Sunday, July 4, 2010

Sleeping, C-PAP Machines, and Pills

C-PAP or PILLS

This blog is normally filled with political nonsense. . . but today I want to discuss something else that bothers me. For over 30 years I've been a restless sleeper. I twist and turn and snore most of the night, but despite the acrobatics I manage to get some rest.

When I retired a couple of years ago my sleeping problem got worse.  The restlessness and snoring increased, and sleep apnea began. For the last few years I've been treated by several physicians, each of whom tried a number of treatments and medications to fix my problem. Nothing seemed to work and the process was frustrating.

Since I was a small kid I have been restless, agitated, and worried most of the time, but only after I retired did I also become depressed. Our family doctor prescribed a few of the popular serotonin adjusters (Efexor, Wellbutrin), and a morphine related pill (Xanax) to help me get to sleep. None of these was of any measurable help and I was eventually referred to a "sleep doctor" who specializes in my kind of problem.

This doctor subjected me to a monitored sleep study (electrical signals from various parts of the brain were recorded during a sleep session), and it was found that during sleep I wake up some 80 times each hour. It was easily determined that I have a condition known as sleep apnea. It  can be a rather serious problem as it may lead to other problems, a few of which can end in death.

The sleep doctor prescribed the use of a C-PAP machine during normal sleep periods. It involves a forced flow of moisturized air through a person's nose during sleep. My C-PAP is set to produce a fairly high air pressure (14) because of the severity of my problem. Air from the machine is sent by a flexible plastic tubing to a full face mask sealed around the nose and mouth by a mask that directs it into my nose.

The face mask seal required fine tuning to get it just right. There can be no leakage between the soft and flexible silicone rubber gasket and a person's face. In my case, because of the relatively high air pressure this was not easy to accomplish. Finally I purchased a product called Remzzz  (a soft, cotton, fine weave, thin fabric) to be placed between the silicone rubber seal and a person's face.  Remzzz  solved the leakage problem.

Unfortunately, using the C-PAP machine does not lessen my tendency to twist, turn and change position during the night and when I move around the seal on the mask is broken and a stream of air leaks out. The air leak is  loud and wakes me. To reseal the mask to the face a person needs to turn off the airflow, sit up on the edge of the bed, locate the Remzzz gasket, re-center it on the silicone rubber seal, and then re-attach the mask. By the time all of this is accomplished the C-PAP user is thoroughly awake. If this happens several times each night, as it does in my case, the person doesn't get a good sleep time period. 

Essentially that is where I am now. C-PAP works for me, but only for short periods of about, 2 to 3 hours at a time. I am awakened several times each night and this is not how C-PAP is supposed to work. I conclude that something else is involved and causing my sleep apnea and consequent lack of sleep. 

POSSIBLE AGGRAVATIONS

My sense of depression does not seem to respond to either the Efexor or Wellbutrin. I know that any change might be very subtle.  For me, the relatively mild depression I feel is an emotional down or sadness that inhibits pleasure, happiness and perhaps sleep. I'm pretty sure that the serotonin adjusters do not address the problem.

Understand, if you will, that I have always been a nervous, short tempered, and  can't-sit-still person. I've had the restless legs syndrome since as far back as I can remember.  The Xanax seemed to help calm my legs for a while, but eventually the pills became ineffectual. Today, my legs twitch as much as they ever did.

So the pills don't help, the C-PAP probably would - if I could sleep without flipping around.




RETIREMENT

I retired a few years ago and the sleep apnea arrived about the same time. I suspect now that they are related. I think the problem is more mental than physical and that it started just after I retired. If so, I believe I know the cause of the problem. Like Sherlock Holmes, one can deduce quite a lot when you put the facts together. 

Let's briefly review my retirement plans. My financial goal was to have enough for Linda and I to live from the age of 70 to 90 with no particular change in our lifestyle. When we finally had a substantial equity in our home and condo, and several good mutual funds,  plus a reasonable level of 401(k) investments, I elected to retire.  MY PLAN was to sell our home in Tustin, sort out our belongings and family treasures, downsize to a home or condo of 1500 sq. ft. or so, and move to a less expensive area. I figured that Linda would work 2 to 3 days a week for about 5 more years in the Dentist office, and  assumed that she might have to commute if we moved out of the Tustin area.  In my mind I pictured Linda enjoying a smaller home with easier maintenance, and working with our daughter Trisha on the challenge of redecorating it. Another part of my plan was to continue our $1,000 per month support of Susie, Ashley and Shane . . . until the condo became an empty nest.

I saw myself in a new home and fresh new environment. I would join a local Masonic Lodge or service club to make new friends in the new community. I would FINALLY purchase a motorcycle for recreation and a hobby, and to ride it as long as I felt able. Note: One major consideration was that if I had a motorcycle hobby it would not interfere with any of  Linda's fears and phobias. All in all, I thought my plan was sound and within our ability - provided (as always) that our health remained fairly good. I was amazed when she refused to accept any change or risk.
  
