Wednesday, March 06, 2013

Post Sleep, part III: Slightly better than abysmal

I have good news!  Or rather, I have less-bad news.  Still, less-bad is good, right?

I did manage to sleep for a significant (possibly even majority) portion of the night.

As foretold, I went back to the sleep clinic for my third night of observation.  From the start, things were different.  I arrived with a relative cloud of other people: three whole individuals! Previously, I had only ever arrived by myself, so it felt crowded.  Another change: the other three patients I saw were all women. I had only ever seen men before.

The technician explained that they had a full house for the evening.  Ten rooms occupied.  I don't know how many staff are involved, since I only ever really interact with a single individual.  Last night was a different person than I happened to end up with the previous two times.  She was more chatty, asking questions about what I did and how I felt about the previous times.  This alone made me feel better, since it afforded the first opportunity to speak to someone "in the know" about the rough times of the previous two observations.

She also cut down the number of pages of paperwork I needed to do, so she's at the top of my Christmas card list now.

She gooped me up and applied the now-familiar complement of sensors, belts, and electrodes.  When she got to the airway mask, I let her know that I had used the nose-cover model both previous times and it hadn't given me any trouble.  For reference, this is what I wore the first two times:

I don't think my strap was pink, but in the dark it very well could have been.

The technician began to strap me into the nose-cover mask again, but the head strap was too small.  It felt like my nose was being pulled up to sit between my eyes.  Most unpleasant!  She left the room and returned with a larger strap (the Elephant man special).  Even after cinching the straps, she stepped back to appraise me.  

She frowned.  "Your nose is weird."  

I automatically responded, "I've been told that before."  Never by a medical professional, though.  It carries a bit more weight.

She motioned with her hand and explained that I didn't have any space under my nose that wasn't lip.   I didn't understand what she meant then, and after examining myself in the mirror this morning, I'm not much better informed. I spent a little time looking at my face in the mirror, as well as images of other faces, but I still don't quite understand what she was talking about.  

The gist was that the mask wouldn't have anywhere to rest that wasn't comfortable. I didn't know any better (despite having worn the half-mask twice before), but she fitted me with a different style.  Ominously, the new one had "nasal pillows", which sounds like a euphemism that I do not want any part of.  

The nasal pillow mask looks like this:

The pillows sit against and the tiniest bit inside the nostrils, holding them open through air pressure. I don't know if the pictures do them justice, but there's a lot less to this second mask.  The clear strap is not rigid, but a thin and stretchy rubber and there's no hard plastic brace piece that balances on the forehead like in the half-mask.  

It is not an upsetting sensation, but I'm not willing to say it's pleasant, either.  I'd consider it "tolerable", on a good day.

The first half of the evening seemed to be lots of moving around, experimenting with sleeping on my back vs. sleeping on my side, and trying to find pillow placement that wasn't distracting (remember that I have head straps and 15 things glued to the front, back, and sides of my head).  I think I slept a bit (at least, I don't have a continuous memory record of the time), but by midnight or so, I needed to urinate.  I dithered for probably another 15 minutes about whether or not I *really* needed to go, before finally pushing the summons button on the wall intercom.  

As before, I had a laughably good time trying to pull down my pants with one hand while holding my wire box in the other AND trying to avoid disconnecting anything..  If it didn't involve male nudity, I'd love to make and post a video that replicates the experience, because I bet it's hilarious to watch.  

By the morning, I also had a few more gaps in my memory record.  Assuming I was sleeping, I was sleeping very lightly, as I remember several instances of moving and reshuffling.  But sleep I did, including when the technician came in to wake me.  

She explained that she, too, had noticed that I was sleeping -- a fact which doesn't feel as creepy after signing forms saying they could do it.  She had also looked at the records of my previous times and saw that I had slept a "whole lot more" than the other times.  She also noticed I was never able to sleep on my back, which I certainly can attest to.  

It was nice to have her be able to speak even a little bit about the previous times and the conditions of my collected nights.  She explained that my doctor's office liked to have "all the information" before they speak to the patient, and I guess that includes sending me back until I get the results I need to have.  It's a bit like being informed that I've failed a test that I didn't know I was taking, but here we are.

The downside of this third visit is that I still didn't get a lot of sleep.  I'm writing this now after a nice breakfast, but I still feel like a multi-hour nap is in my future today.  I slept some during the observation, but I also didn't sleep quite a bit, so I'm still behind for the day.  

Filling out the after-sleep evaluation, I made sure to note that I felt much better this time and had actually managed to sleep a bit.  But when I got to the question "I feel my sleep is improved with the CPAP mask: Yes/No?". I still hesitated.  My sleep was improved over the other two times that classified as something a Nazi would do to Lee Marvin in a movie, but still a FAR cry from a night's sleep at home.

So what do I say?

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