My In-Lab Sleep Study Experience

As per my last update, my sleep study was originally scheduled for Monday, February 1st. A few days before the study I started having second thoughts about it and I started getting nervous about our insurance coverage.

I wasn’t sure if the study was going to be covered as the sleep clinic didn’t say anything about it. The last thing I needed was a $2,000 bill for a sleep study so I decided to take a time out to get my ducks in a row. I rescheduled the study for Monday, February 8th.
 
 
The Day Leading Up to My Sleep Study

I can’t quite describe the feelings I had leading up to the study. I wasn’t overly anxious or nervous but I certainly wasn’t looking forward to it either. I guess if I had to pick two emotions that stood out they were irritation and concern. I was irritated because my doctor didn’t think an in-home sleep study would work so he was “forcing” me to do an in-lab study. I was concerned because I didn’t think I would sleep during the damn thing!

The night before the study I decided I was going to pull an all-nighter. My thinking was this would make me super tired the night of the study and I would be assured to sleep. I got so bored and tired, however, that I crashed at 4 a.m. The alarm went off at 7 a.m. so I got three hours of sleep. I didn’t quit make the all-nighter.

Even for me, though, three hours of sleep is hard to get by on so I was good and tired the day of the study. I was confident I would fall asleep quickly – and stay asleep for at least a few hours for the study. This strategy would prove to be faulty as you’ll discover shortly.

As per the instructions from the clinic, I avoided all caffeine and alcohol the day of the study. I also ate light throughout the day and was careful I didn’t eat anything that would potentially cause heartburn, bloating, etc. I drank plenty of water throughout the day as well as I’ve read that if you’re dehydrated when you go to sleep it can affect your ability to sleep.

I was doing everything I could to ensure the study would be a success. I defined success as being able to fall asleep quickly and staying asleep for at least four hours. I would achieve one of the two so it would end up being a partial success.

Arriving at the Sleep Clinic

The check-in time for my study was 8 p.m. I was a bit concerned about this as I normally don’t go to sleep until 11:30 p.m. or midnight. I called them earlier in the day to see if I could check in later. They said that wasn’t possible as they need all sleep study participants checked in and in their rooms so the sleep technician can get everyone “wired up” and ready for their studies.

They said the room had satellite TV so I was welcome to watch TV or read a book until I was ready to go to bed. I didn’t have to go to sleep early but the latest I could stay up was midnight so that worked out just fine. I loaded up my iPad with a couple TV episodes of Longmire (my new favorite TV show) and brought my Kindle as well so I could read.

The sleep clinic was actually part of the main general clinic building. As you can see from the photo, it was your typical office/clinic building. The photo provided is from Google’s Street View taken in the summer obviously. It’s winter here now so we don’t have trees with leaves or green grass right now. When I arrived at the clinic the temperature was below zero and everything was covered with snow. And because it gets dark here early it was pitch black out at 8 p.m.

The main clinic was already closed so the parking lot was empty and the only lights on in the building were ambient lights. It was extremely cold and dark out and very quiet, which kind of set the tone of the whole experience.

When I officially checked in it was so quiet you could hear a pin drop. The only person working was Jason, the sleep technician on duty. He was a very friendly guy and introduced himself as the guy that would be working with me and conducting the study. After a quick introduction he immediately walked me to my room and gave me a brief summary of what was going to happen.

My Sleep Study Room

The picture shown is of my actual room. You’ll see they try to make it look and feel like a hotel room. While it was really nice, it still had that “smell” and feeling of being part of a clinic so I wasn’t able to trick myself into thinking I was just staying overnight in a hotel. It still felt like I was about to sleep overnight in a hospital!

The room had a satellite TV so I had every channel under the sun I could watch and my bed was one of those expensive sleep number beds so you could adjust it to whatever comfort level you wanted. I was impressed that they didn’t spare any expense to make the room (and bed) as comfortable as possible.

I don’t know why, but for some reason I expected to see a huge one-way mirror somewhere in the room like you always see in those cop shows. I know you’re being monitored during your sleep when you have these studies so for some reason I thought it would be done through a one-way mirror…lol.

