By John R. Greenwood
It’s 4:45am and I just returned from my physician prescribed sleep study.
Warning: I’m not happy.
First of all let me say, this is not one of those, grumpy-old-man-sour-grapes-mad-at-the-world rants, it’s a simple observation inflamed by the fact that I’m tired and I haven’t had anything inspire me to start typing in quite awhile.
That changed this morning.
As a professional truck driver and transportation manager I have carried a Class A CDL driver’s license for decades. One requirement of being a CDL (Commercial Driver’s License) holder is you must pass a DOT (Department of Transportation) physical every two years. If you have extenuating health issues you may need a yearly physical. Up until a year ago I never had any issue of any kind and I always passed my two year visit with flying colors.
That is until I got the Neck Lady. The infamous lady with the rubber ruler who told me my neck size coupled with the 1940’s weight chart on the wall dictated that I was a “candidate” for sleep apnea. When I responded with the fact that I slept like a baby and never experienced insomnia more than a handful of times in my life, she only seemed more determined to send me to sleep hell. It’s not that I don’t believe sleep apnea is a serious and problematic health concern, because I do. I know several people who wear their CPAP apparatus faithfully and swear by it’s results. Part of me was upset about having to incur more expensive testing when I didn’t feel there was reasonable cause. Maybe a tiny sliver of my ego was upset because I’d been reduced to once-a-year re-cert status—that is, until I could be properly diagnosed.
So after dragging my feet for a few months I decided to talk to my own doctor. She seemed minutely sympathetic but ultimately suggested that I suck it up and find out for sure. So, I did.
A week later I got a call for a consultation appointment. Three weeks later I had my consultation which basically consisted of filling out paperwork, answering a few questions, and another $40 copay. “The Sleep Center will be in contact in a week or two with your appointment,” were the last words I heard for two months until I called them back and asked what the story was. My physical would be running out in September, it was June, and my consultation had been in April. “Oh, we’ll get right back to you.” The following week I got a call and a date.
It’s now the second week in July and I’m heading to my 7:30pm sleep study and where the fun stuff is about to begin.
I arrived on time with my Walmart backpack. It contained a pair of shorts and a t-shirt to sleep in, my iPod for some relaxation music, and Tom Brokaw’s book, “A Lucky Life Interrupted.” I smiled the next morning when I thought of titling this piece, “A Sucky Night Interrupted.”
I knew I was at the right location when I saw Ma & Pa Kettle (Google them) heading in the door—Pa with a big pink pillow nestled under his arm. I wondered if I missed the memo telling us we could bring our own pillow(s) to the sleep study? Ma & Pa took the elevator to the second floor, I took the stairs. The elevator was small and the pillow was big. It was a long way to the second floor in cozy quarters. I wasn’t in the mood for cozy. We all arrived at the intercom simultaneously so I pushed the button and stepped aside. I let the Kettle’s go first. I had all night.
Once we were allowed access a young girl whisked the Kettle's away. I wasn't sure which one was taking the study. Maybe they both were, but the pink pillow case told me Pa was going to deposit Ma then head back to the hills. I was greeted by slender and pleasant Dustin. He was grey in color and polite. He sensed a less than exuberant old man, I sensed an overly precise young man who took his job seriously. He led me to Room #2 and with clipboard in hand proceeded to recite the rules and regulations of the house. I listened with the same excitement I did when listening to the Neck Lady list the markers for sleep apnea a lifetime earlier. I did my darnedest to handle this whole ordeal procedure like an adult. I had done everything I was supposed to do. For the first time in my life I felt prepared for a test. I was tired and all I had to do is sleep—right? How hard could it be to sleep in a strange setting? I’d slept in the passenger seat of a rolling eighteen-wheeler at 65mph on the NYS Thruway with my head bouncing off the window at 3pm in afternoon. This would be a piece of cake. I finally found a test I might be able to get a 100 on and maybe even get extra points for drooling.
Hook me up Dustin I’m raring to go…
Then reality set in.
I saw the wires, probes, machines, monitors, and additional paraphernalia that was about to be connected to thing atop my self described, fat neck.
Maybe my optimism was premature?
