Last night I had my not-so-eagerly anticipated second sleep study, in which I had to use a CPAP machine and decide which style of mask I preferred. For the first sleep study, I found it uncomfortable enough having so many wires attached to me that I was afraid to move around very much. Add to that a mask over my face, connected to a machine on a table by a flexible hose – how was I ever going to get to sleep?
A few years ago my husband had persuaded me to try his CPAP machine, as he suspected I also had sleep apnea, but I found I simply could not sleep with that thing over my face. I told myself I could breathe just fine, but there was something about having my mouth and nose covered that made me very nervous. The longer I lay there trying to relax, the more wide awake and irrationally frightened I felt, until finally I pulled it off. I might not sleep deeply, due to the apnea, but at least with my face open to the air I could get to sleep.
I’ve never had a problem with claustrophobia, so my reaction surprised me. When I went on a business trip to St. Louis some fifteen years ago, I went up to the top of the Gateway Arch, and you sit in a pod that people have compared to a large clothes dryer. It didn’t faze me in the least. Nor did I have any trouble being inside an MRI machine (though, to my disappointment, the MRI didn’t show why my knee bothered me the way it did).
When I read Amanda Ripley’s The Unthinkable recently, I found another explanation for my problem with the mask on my face. In her chapter about panic, she recounts the drowning death of a scuba diver who pulled out his air regulator and refused to put it back in. The conscious mind knows that this thing in the mouth is the source of life-giving air. But the instinct of a land-dwelling creature is to leave the mouth clear in order to breathe. In a panic, instinct takes over.
I didn’t panic when I was using Jon’s CPAP machine, but I sure felt close to it. There was simply no way I could convince my body to relax and trust my conscious mind that I was just fine despite having both mouth and nose covered. I hoped that at least part of the problem was that his mask had been fitted for his face, not mine, and the settings on the machine were likewise configured for his pattern of respiration.
The first mask that the sleep technician put on my face last night was very much like Jon’s. At first I thought it was much better, as the only discomfort I felt was the cool air blowing against my face every time I inhaled. As time went on, though, I couldn’t see how I could relax enough to sleep when I was so aware of each breath. Then my feet started moving from side to side, something that I’ve learned to recognize as a symptom of nervousness (I suppose it’s the lying-down equivalent of pacing).
After a while I couldn’t lie still at all, and I wondered how soon the sleep tech would come back to try another mask on me. Then I realized that I was cold, although I was still fully dressed. I got under the covers and my legs settled down. But I was still very glad when the sleep tech finally returned and took that thing off my face.
The next mask looked similar except smaller. It went only over my nose, leaving my mouth free. That meant slightly more pressure (per square inch) when I exhaled, but not uncomfortably so. Having nothing blowing against my mouth was a big improvement, and I actually found myself starting to doze a couple of times. Each time, though, the pressure of the air through the mask startled me back to awareness. Maybe my breathing changes when I go to sleep and the machine doesn’t adjust right away?
Anyway, the sleep tech came back and put the third “mask” on me. It covered only my nostrils, which meant I could have read a book with it on. (The other two have too much plastic across the bridge of my nose to be able to look at something right in front of me, even if I didn’t need reading glasses.) That was one thing that I hadn’t liked with the first two, not being able to relax by reading or playing a handheld electronic game.
I had been warned that this third mask would have the highest pressure per square inch, since I still had to exhale the same amount of air against the same pressure, but through a much smaller tube. It didn’t feel all that difficult – but on the other hand it felt surprisingly uncomfortable to have the sensitive part of my nose squished up against the plastic of the mask with each exhalation.
I decided I could forego reading myself to sleep, and I went with the nose-only mask. I have no idea how long it took me to get to sleep. (I was surprised to find out, when the tech read me the results from my first sleep study, that I had fallen asleep in only twelve minutes – it felt like longer.) But I woke only once that I remember, to go to the bathroom, and I had trouble getting back to sleep primarily because my tummy kept asking for a middle-of-the-night snack (normally I oblige it, since that lets me get back to sleep quickly instead of listening to it complain).
The sleep tech told me, in the morning, that I had done very well with the mask. I got to keep it (though when he said it was free, I couldn’t help thinking that the cost of it must be included somewhere in the hospital’s overhead expenses, even if not in my bill, and still ends up costing me money), though for now it goes on a shelf until I get my CPAP machine (a rent-to-own arrangement, I’m told).
It’s 2 PM on a Sunday afternoon, and I’m not yet feeling so tired I have to go take a nap. (It’s a very rare Sunday when I don’t.) So perhaps I did get more sleep last night than I usually do. Though I’m sure if I went and lay down I could very easily nod off…