to play when I get home from work but I have almost no energy to do so. I would love to exercise when I get home or after the kids have gone to bed but I lack the energy for it, yes I understand that you can also gain energy from exercising. I am probably more irritable and easier to become angered or frustrated and I want to fix this. I’m tired of being tired all the time. I also want to lower my blood pressure without the use of medication as well.

CPAP or Continuous Positive Airway Pressure

During my consultation session with the RT at the sleep clinic, CPAP with Sleep Therapy is what we are going to try to curb my Sleep Apnea. CPAP or Continuous Positive Airway Pressure, works by sending air (room air, not additional oxygen) through a tube into a mask of sort and down into your airway to keep the airway blockage free.

The device that I’ll be utilizing for my 1 month trial is a ResMed AirSense 10 AutoSet. It is an auto-adjusting pressure device with integrated humidifier and advanced event detection. It even has cellular connectivity to a central (cloud) service. Along with the AirSense unit, I’ll be utilizing the ResMed AirFit P10 nasal pillow mask. I wouldn’t really call it a mask as it just fits underneath your nose.

The RT set up the values for my trial. Being an AutoSet device, she dialed in a range of air pressure (5-10) for me to try out. The unit will build up the pressure to a value of 5 and then during the course of the night it will adjust between 5 and 10 if my breathing requires it.

Setting the unit up is really easy as well. First, find a place near the bedside that has access to an electrical outlet. Then fill the included humidifier reservoir with distilled water. Place the mask on, hit the “On” button and I’m good to go. When I first put the mask on and had the machine on I right away noticed the air pressure. Since you are breathing through your nose, the inhale is easy (as expected) but it is the exhale through the nose that is different at first. Your first instinct is to breath through your mouth which creates a really odd feeling sensation as the air passes through your nose out your mouth right away. Sort of like a void of air not reaching your lungs. You also can have a little troubles talking at first but that feeling subsides and you just sound like you are talking as if you were plugging your nose.

My Experiences So Far

Yup, still not me either as I would be lying on one of my sides. But it is exactly the unit I have with the mask I use.

I’ve had the unit for 2 days now and found that when lying down, the nose mask isn’t much of an issue. I can easily flip from side to side or my back if needed without feeling like I am tethered to something. My wife has also mentioned how quiet I am; no more snoring. I didn’t realize how bad of a snorer I could be. I always thought when I flipped on my right side I would stop snoring but she’s told me because I am not snoring in her face it was not as much of an issue when I was not facing her. Now I do not seem to be snoring at all.

Remember how I mentioned how there is a cellular connection with the ResMed AirSense 10? Well each morning after I’ve turned off the unit when I get up, it will send it’s data to MyAir.ResMed.com. The unit itself will show me my sleep report, but I can also look over my data on their website. The RT also has access to read this information (not sure if they have more data than I can see) but it’s a neat way to continue my sleep therapy. I don’t need to go into the office to talk about my results and progress.

With night 1 and night 2, my sleep has almost instantly corrected itself.

As you can see from the above screenshot (taken from my second night of sleep) my AHI is almost non-existent. I had on average 0.5 events per hour over the course of 7hrs. My first night was 0.1 events per hour. That being way way down from the original sleep test where my AHI was 35 events per hour over about 7 hours.

Do I feel more rested? Not entirely sure yet. Most people I’ve talked to have mentioned it can take 1 to 2 weeks before feeling less tired. The downside to this Sleep Apnea situation is that I have it for life and for being well rested every night I will need to use CPAP. I’m going to be an elephant at night. Not the most attractive thing to look at for my wife mind you.

Here is to my journey of better sleep and regaining lost daytime energy to being a better father and husband!