Saturday 13 May 2017

Story Time : "Younger Man" with Sleep Apnoea

Not dissimilar to the description J K Rowling gives to the character of Uncle Vernon in the Harry Potter series, I am a "Big Beefy Man" with "not much neck".

As a result last year it became blindingly obvious that my waist was expanding, I also personally noticed a drop in my day-time alertness.  Initially I would like to point out that I have always been a night owl, and it was not uncommon for me to stay up late and get stuff done (especially programming things) and then sleep later.

This fit well with my employment offering flexible start hours too, and so happily for very many years, I got slowly fatter and fatter, sitting down and eating too much, and I slept later and all was merry.

Except, it wasn't... I suddenly noticed I had become extremely moody, irritable, bad tempered, my concentration was dropping and I found it nearly impossible to remember new things.  Initially I bit back my bad temper, and to compensate I started to use a series of physical notebooks and then scheduling apps to help abate my failing memory.

This crooked self-dillusion carried on for about four weeks, the wife later told me I was a nightmare to live with, however at the time I could not explain the reasons for the change, I could think I didn't want to act that way, I didn't want to forget my lunch, or eat junk, or be a bastard.  But I was being, and there was nothing I could seemingly do about it.

So, I took a few days to think about what I was doing, what had changed, I was very tired, I had to admit.  I kept going though... Kept going, caffeine, pushing black coffee down me, and sugar, lots of sugar.  I never felt I was eating well, but I needed the energy, without it I faltered, stumbled and one day I said "no caffeine today, lets see how I get along".

Driving home one moment I was at red lights, a blaze of other tail lights a head of me, the next blink, I was alone... Sat at the lights still, no-one around me... I had fallen asleep at the wheel.

I literally pulled over and slept there and then.

I contacted my GP, and said "I think I have sleep apnoea", this notified the DVLA, I suspended driving and got one with treatment... Unfortunately this took sometime, so my coping mechanism in the meantime was to sit up in bed more, and to fit a black-out blind to the window.

This alleviated symptoms, but I knew I wasn't sleeping deeply, a short time later and a night of sleep monitoring it was confirmed, I have obstructive sleep apnoea.

I thought this was because I was fat, because I was getting older.  But it seems thats not just it, I am large, and all my family are.  However, the tiredness makes you want to eat more, the BBC has recently covered this phenomenon more than once, and I have to admit it was nice to hear.

I was issued with a CPAP machine, was immediately sleeping so much better.  It was like night and day.  And for the last year I have enjoyed this machine immensely.

However, the straps for the masks go slack over time, as they go slack your sleep falters again, as a man if you have too much facial hair air escapes the mask (have a beard but very short trimmed it's not a problem), far more of a problem is how the mask  seal skirt wear and then the straps go slowly slack.

I would have to argue that the company making these (Phillips) could be held somewhat to account for the latter, as it seems to happen at a predictable, almost designed rate, however I have to concede that the material used has certain requirements and the felt like vencro fastening straps with their slight elasticity are pretty good, but the continual re-stressing of the product does result in quite quick deterioration in performance, even before you take into account the biological factor (sweat & skin cells, and having to then wash the straps).

However a year on, I'm not wondering whether the machine is enough for my condition, I've noticed more than just slack straps, more than wearing seal skirts, more than just a bad nights sleep that more days than not I am quite tired of a day.

This is not everyday, but perhaps two days every fortnight or so, there's no obvious reason for this biologically, environmentally there's no changes either.  I have to admit to slightly more stress in my life at present, however pressure or stress have never stopped me sleeping before (a side effect of studying the martial arts - if a bloke bigger than me can hit me, a bit of code not working in the office is nothing to sweat over).

I will have to discuss this with my consultant in early June.

Being an every inquisitive soul I have started to look at other factors into why I might have apnoea whilst my brother (a close body match to me) does not, and as far as I know no-one else in my family - despite our having a string of heavy snorers - doesn't have apnoea.

One thing I mulled over, before doing some reading, is that during my mid to late teens I had orthodontic treatment, I had four healty pre-molar teeth removed and the two following molars behind these pulled forward.

I've just read, in two sources, that these molars play a role in strengthening the stiffening the sides of the soft pallet, and they also provide a framework onto which the throat muscles structure, then of course the net result is that your jaw is shrunk, leaving less room for the tongue.

I have to be completely honest here, if I let my tongue rest in as natural a position as it can, as easy feeling as it can be, it sticks out over the end of my lower front teeth.  But sits slightly behind my upper bite.

I have the distinct feeling that if I had not had this procedure, yes I would have slightly wonky front teeth, and yes there may not have been space for my wisdom teeth to fill in but my tongue would fit inside my teeth.

As a consequence of this poor fit I have to draw my tongue slightly backwards, with a kink mid-way, to let it sit behind my lower teeth, add the very nature of the action of the flesh being slack in my apnoea and this is a recipe for real trouble.

Having made mention of my weight problem, I did grow whilst without my CPAP machine, I went up to 21 stones around July 2016, by December I was 19 stones, and now today at posting, I am 17 stones and 9 pounds, you can go convert that yourself.

I'm still big, but I feel so much better, even with a few crappy days sleep I feel so much better.

Coming up in June, lets see if my consultant agrees with my orthodontic question, and if I need anything corrected or improved with my CPAP machine.

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