Further advice from the Face Doctor ...

... about my sleep habits. I usually stay up until 2 or 3 a.m. and sleep as late as I can. Those are no longer productive hours for me though - I am awake and not sleepy but I can't concentrate much after 11 pm.

He advised me to try to go to bed earlier and to get up earlier. I told him that I was aiming at getting to bed at 11 and getting up at 7.

He said that was an improvement, but the ideal schedule would be to go to bed at 9:15 and get up at 6 am. I almost screamed "Nurse! Someone has kidnapped the doctor and replaced him with a lunatic!"

But he was serious. It's the timeless farmers' schedule. As Ben Franklin said, "early to bed, early to rise, makes a man healthy, wealthy and wise." He was probably a lunatic too. As for the healthy, wealthy and wise, two out of three would be great.

The Incurable Sleep Apnea ...

... or whatever it really is. Carmen laughs at me for blaming any and all failings and shortcomings I display on my "incurable sleep apnea."

Well why not? We don't know what the problem is, so we aren't sure what it is doing to me. So if I am late, or forgetful, or cranky, or spacey, it's "incurable sleep apnea." So there.

What was I saying? Oh, yes. Incurable sleep apnea. Actually something of a misnomer, but since the doctor can't tell me what the real problem is I might as well give it a name. The problem has been that after getting the special little machine and hooking it up to my nostrils, learning to tolerate it and use it every night, none of the wonderful things I had been sold on happened. Very frustrating.

I went to see the face doctor in Boone. (I've been to see him before: the first time he cut a piece of my ear off, the second he stuck a long flexible tube down my nostril til it touched my tonsils). He looked over the computer readout of the results (something the sleep doctor had never done - a Romanian btw - I think he graduated from Carpathia U). The face doctor told me that I do have apnea but that it was mild enough that using the CPAP machine to treat it was a judgment call. It showed I was only waking up 7.5 times an hour because of the apnea and some cases reach up to 50 times an hour or more.

But I definitely have a sleep problem. Of the six stages of sleep, with REM sleep being no. 6, I am missing the last three stages. In other words, no REM at all and it is the last three stages that provide you with the deep rest that everyone needs.

So where does that leave us? He doesn't know so he gave me a pill to take every morning. I think its speed. He said it wouldn't cure me but it might help deal with the symptoms. If that doesn't work (and I don't think it does) then in two months we will try something else.

In the meantime, the minor part of the sleep disturbance caused by the actual apnea seems to be taken care of by the machine. At least, enough so that I don't fall asleep at the wheel of the car anymore. But I still feel groggy for the first two hours of every morning and have trouble concentrating on work late in the evenings, which used to be my most productive hours of the day.

It's been a long day here in Wilkesboro today ....

... First Ben got both of us up bright and early so she could... well, ... yell at us, I suppose. Don't know what else she wanted.

I got up and read some research for the paper I am writing, then rushed up to Boone to meet with Roger the Respiratory Therapist. Once we established that I went to a church and believed in Christ he outfitted me with a brand new, very latest, oh so stylish ResMed S8 Escape System (the little vacuum cleaner part), along with a HumidAire 3i humidifier, AND the Mirage Swift II Nasal Pillows System (the mask part I breathe through). It vacuum cleaner, excuse me, the S8 Escape System, will force a blast of air down my throat that will expand my airway like blowing up a baloon. Supposedly I will get a good nights sleep with lots of REM sleep. We will see.

At least it feels less uncomfortable and looks a lot less frightening that I expected it to be.

After this I rushed back to Wilkes and drove Carmen to the airport so she could take off for her reunion trip to Mount Holyoak. Got back late and decided to take the beast out for a late night walk.

The results of my sleep test ...

... of a few weeks ago finally came in - I definitely suffer from sleep apnea. That is almost certainly the reason I have trouble staying awake when I am driving. So - one more trip to the sleep lab to see if I can sleep. This time with the C-PAP as they call it. It consists of a small vacuum cleaner on exhaust attached to various types of clear plastic masks to force enough air down your throat to keep the soft tissues from collapsing while you sleep.

Nurse Cindy was there at the door to greet me when I arrived about 9:30 pm. Got me set up with the first of the sleep masks she wanted me to try. It only covered my nose.

