Sleep, Perchance to . . . Beep?

I'm currently involved in some proactive health assessments and evaluations.  I'll be 54 soon and I'm overweight, so there are things that need to be checked.  This lead me to my first ever consult with a pulmonologist earlier this week.  I had no idea what to expect but went into it with a positive outlook.

I was impressed right from the get-go when the nurse took me back for my vitals.  Paper charts and manila folders are so yesteryear in this practice.  The woman carried an iPad loaded with a special medical record program (app?) into which she typed my deets.  She then took me to another room for a breathing test.  Yes, I know it's obvious whether we're breathing, but it's all a matter of degree and this test analyzed things like my lung capacity, how much capacity I used and some other stuff I assumed had something to do with the efficiency of my breathing.   Again the equipment was connected to a computer and even if I had no idea what the patterns and numbers meant, I could at least watch them appear.

The tests weren't complicated.  Just put my lips around the mouthpiece and blow.  (Points if you know the actress I just paraphrased and what actor she said the line to.) 

It wasn't that easy.  It started out with regular breaths, which was fine.  While I breathed, a line appeared on the computer screen, moving around and creating circles, sort of like an air-powered etch-a-sketch.  Then the nurse instructed me to take the deepest breath possible and blow it out as hard as I could and keep pushing.  To emphasis her point, when it was time to exhale, she clapped her hands together and yelled, "BLOW!"

Readers, I blew until no air remained and with her urging me on with "More! More! More!" continued to force still more air from my lungs.   Not so easy when one is a romance author who immediately thought up innuendos and had to fight back laughter.

My reward was to repeat that particular test.  The next exercise required me to force myself to hyperventilate.  I did that one so well that my head spun and I subtly grabbed the desk to steady myself before I passed out.  "I'm okay," I assured the nurse, ignoring the throbbing temples and pretty sparkling lights dancing in front of my eyes.

She adjusted the equipment for the final test.   My wooziness cleared in time for me to breathe in against resistance.  Again, I'm not sure what that test indicated.  I would have asked but my head began to spin again and I needed my concentration to stay upright in the chair.

Thankfully, everything steadied while she clicked some keys on the computer laptop that had tracked my results.  I'm fairly sure she also magically beamed the results to the doctor's laptop because he had everything at his fingertips when he met me back in the exam room a few minutes later.

I really liked this doctor.  He's warm, friendly, and a smart aleck, but he talks to patients like we're intelligent and capable of understanding his explanations.  I respond well to that kind of personality and within a minute was kidding back with him.  He reviewed my medical history and that of my family and then gave me a heart-to-heart, in depth explanation of sleep apnea, which is drastically underdiagnosed in women.

Prior to this appointment I knew that with sleep apnea you can momentarily stop breathing sometimes when you sleep which is bad for your heart and contributes to high blood pressure, and can make you sleepy during the day.  I now know that it can also contribute to a variety of other conditions including diabetes, restless leg syndrome and night terrors.  It might also cause global warming and be responsible for our national debt.

Wanting to help our enviroment and economy while also increasing my chances of surviving my next nap, I naturally consented to a sleep test.  They scheduled me an appointment for last night and sent me off with my instruction sheet.

1) No stimulants (coffee, tea, drugs) after 12 noon.
2) Bring pajamas or something comfortable to sleep in.
3) Make sure my hair was clean and dry
4) Bring toiletries but there were no shower facilities
5) No nail polish (I clarified that one bare nail would suffice.)
6) Eat dinner since there's no food in the sleep lab.
7) TV would be available but I might also want to bring a book.
8) No wild parties or loud music after 10 p.m.  (Oh, sorry, that was a dorm rule back in college.)

The instruction sheet assured me that I would quickly grow accustomed to the monitoring equipment and that many patients ceased noticing it at all.  (More on that.)

At the door, the sleep tech met me and the other two patients who were booked for accommodations that night -- both men -- and escorted us to the sleep lab.  They went out of their way to make the rooms look like home bedrooms.  Mine had a double bed and warm gold comforter-pillow sham decor with wood night tables, a comfy recliner and a flat screen television.  I assume the other rooms were similar.

I filled out the consent paperwork, including the paragraph that said they could videotape me while I was sleeping and use it for instructional seminars.  About that time it struck me that I was going to spend the evening in my pajamas with a couple of middle-aged men and two twenty-something sleep techs.  With cameras.  That's considered a good time in some situations, and illegal in several foreign countries.

The tech came back to collect the paperwork and explain the routine.  I had a couple of hours to settle in and relax and then, about half an hour before I wanted to go to sleep, they'd come in and hook me up for monitoring.  I went about my routine, appreciating that they'd given me the room closest to the restrooms so I wouldn't have to shuffle past the other patients in my jammies.  I stretched out in the recliner, watched television, did some sewing, text messaged with my friend and whiled away the time.