I kept hearing my well intentioned primary care doctor’s voice, “Suck it up.” I stood there like a real adult and did just as Dustin directed. He began attaching sticky probe tape on me from head to toe. I remained calm and compliant. Once Dustin had attached 95% of my testing paraphernalia he told me to go ahead and relax until I was ready to actually go to sleep. At that point he would finish hooking me up and after a few minor calibrations I would be ready for a peaceful nights sleep. After he left I turned on some relaxation music and sat quietly reading my book. Reading is a great sleep inhibitor for me and within 45 minutes I was ready to begin my sleep journey. After waiting another 30 minutes for my host to return I was beginning to lose some of the calm I’d collected. Dustin finally arrived to complete the connections. I wasn’t as prepared as I thought I was. Once all the apparatus was connected I could barely move my head. He gave me my final instructions and turned the light off as he left. I managed to get on my side and as I lowered my heavily wired head to the so called pillows that were provided I knew instantly I was in trouble. The pillows they expected me to sleep on were like flimsy foam from a stuffed animal. The bouncy cheap stuff you might find in a sofa pillow if it were being used as a movie prop. It was like lowering my head onto a half inflated balloon. I’m not a pillow snob. Although I prefer my own pillow(s), I can usually survive a night or two on hotel pillows of substandard construction. These pillows had no business even being called pillows. I began to panic. With each attempt to adjust my position and get comfortable my fear grew. I began to get claustrophobic. My hopes of acing this test were beginning to fade. No matter how much I punched and poked those puny fake pillows they were not going to comply. I felt sure my night was going to be filled with nightmares of Neck Lady cackling like the Wicked Witch of the West in my ear, “You have apnea, you have apnea. Ha, ha, ha, ha, ha,ha!”
I can honestly say that, other than the night Taco Bowl tried to food poison me, this was the worst night’s sleep I have ever experienced. I’m sure that if this sleep test was graded on a scale of 1-100, my score was going to be a 12 or less. I felt like someone was trying to strangle me all night with a phone cord. Those of you over forty may know what phone cord is. If I’m torturing you by dragging this story out, you’ll have some idea of how torturous a night I had.
I think I may have had a couple of two hour stretches where I finally fell asleep.
I was awakened by a quiet rap,rap,rap on the door. It was Dustin. He apologized for having to disturb me but he said, “You’ve managed to disconnect all but a couple of your wires. I’m sorry but I’m going to have to re-calibrate the equipment.”
I looked at him with vacant eyes of disbelief.
“That’s not happening scooter. It’s 4am and that’s when my alarm goes off. There’s no way I can go back to not sleeping.”
He had that look of victory, like David beating down Goliath.
“Well, we have six hours of data. You can go home if you want.”
I’m sure he’d just told me the machine had been disconnected from the majority of probes. If that was true my data would be incomplete or at best show I slept like a barrel of monkeys. I knew right then I was doomed anyway.
Get me out of here.
When he went to unhook me from the contraption where all the wires came together he found it on the floor between the nightstand and the bed. No wonder I couldn’t move, with the unit on the floor all my wires were taught as a Wicked Tuna fishing line. I’m surprised he didn’t come in to find me blue and unresponsive. I looked on the other side of the bed and there were the two pillow imposters against the far wall. Obviously I’d had a midnight hissy-fit and flung them with an anger they deserved. I had stripped the blanket from the bed and tucked into a ball to use as a pillow backup and slept with just a sheet over me. The bed looked like a crime scene. I might be sent away to sleep prison after this episode. I felt like a failure and a fraud. I’d always boasted that after working the nightshift for two years in the 80’s, I could sleep on a ladder if I had to.
Dustin couldn't get me out of there any faster if he tried. The only thing he was worried about was the survey on the clipboard. He’d told me the night before that I would need to fill one out before leaving. I couldn’t wait. I was ready to share my viewpoint right then and there.
“I can tell you right now those pillows belong in the dumpster”
“We’ve had a couple people say that.”
“We’ll to be honest one lady said they were the best pillows she’d ever slept on.”
“Who was that, Wilma Flintstone?”
Dustin gathered up his stuff and told me to come out to the front desk when I was ready and he’d let me out. I felt bad. I think I was scaring him. I had flashbacks of my father when he would lose his patience during one of his prolonged hospital stays. He could be a nurses nightmare and dream all in the same day. I could hear him laughing from above while cheering, “That’s my boy.”
As I snapped a farewell photo to memorialize my experience I sat for a moment and tried to put it all in perspective. I had come to some serious conclusions about sleep apnea. Foremost, it is a real and serious condition that should not be taken lightly. This piece was meant as a relief valve for my frustration with the sleep study itself. I shared it as entertainment more than a health care review. I do wonder if the CPAP industry isn’t thrilled to death by this additional gold rush. I think there should be a more in-depth interview process before sending someone for testing that I found to be questionable at best. As the case in any issue you can usually justify the means if you weight the argument enough to one side. It’s hard to argue with the positive results many people see when properly diagnosed and treated. I argue that you would be hard pressed to find any person who didn’t possess a sleep issue of some kind from time to time. Are we destined to be a society filled with mask covered faces attached to breathing machines? Maybe we place too much emphasis on perfection. In doing so we create a culture of doubt and despair. Often to such a degree we create a more complex mental or physical problem. I will follow through with my testing and take my medicine no matter what the final diagnosis may be. I may not agree with it but in the end I must set an example for others and comply with the regulations my industry has created in the interest of public safety.
When I complained to Sleep Tech Dustin about the horrible pillows we were expected to ease into slumber on he did add that regulations require the pillows to be flame retardant. He said, “These are the only flame retardant pillows we could find.”
I’m thinking maybe they were the cheapest fame retardant pillows they could find but I know one thing for certain they were definitely sleep retardant.
I need a nap.