Well, I blew it big time.  I vastly underestimated my ability to get Linda to agree to the plan. I absolutely should have hashed these things out with her BEFORE setting it in stone. This was a HUGE MISTAKE.

I think it is the cause of my depression and my sleeping problems. 

Linda has always been timid and afraid of situations she is uncomfortable in - or can not control.  This severely limits her pleasure in many, many  activities. I'll mention a few to illustrate;  Linda is subject to acrophobia (fear of heights) and suffers from vertigo in many situations. For example, she is not happy on a boat (it tips), in an airplane (she has no control), on a long car trip (no bathrooms), in RV's or trailers (carrying dirty dishes from one run down park to another). She does not enjoy traveling, or sightseeing, and has no interest in most tourist destinations. Considering that she turns down all of these potential activities,  what is there left for us to do and enjoy as a couple? 
  
Linda's is reluctant to do most of the usual things that retired people enjoy. When planning our retirement I was very careful to work around her inhibitions so as not to upset her. I WAS WRONG. She did NOT want to sell our house or to MOVE anywhere. She does NOT want to visit anywhere special,  or at least anyplace where she had not been before. She has NO INTEREST in commuting from a less expensive area to her job, NO INTENTION to quit, and  does NOT especially want to make new friends.

Linda REALLY doesn't want me to have a motorcycle. I purchased a small one thinking it couldn't possibly interfere with her problems. WRONG AGAIN. It made her so unhappy and uptight that I sold it within a few months. Her attitude rocked me to the core. It shouldn't have, but I thought it was selfish and inconsiderate.

I still do. . . . and THAT is where my depression and sleep problems come from.

For the very first time I am worried about  our 50 years of marriage. We've managed to stay together and enjoy almost every minute with no regrets. Only recently, with my sleep apnea and restlessness, has Linda's various timidness been a significant bother and only recently did I decide that I would not do things that would upset her.

But I can not turn off my mind or my sleep problem.

OKAY MR. & MRS. AMERICA,  THIS BLOG IS TOO LONG BUT I'D LIKE TO ADD SOME THOUGHTS.  IF I HAVEN'T BORED YOU TO SLEEP YET,  PLEASE CLOSE THIS BLOG AND LOOK FOR :  "Sleeping, C-PAP Machines, and Pills - BLOG 2"

4 comments:

Greybeard said...

More and more of my contemporaries are using the CPAP and swear by it. I think it's likely that anyone who snores probably has some degree of sleep apnea and could benefit from them.
Keep us updated on your progress please. I'll be following with interest.

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Maggie Thornton said...

Bump, maybe you can find something to do with other men friends. Do you play golf? I know many men who play for the sport and for the friendship. Do you have a group of guys you like being with? Can you meet each morning, or once or twice a week for coffee and doughnuts? It sounds to like you must find something to fill your life. If going back to work is not the answer, then your guy friends might be.

Not sleeping is a terrible thing and it puts us at risk for many undesirable additional "things." Depression, of course, is insidious. I would encourage you make a daytime life outside of home, with your friends.

You write beautifully. Have you thought about volunteering to help adults learn to read - anything that keeps your mind interested. If you like blogging, ramp it up to all day every day, if you can stand it.

I understand about your wife's fears about the motorcycle. My dad was a rider. He was a great rider and a safe rider. Some woman hit him anyway. He lived but lost all the skin on one side of his body. He sold his bike, as did both brothers. I was grateful.

I have a friend who was a terrible sleeper. He also could not turn off his mind. His doctor gave him something - Resteril,I think. He took it for a year. It's an older sleeping med. He says it taught him how to sleep.

I wish I could offer something productive. It's is just not good to not sleep, and you are testimony to that. I hope you get through this, and remember, retiring is not always easy. Good luck Bump.

Rain said...

Wow, you have the problems many do in our age bracket especially with holding onto a long term marriage where both have changed through the years and yet divorce is expensive and emotionally devastating. The only thing I can say is you must think of what you need for your own happiness, not just hers. If you put aside you, the end result will be more health problems and an earlier death than is required. Then she's alone anyway. Your problems are not unusual but knowing others share them doesn't help a lot.

I think my husband might be a lot like you-- a problem solver all his life and it's hard to give that up when you reach old age. You take on responsibilities, like for a wife's happiness, that aren't yours to deal with. We can't make others happy. We can sometimes barely make ourselves happy.

Good luck with the apnea. I would suggest acupuncture if you are not averse to needles. It's amazing what it and chiropractors can help with. Also did you look into Vitamin D deficiency. Many have that and it is common now to test for it. You are right to not ignore the apnea. it can lead to organ failures with insufficient oxygen. I do not think you should ignore the restless sleep problem as it can lead to mental upsets as well, but possibly look into Eastern solutions. They aren't religious but energy oriented. Maybe take a trip with some guy friends. By our ages many couples do take separate vacations. Whatever you do though, don't put yourself last or take on burdens you don't need to take. It will guarantee illnesses. It's not easy for problem solvers to put themselves first but it can be done... It has to be.