There wasn’t a one-way mirror in the room but there were a couple of cameras in the corner of the room. Take a look:

After I removed my coat and put my bag down, Jason asked what time I normally go to bed. I told him midnight. He was happy to hear that because the other participant (there were only two of us being studied that night) was also a night owl so he didn’t have to rush to get us wired up.

Because the other participant got there before me he said he would wire her up first so I could just relax and watch TV for the time being. Before he left he wheeled in the “tree of wires,” as I called it. He jokingly smirked and said all those hanging wires would eventually be hooked up to me. I was so thrilled – NOT!

Here is the picture of the “tree of wires”:

Getting Wired Up & Prepped for the Sleep Study

After about two hours of watching TV, Jason knocked on my door. It was my turn to be wired up! This is when the fun began.

Before he started the process of putting all the wires on me, he sat down to explain what was going to happen during this study. He said after two hours of sleep if I had more than 15 apneas per hour – 30 or more for the two hour period – he would come into my room and put a CPAP mask on me for the remainder of the study.

To prepare for that, I had to decide which type of mask I would prefer to wear. I had a choice among three masks. Two masks were “nose only” and one was the full nose and mouth mask. Of the nose only masks, one was the kind that goes into your nose and the other one was the kind that goes over your nose. Without hesitation I choose the nose only mask that went over your nose. He said that’s the same one he uses and is the most popular mask so he said I made a good choice.

After I made my choice he turned on the CPAP machine and had me put it on to see how well I would tolerate it. I had no idea what to expect. When I put it on I immediately felt like I was being suffocated, which was odd because air was actually being forced down my throat. That’s how CPAP machines work. After a handful of breaths it got better but it still felt somewhat suffocating.

After observing me with the mask for a few minutes he said it looked like I was doing well so we would go with that mask and setting if I ended up needing to wear one. The CPAP setting was set to “8” whatever that meant. Apparently the higher the number the more air is being pushed down your throat. He said people with really bad sleep apnea will have a setting of 15 or more. I couldn’t imagine what that would feel like because even at 8 it felt like I was drinking water from a fire hose – except instead of water coming from a hose it was air.

When the CPAP test drive was over he started to wire me up. If you’ve ever had an EKG done it’s basically the same thing except the electrodes are put all over your body and head.

For every electrode pad he had to put on me he had to clean the surface of my skin using a kind of lava/exfoliate soap with a Q-tip to remove any oil, dead skin, etc. This was to ensure the electrodes would stick properly and not come off.

Here is what I looked like after all the wires were in place:

Interesting Tidbits About Sleep Apnea

During the 30+ minutes Jason spent wiring me up, he shared a lot with me about his experience with his CPAP and sleep apnea in general. Here are the bullet points of our conversation that I found interesting:

• The ratio of Asians to Caucasians that have sleep apnea is 4 to1. The ratio of Blacks to Caucasians that have sleep apnea is 2 to 1. Yet despite these statistics, the vast majority of those who have sleep studies done and consequently have their sleep apnea treated are white. If you are Asian or Black and you have afib, you should definitely be tested!

• When you have untreated sleep apnea, your heart is basically running a marathon when you sleep. While you’re sleeping your heart rate might be at 55 and when you wake up during an apnea it might race up to 100 beats or more. Now imagine if you have 15, 20, 30 or however apneas per hour. Your heart never gets to rest. It’s on a constant roller coaster ride. You can see where this might lead to various heart problems such as atrial fibrillation!

• Treating sleep apnea can help eliminate night time urination. Often times if someone is always getting up in the middle of the night to go to the bathroom, sleep apnea might be the cause. Because your mind is constantly waking up throughout the night, all other aspects of your body wake up as well – including your body’s creation of urination and the bladder wanting to go to the bathroom!

• Treating sleep apnea can help treat night time heartburn. He went into a long scientific explanation of this but the bottom line is the air being pushed down your throat essentially pushes down the acid and keeps it in your stomach where it belongs.

• If nothing else, if you are a heavy snorer treating your sleep apnea will make your bed partner happy as they’ll finally be able to sleep too!

• Sleep apnea isn’t only a “fat person’s” problem. Anyone can have sleep apnea. He has done studies on 300 pound people and they have no sleep apnea. Likewise, he’s done studies on 90 pound senior citizens and they have severe sleep apnea. Just because you are skinny or aren’t over weight doesn’t mean you can’t have sleep apnea.