I didn't like it. It felt like the Alien stage that attaches itself to your face. But after about a half hour I fell asleep. A bit later Nurse Cindy woke me up and told me my mouth was falling open, which destroys the effect of the C-PAP. She attached an elastic band around my head to keep my mouth shut. Now I felt like both the Alien and the Mummy. Not very comfortable.

She woke me up a bit after that and said let's try another one - this one covered my nose and mouth both. It felt better than the first one, though I felt a bit like Jacque Cousteau on an aqua lung. After a bit the piece across the bridge of my nose begin to cut in a bit too much. Didn't like it much, but it was an improvement from number 1. And I did fall asleep with it on.

A bit later she woke me up a third time to try yet another one. This one simply stuck up my nostrils with a rigid plastic bar built in to keep my jaw up. It was the least obnoxious of the three, though when she took it out after the test my nostrils hurt. Still, she said that was the one I did the best with as far as sleeping went, and that I would get used to it. Easy for her to say.

By then it was 5:30 am so I packed up and left. Went to the Huddle House for a good old fashioned high cholesterol greasy breakfast of pork chops and eggs. Then out to the Boone Greenway was a long walk, and then over to my office at school.

It was about 9:30 and I needed a nap.

Here it is! The sleep mask...




I haven't gotten the results yet from the Sleep Doctor, but if it turns out I have apnea this is one of the mask styles I can wear. Hope Carmen can get used to it. Hope it scares the beejeezus out of Ben.

So Nurse Tech Cindy wakes me up at 5 am...

.... and by 5:30 I am out the door. It's still full night and I have nothing to do until I meet my friend Tim for breakfast. I go over to the Boone Greenway for a walk. It is remarkably peaceful that early in the morning waiting for sunrise. In the mountains there is no real moment of the sun popping up but simply an increase in light. The Greenway is a paved walking/biking path along the New River Valley as it cuts through the mountains around Boone. You walk along the flat valley floor surrounded by low ridges on every side. At that hour all I could hear was a faint hum of traffic nearly drowned out by the chirping of birds and the rippling of the river. Walked all the way out to the ruins of the old electric dam power house. It looks like an old medieval keep and lends a suitably romantic air to the place.

It makes up a bit for the cement man hole emplacements for the sewer system that erupt out of the valley floor here and there. They look like turrets of old Renault battle tanks abandoned from some forgotten war amid the cow pastures.

I don't think I will see the sun come up at the Greenway again, but it was a nice way to start the day. After breakfast I went to my office and took a nap.

And another one when I got home this afternoon.

I took the sleep test and ...

... I passed with flying colors as far as falling asleep went.

For a few years now I have been having troubling bouts of sleepiness when driving. That is, I would almost fall asleep at the wheel and wouldn't realize it until I was heading into the other lane. So I went to Nurse Leanne (I don't see a doctor) and asked her what was up. She scheduled a sleep exam to make sure it isn't sleep apnea which would account for my symptoms.

At 9:30 last night I drive up to Boone and checked into The Sleep Clinic with Nurse Cindy. She was very pleasant, showed me to what looked like a nice guest room in some one's home, and hooked me up to dozens of little wires and sensors on my chest, my back, my leg, my head, up my nose, and a cute little click on for my finger that made me look like ET. Then she hooked me up to a couple of machines, one named ALICE-5 and said good night. Apparently I fell asleep a lot quicker than most people do with all those wires pasted on to them. She was impressed. Carmen was reminded of Li'l Abner and his job testing out mattresses at the mattress factory. We both have the talent.

I thought I slept pretty well, except for that one little trip to the bathroom at about 3 am which has become almost obligatory for me lately. Cindy has to monitor the machines all night and listen on the intercom for any requests since I could not get out of bed unless she came in and unhooked all the wires!

She said two significant things in the morning. Since she is a nurse technician and not a doctor she couldn't discuss the results, but said that "This test will answer a lot of questions." She also said that 'the Sleep Doctor (what a great title!) would probably want me to come in for another night to test my sleeping with one of the sleep masks.

So I think I probably do have apnea and it may be correctable if I wear one of those masks. They look goofy as hell, like a scuba mask with a snorkel running up the front, but if it keeps me from falling asleep at 60 mph, I'll wear it and be happy.

Besides, when I go to bed with it strapped on my face it might scare Ben bad enough to keep her from wailing and bumping heads all night.