Right on schedule, the techs wheeled in a table and asked me to take a seat in a straighter chair.
"Are you allergic to rubbing alcohol, rubber or latex?" they asked.  When I told them no, they got to work.  I soon learned why they wanted my hair clean and dry.  They needed to part their way through it to my scalp so that they could first clean the area with alcohol, and then apply some rubbery adhesive stuff to stick electrodes to my head.  They strapped stretchy belts around my chest and abdomen with additional electrodes, planted a couple in the area of my collar bones, put one on each leg and one on the bottom of my left foot.  I'm pretty sure there were 12 or 13 electrodes in all.

They placed an oxygen tube in my nose and looped it around my ears, then banded all of the wires and tubes together for neat organization and individually plugged them into a rectangular box.  That box was then connected via one cable into another piece of equipment. 

He then gave me what I like to think was the sleep lab version of a pep talk.  "So, all you need to do is relax and have a good night sleep.  We'll be monitoring you from the other room.  If you need anything, just talk to us and we'll hear you through the intercom and answer."

I nodded my understanding and he finished up his speech.  "While we're monitoring you, if we determine that you're having an extreme number of unusual breathing events, the doctor has given us permission to enter the room and place a mask over your face."

Ohhhkayyyy.  I could stop breathing so many times that they might rush in and put an oxygen mask over my face?  Oh yeah, I was sooo ready to relax.

The sweet sleep tech pulled back the covers for me.  I climbed in and pulled them back over my shoulders.  He clipped a pulse-ox monitor on my polish-less finger, wished me a good night and shut off the light as he closed the door. 

Unlike many medical tests where the patient is required to participate, all I had to do now was be passive, sleep, and breathe.  Should be easy, right?  Even with 13 electrodes, gunk in your hair, a tube in your nose and a clamp on your finger, there's nothing to it.

Except that the mattress was too soft and the pillows flimsy.  The electrode behind my right ear was jabbing me and the oxygen tube pulled too tightly against my throat.  I don't know who those patients were who don't notice all these things, but I'm not one of them.  Still and all, I managed to doze, probably for an hour, before waking up and then all of the things that were uncomfortable before seemed even more so.  I stuck it out for awhile before finally speaking aloud into the dark room.

The tech immediately answered and returned to help me out.  I figured I'd hit the restroom while I was at it, so he disconnected my cable for me to leave the room.  I explained the other discomforts and he made a few adjustments, then left me to my slumber once more.

It took awhile for me to drop off again, partly because I could hear the guy in the next room snoring.  You've heard the term "sawing wood"?  This man could fell a forest. His wife must sleep with ear plugs.

The next several hours passed in a weird fusion of sleep and awakefulness.   All night long I dreamed of being in the sleep lab.   When awake, I tossed and tried to get comfortable.  In my dreams, I did the same thing.  I think at one point I had the hand with the oxygen monitor lodged under my pillow and the tech had to come in the room and ask me not to do that anymore.  For the rest of the night, I thought about that in dreams and in reality.

Finally, I woke up and went through the process of getting disconnected, talking to the day shift, and having to demonstrate my morning balance by walking a small obstacle course they'd set up in the hallway.

Oh, no, that's the dream I had right before I woke up for real.  I figured that out when I opened my eyes and realized I was still in bed with electrodes pressing into my scalp.  Just to be sure, I propped myself up on an elbow and looked around the still dark room while my brain roused the rest of the way.  I checked the time on my phone and figured 5:45 was late enough.  I called out to my keeper observers.  They were pretty cheerful for having been awake all night.  Gabe carefully removed the leads and electrodes.  It only hurt once when a little too much of my hair went with the adhesive.

Still, I kept a bright attitude.   "I don't know how much sleeping I did, but at least you didn't have to rush in with the mask!" I said.  "You really did sleep and you didn't need a mask," he agreed.  "But that doesn't mean you didn't have some events."

Ahh, a pre-dawn reality check!  Just what I wanted. 

He packed away all of his wires and gear and told me I was good to go whenever I was ready.  I padded off to the restroom to wash my face, brush my teeth and dress.  I remembered seeing a Starbucks when I drove in and my mood elevated over the thought of a steaming cup of tea.  Maybe I'd even treat myself to breakfast at Cracker Barrel before driving home!

 After checking the room to make sure that I had everything, I stuck my head into the monitoring room to thank the guys.  "Our pleasure," Gabe said.  "Oh, one more thing.  The gunk that's still in your hair will wash out with hot water."

Gunk.  In my hair.  Clearly, I hadn't had enough sleep because I'd looked at myself in the mirror and not even reached for the hair brush.  How could I have forgotten about the adhesive?  

The idea of a hot breakfast was shelved and I breathed a thank you that Starbucks had a drive-through window.  With a caffeine boost in hand, I hit the road, glad that my first ever sleep test was behind me.

I'll find out the results at the end of next week.  I'm hoping that any "events" of stopping breathing are few in number.  If not, then I might be told that I have to schedule a return reservation at the Sleep Lab Hotel.

Next time, I might bring my own pillow.