• Having to wear a CPAP mask is no fun for anyone. It’s weird, strange, and all those things. He’s been wearing a mask now for over 5 years. It took him a full 6 months when he first started wearing one to adapt to it. Unfortunately, he said most people won’t stick with it that long. They’ll try to get used to it for 3 nights (if that) and then they’ll throw in the towel and shove the machine in a closet. He said if I did end up needing a mask to be patient and give it time. Accept that it’s weird and strange but that it’s going to improve your health and your life so give it time and stick with it!

• Wearing a CPAP mask to treat your sleep apnea isn’t the only option. There are dental devices that might work for you and surgeries you can consider. All options have their pros and cons. We all have our own tolerances as to what we’ll accept as a treatment option. As an example, he talked to one sleep doctor who said he would actually opt to have a tracheotomy (literally have a hole cut in his throat) vs. any other treatment option. Jason and I thought that was insane but the point was we are all individuals and we all will have to decide which treatment option is best for us. For Jason it was the mask. For another person it might be a dental device and for another person it might be a surgery.

How I Slept During the Actual Sleep Study

After Jason wrapped up the wiring and our long conversation, he said I had about 45 minutes to relax before lights out. I drug my wires along with me and hopped into bed to watch TV for the remainder of my time. I also took another pictures of my wires:



At around 11:30 p.m. Jason knocked on my door and told me it was time to get started. I downed my 10mg of Zolpidem and 1mg of melatonin and got settled into bed as Jason put an oxygen tube in my nose and taped a pulse oximeter to my index finger. Here is what I looked like just minutes before lights out:



Despite everything I did in preparation of this study AND downing double the usual dose of Zolpidem I would normally take, it took me over two hours to fall asleep! It was awful as I tossed and turned endlessly.

Finally at one point I fell asleep – only to be awakened by Jason sometime in the middle of the night because the pulse oximeter wasn’t on securely. He had to quickly readjust it and then exit the room. I fell right back to sleep after that and before I knew it Jason was waking me up at 6 a.m. sharp. That was the time the sleep study officially ended.

All told, I only got about 4 hours of actual sleep and it was awful sleep to boot. It was the kind of sleep where you feel like crap and you feel like you didn’t sleep well at all – like you were restless and mostly awake most of the night (but weren’t really awake).

Thankfully, Jason said I got at least enough sleep for him to capture the data necessary for my sleep doctor to make an assessment. Jason wasn’t allowed to share anything with me, even though I tried to pry some details from him. He said my sleep doctor would go over everything during my follow up appointment on February 25th.

Important Lessons I Learned About Preparing for a Sleep Study

In hindsight I made two major mistakes. I shouldn’t have attempted to pull an all-nighter the night before the study. While it might make sense on paper, in reality I think it threw my whole sleep schedule out of whack which is why it probably took me so long to fall asleep during the study.

Second, I shouldn’t have messed with my nighttime drug routine. Normally I take one Kavinance PM (a natural sleep supplement) and about .5mg of Lorazepam before bed every night. If I ever take Zolpidem I only take 5mg. The night of the study I took a 1mg sublingual melatonin tablet and 10mg of Zolpidem! I think this totally new drug routine messed me up.

If I had to do it all over again, I would just stick with my usual sleep and nighttime routine. I was so concerned that I wouldn’t be able to sleep that I over compensated by messing up my routines. It back fired big time. Don’t make the same mistakes I did!

So Do I Have Sleep Apnea or What?

Even though Jason wouldn’t even hint if I had sleep apnea or not, I was at least able to conclude that I didn’t have moderate or severe sleep apnea as I didn’t get the dreaded “CPAP mask visit” in the middle of the night. Unfortunately, that still didn’t rule out mild sleep apnea. I won’t know anything until February 25th.

You know me, I’ll have a full report after my appointment. For now, I’m just so thankful this sleep study is water under the bridge. I waited for over a year before I finally bit the bullet and had this done. It feels great to be done with it! Now I’m crossing my fingers I don’t have mild sleep apnea.

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