Happy New Year! No year-in-review posts, no resolutions/goals posts, just something I've wanted to write about for a while, but it's taken some time to put the whole post together. Read on, if sleep is important to you, especially if you are or know a snorer.
I used to be an insomniac. Insomnia can take many forms, but for me, it used to be hardest getting to sleep. When I was a kid, my parents used to try to coach me to think happy thoughts, but little boys’ happy thoughts tend to be fairly exciting, not so much relaxing (I think I can see a pattern with Shark Boy’s night-time routine). When I was older, I could easily let my mind race.
Nowadays, I don’t really have that problem anymore. I’m able to think of relaxing thoughts, and frankly, I’m exhausted enough at the end of the average day that I can just drift off - happy thoughts are more like being on a hammock at the beach, for example. I did learn a lot about good sleep hygiene in the interim though, and I’d consider myself about as big an expert as a layperson without formal training or certification can be. Some top tips for higher-quality sleep include:
Keep the room as dark as possible. Our body’s hormonal releases are triggered by light, so night lights, street lights shining in from the window, etc. can all interfere with that. We have opaque black-out blinds in the master bedroom and the Lightning Kid’s room.
Similarly, try not to engage in any screen time immediately before bed - TV, computers, or even smartphone screens’ light in your eyes puts your brain in the wrong state for sleeping. Reading is better, if you use an e-reader, try to find a night-mode where the ‘paper’ is black and the letters are white for less light into your eyes. I once found a way to do this on my Kobo, but a software upgrade reverted it.
In fact, make sure your bed is only used for sleeping (and maybe one other thing). TV in the bedroom is a definite and obvious no-no, but overall, the idea is to use Pavlovian conditioning to get your mind and body to equate being in that space with sleeping, and nothing else.
A hot bath is relaxing and appealing before bed, but if it’s too hot, it can make falling asleep difficult. I’m a little guilty of this one sometimes.
Caffeine and alcohol can interfere with the body’s rhythms, so limit your intake.
Obviously all of these have to be varied according to personal taste, I really only include them here to show that I've done my homework when it comes to a good night’s sleep.
I've been a snorer for most of my adult life. In January of 2014, things got a lot worse, in that it got so loud that my wife and I couldn't sleep in the same room anymore. I found an app called Snorelab and downloaded it to my iPad. I wear a mouth-guard to prevent teeth grinding (known as bruxism), and the other issue I started having was waking up with a dry mouth. I mean, incredibly dry. It felt like I’d spent a week in the Sahara. So I tried playing with having a glass of water nearby to stay hydrated, running a humidifier in the room, and using a mouth spray to fight the dryness. I also tracked the effect of my snoring.
I managed to reach “Epic” levels of loudness, and it put me in the top few percent of snorers. Between that and the dryness of mouth, it was time to book a sleep study.
I didn’t get an appointment till July of 2014, and when I did, I found the experience to be not too unpleasant. Yes, I did have to get wired up in weird ways with something like 20 electrode pads all over my body, including my head and face, torso and legs. While I was lying down, they had to do various calibrations where I had to move (or not move) and breathe (or hold my breath) in various ways. It also meant having to call for help when I had to go to the bathroom in the middle of the night to get unhooked from the wires.
It took a few weeks to get the results, but when I sat down with the doctor at the sleep clinic I was diagnosed with a mild obstructive sleep apnea (which gets severe when supine, i.e on my back). This means my breathing gets disrupted while sleeping, and to fight this, my body wakes itself (not always to the point of consciousness necessarily). With these arousals (numbering close to 40 in total), there is also (in my case) “mild periodic leg movement disorder”, but more importantly, it reduces the quality of sleep and puts undue strain on my heart while my oxygen levels dip below 90% which is a sort of safety threshold.
The first issue is important, because we all know that sleep is important and we all struggle to get enough in terms of quantity, but if the quality is poor, what’s the point? Even on nights where I seemed to get plenty of sleep, I’d wake up tired.
I don’t worry about my heart too much since there aren’t too many issues with it from a hereditary perspective and the fact that I get lots of cardio-vascular exercise, but I do think about all the times I read about heart-attacks in marathons and triathlons. The victims are usually in good shape, long-time endurance athletes, so what happens? The blame is usually put on some undiagnosed heart-defect. I searched Dr. Larry Creswell’s Athlete’s Heart website and though he has some articles about athlete's sudden cardiac death, I didn’t find much linking obstructive sleep apnea to these kinds of problems. Still, it can’t be a good thing to keep on living with it.
I was hoping that the solution could be simple; a mouth guard that would alter the position of my mouth. I already wear one for the teeth grinding, so no problem! The solutions presented were:
Surgery. Very little chance of success.
Mouth guard. Chance of success was also not high and the cost would be in the thousands of dollars, not covered by the Ontario Health Care.
A CPAP (continuous positive airway pressure) machine. This has the highest success rate, and the Ontario government covers 75% of the cost.
I didn’t like idea of the machine as I thought it would restrict my freedoms (travel, camping, or even the ability to switch beds spontaneously), but I’d heard from friend (who suffers from a more severe obstructive apnea) that sleeping with one had been life changing and theree was a night and day difference in the quality of sleep he enjoyed. Between that, the cost and the chance of success I pretty much had to give the CPAP a try. I was signed up for a free trial for a month (which ended up turning into 6 weeks).
How the machine works is that it increases the air pressure in my airway inflating it a like a balloon a bit, so that the passageway doesn’t collapse and block the travel of air going in and out. The machine needs to be loaded with distilled water (which humidifies the air going in), and I wear a mask over my nose. While this is better than something covering my whole face, I still can’t really open my mouth while it’s running or it won’t function properly - and I can’t talk very well as the difference in air pressure affects my ability to get words out - it’s like a mild form of gagging. Still, it’s comfortable enough when my mouth is closed, and the mask has utterly failed to frighten my children when they’ve seen me wearing it. I’m actually able to fall asleep wearing it without problems, but I've noticed that getting back to sleep once I’ve gotten up due to one of the Lightning Kid’s wake-ups is harder. It’s really a matter of habit. I do seem to be better rested when I sleep with the machine, but it’s marginal, not a night-and-day difference.
In October, I went in for another sleep study while using a CPAP machine. The machine I had trialled was actually an APAP machine; it automatically varies the air pressure during the night, to what is needed, rather than be set to one constant pressure. The readings from the machine were downloaded to a memory card which I turned in before my second sleep study. It was found I could get by with a constant pressure.
For the second study I managed to fall asleep in 9 minutes (it took 13 the first time) and I had 19 awakenings, no breathing interruptions nor did my oxygen saturation sink below 95%. I should also mention that using the mask eliminates my snoring and only makes a light, white noise that my wife doesn’t seem to mind.