My CPAP Machine and Me

My dentist discovered it. As we chatted, instead of looking me in the eye, she was focused on my mouth.

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“Your front teeth,” said Dr. Cynthia Brattesani. “You've got that pirate look again.”

Telling her it was just a chipped tooth, she reminded me that it was two teeth, one of which she’d repaired three times.

She looked down my throat and asked me if I have trouble sleeping, if I fall asleep during the day or feel depressed. No.

Then she asked if I snored, and she had me there. My wife says I snore like the Midnight Special (the famous passenger train from Houston that Creedence Clearwater Revival sang about).

“Jules, I think you may have sleep apnea,” Brattesani said.

“No, I don't. I sleep seven or eight hours a night. I'm a bundle of energy in the day. I'm just an old guy who snores,” I replied.

“I don't think so. Sleep apnea is serious business. Strokes, heart attacks, diabetes, depression; please have yourself tested,” she said.

I groaned. “What? Spend three nights in a ‘sleep clinic’ because I have a chipped tooth? I don't think so.” (Bruxism, which means grinding or clenching teeth during sleep, is more common in those with sleep apnea and can cause tooth damage.)

“It isn't like that anymore. The sleep clinic at Kaiser Permanente will send you home with an electronic tester, and you'll wear it for a night. That's all. Do it. Please," she said.

Reluctantly, that's just what I did. I didn't fear the results — I had a chipped tooth or two, not sleep apnea — but I resented having to take the time for this exercise. That resentment grew when I filled out the one-page questionnaire at Kaiser’s Sleep Lab in San Francisco.

Except for “Do you snore?” my answer to every question was a decisive no. No, I don't fall asleep in movies. Or while driving. Or wake up tired. Or suffer headaches.

But I took the sleep apnea test machine home, wore it for a night and returned it the next morning.

A week later, I got an email from the clinic. I’ll spare you the details, but here's the key line: “You have SEVERE difficulties breathing during sleep. Make an appointment to pick up your CPAP.”

It went on to explain: “CPAP stands for Continuous Positive Airway Pressure and consists of a mask over your nose, attached to a small air-pump that helps you breathe during sleep by keeping your airway open.”

No. No, no, no. I emailed my doctor at Kaiser, Aana Brenman. “I want a re-test. I think this one’s wrong.”

She wrote back: “I know it can be difficult to believe, but the test does uncover sleep apnea for many patients. The tests are very accurate. Sleep apnea causes damage to organs long term (because of the decreased oxygen at night). I know it's not something you want to hear, but I would recommend trying the CPAP machine.”

So, yes, in I went. And came out with a CPAP machine to test for a week, with instructions from respiratory therapist and polysomnographer, Catherine Brannigan, on how to use it.

Physically, the first night went well. I wore the mask and slept about seven hours. Psychologically, not so well. Wearing the mask, I felt like Darth Vader meets Freddy Krueger. And that wasn't all. Just seeing the thing made me feel old and frail and infirm and everything else I didn't want to feel. I hated the idea, hated the very sight of the machine.

But I wore it. The second night, I kept waking up feeling like I'd walked into a door, nose first. In the morning, I found out why — I'd fastened the mask too tightly, and my nose turned blood-red and bruise-blue. It was also a little painful and had a new bump. I decided to take the third night off for recuperation.

Turns out, a too-tight-mask is a common CPAP learner’s mistake. So, two nights later, I put a Band-Aid on my nose, and back to CPAP sleep I went. But before I did, my wife saw me staring at the machine. “What are you doing?” she asked.

“Adjusting my attitude,” I said. “I need to move from ‘I hate this ugly thing’ to ‘Thank you, CPAP, for potentially saving my life.’ I'm working my way through that now.”

Despite loosening the mask, and wearing the Band-Aid, I still woke up with a bump below the bridge of my nose, so I asked the polysomnographer if I should have a different face mask. She agreed.

Instead of sitting on my proboscis, the new device, a Swift FX Nasal pillow, slid into my nostrils. (No, not all the way up, just the first half inch.) Not only was it way more comfortable, this CPAP didn't make me look and feel like a freak. OK, maybe an elephant with a prosthetic trunk, but not a freak. Hello, Jumbo; farewell, Darth.

A week later, I gathered the CPAP items and returned them to the sleep clinic for a usage review with Catherine Brannigan. She took my machine. She checked her screen. And she gave me a shock.

“Jules, you now stop breathing for ten seconds or more roughly twice an hour," she said.

“That's terrible!”

“No, that's fine. Anything under five times an hour is normal. Now, would you like to guess how many times an hour you stopped breathing before you started using the CPAP?”

“I have no real idea. Maybe eight?”

“Thirty-eight. You've gone from thirty-eight sleep interruptions an hour to two.”

And my wife said I was no longer snoring.

“My god,” I said, as I feel myself near tears. “It’s a Digital Age miracle.”

I left with my new CPAP machine, which, Catherine assured me, will still report my sleep patterns to her at the clinic. A month later, she called me for a follow-up phone conversation, but essentially said, “You are cured. As long as you use the machine, you're getting a normal night’s sleep. Congratulations.”

Cured? That's a word seldom heard in modern medicine.

No more snoring? That's a major bonus.

Along with reducing the likelihood of dying from all those things that top the lists of causes of death.

It’s a Digital Age miracle.