It all began for me with pre-admission testing prior to scheduled thyroid surgery a few weeks ago. When my doctor was going through her list of questions at my exam, one of them was, “Do you snore?”
At that I let out a brief laugh, remembering the night before my younger granddaughter Nikki remarking to me, “Grandma, you’re snoring!” So I had to answer that, “Yes, I guess I do.” (And over the years my husband has remarked about same.)
My doctor was not smiling when she responded, “Pat, you are going to have to pass a sleep study before I can okay you for surgery.” I was told that older people with sleep problems sometimes endure complications arising from undergoing anesthesia.
I had less than a week before the surgery date and time was of the essence, so I went full speed ahead to get scheduled for the sleep study. My doctor’s staff went the extra mile on my behalf to get me in with a private sleep medicine practice the following evening.
Here is how it went. After a lengthy consultation and gathering of medical history in the afternoon, I reported at the sleep study lab that evening around 7:30, bringing with me pajamas and toiletries for the night. A pleasant nurse/tech showed me to my ‘bedroom’ and had me dress for bed. My first thought was how in the world was I going to be able to fall asleep at 10 in the evening, when my normal bedtime is not before midnight. Then and there I began to feel a bit uneasy.
The next step was being taken to an examining room where I got my first glimpse of the many electrodes that would soon be attached to my head and body via a gooey glue paste. The wires were attached to a board that would enable mobility, should I need to get to the bathroom during the night.
I was given an hour or so to ‘relax’, sitting at a desk beside my bed and thumbing through some very out-of-date magazines. Around 10 the tech reappeared, asking me if I were ready for bed. (I really felt more like running around the block a few times than hopping into bed.) But I answered, “Okay.”
I was told that the monitoring equipment was down the hall, but I could call my tech’s name at any time and she would hear me. To pass the test I was told I had to have 15 or fewer breathing lapses during sleep. And should I go over the 15, I would be immediately placed on a CPAP machine for the remainder of the night.
CPAP stands for continuous positive airway pressure. Its function is to provide a continuous mild air pressure to keep an airway open, typically used for people who have breathing problems such as sleep apnea. I was told the CPAP is the most effective treatment for obstructive sleep apnea, which I now know I have.
I had absolutely no idea I had this condition until I undertook the sleep study. However, I do remember my mother’s interrupted breathing and my tensing, waiting for her next breath.
Getting back to my sleep study experience, once the light was turned out, my room was pitch black except for the red outline of the video camera trained on my head. Even though the bed was most comfortable, sleep would not come. How does one fall asleep on command?
After a half dose of Ambien, calling for a glass of milk, and consuming a few munchies I had brought along, mercifully I did drift off around 2:30 or 3:00, I learned. When I awoke sometime around 6:00, I realized I was not wearing the CPAP mask and felt good, believing I had passed.
But around 3:00 that afternoon I learned from the sleep doctor that I had a very poor showing, averaging 45 breathing lapses per hour and a blood oxygen reading down in the lower 60s. My doctor was not going to certify me for surgery; and what more, I had not slept long enough to try out the CPAP machine. Hence, I was scheduled for a redo of the study the following week.
I went through the second night of sleep study four nights ago, using the CPAP the entire night. Again, falling asleep was a challenge. This time, however, I had an average of only 18 breathing stoppages per hour, but my oxygen level fell again to the low 60s. Yesterday I met with the sleep doctor to discuss the second study results.
I was told that wearing the CPAP did help. I will be given a CPAP machine. It will be calibrated to run on Auto — that is, the air pressure will increase automatically as my breathing need warrants. My oxygen reading will also be monitored at home for a couple of days. Should I need it, I will receive a CPAP that also delivers oxygen.
You may be wondering why I am going into such detail about the sleep study. Since all of this began, I have learned that recent research suggests that ongoing sleep deficits can take a considerable toll on the brain.
From the article “Sleep Well” by Amy Paturel, M.S., M.P.H., appearing in NEUROLOGY NOW (Feb/Mar 2014) I read that, “Recently, scientists have started to link longer waking time with increased risk of cognitive impairment and a higher risk of developing Alzheimer’s disease.”
From the same article I read that, “In a 2009 study of mice published in the journal SCIENCE, researchers found that sleep deprivation increases the concentration of harmful plaques in the brain.”
Further quoting from “Sleep Well” in NEUROLOGY NOW (Feb/Mar 2014), “For centuries scientists and philosophers have debated what our brains do during sleep. Now, for the first time, researchers have solid evidence that a good night’s sleep may literally clear the mind. In a study published in the journal SCIENCE, researchers found that the space surrounding brain cells — called the interstitial space — may increase during sleep, allowing the brain to flush out toxins that build up during waking hours. Previous research shows that proteins linked to neurodegenerative diseases, including beta-amyloid, build up in the interstitial space.”
According to Dr. Adam Spira, Ph.D., assistant professor in the department of mental health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, MD, “These findings provide a potential mechanism for the link between poor quality sleep and greater cognitive impairment,” (again quoting from “Sleep Well”, NEUROLOGY NOW from Feb/Mar 2014).
Same article, quoting Dr. Rashid Deane, Ph.D., research professor in the department of neurosurgery’s Center for Translational Neuromedicine at University of Rochester Medical Center in New York, “The restorative function of sleep may be due to the switching of the brain into a state that facilitates the clearance of waste products that accumulate during wakefulness.”
Again, credit for the article, “Sleep Well” in NEUROLOGY NOW from Feb/Mar 2014 goes to Amy Paturel, M.S., M.P.H. I hope you will access this article and do further looking on the relationship between sleep deprivation and buildup of beta-amyloid.
How many of us have sleep apnea and do not realize its possible ramifications!