Trial by CPAP
by Margery Hankinson
Over the last couple of years, I have had problems breathing while sleeping, partly due to overweight and partly because my right diaphragm is paralyzed. I spent many months sleeping part or all of the night in my good old swivel rocker. I eventually learned to use a slant pillow to keep my head slightly elevated and was able to go back to sleeping in my bed. There were still nights when I ate too near to going to bed and had to head for the rocker.

In the next phase I started waking up with headaches. I found that if I breathed deeply several times they would go away. After a while I was awakening several times during the night with the headaches, doing the breathing, and going back to sleep.

The next phase was being tired all day and dozing off many times during the day. The scary part of this phase is the lack of concentration and the forgetfulness due to lack of sleep. I was now getting less exercise since I dragged through every day and added weight to an already overweight body.

On my yearly visit to the doctor for a blood test, I mentioned how bad things had gotten and the doctor suggested a sleep test. As Linda described it, you have wires attached all over you and then you attempt to sleep while you're being monitored. It's not painful, just awkward. Gary Prezkop, who ran my test at Geisinger Hospital, Wilkes-Barre, PA, explained everything beforehand and encouraged questions at any time. He assured me with his monitoring he would know if I was having problems, and if I needed him, I just had to say "Gary" or "hey you" and he'd be there. During the night I had to go to the bathroom, and sure enough, I barely got the words out before he was there. He released the wires from the bed and threw them over my shoulder so I could go. This really reassured me I was not alone.

The results of the test showed I definitely had sleep apnea. I stopped breathing 89 times in five hours of sleep and my oxygen level dropped from 90 to 70. Gary came in at this point and put me on oxygen so it would not go any lower.
When I met with Dr. DelaRosa, the neurologist in charge of my test, he gave me three choices: first, the CPAP mask with oxygen at night; second, operating to remove the soft palate and cleaning the throat area; and third, doing a tracheotomy. Detesting operations as I do, there was no choice but the CPAP. I made a vow this was going to work!

The first step was back to the sleep clinic, only now he added a mask to all the wires. Again, everything was explained in detail and my husband and I watched a tape about the mask. All my life, I have had a fear of the unknown, and covering up your nose with a mask (it does have a hole to allow excess air out or air in) is a very scary feeling. To me the terror is greater than the suspense in a thriller when the murderer chases the victim. Gary was very reassuring and advised me not to think about breathing but to concentrate on going to sleep. Knowing that he was monitoring certainly helped ease my mind.

During the night he experimented with the pressure of the CPAP in order to determine how much pressure I needed. The big problem seemed to be with the chin strap that was to keep my mouth shut. It didn't do the job and my mouth dropped open and the pressure dropped. That time, however, I only quit breathing 39 times.

The doctor suggested a rental unit for a few months to be certain I could adjust. The salesman from the company came out with all the equipment and explained it in detail. He suggested it would probably take about a week to adjust. One of the nice things about the Healthdyne CPAP unit is that you can set the timer on the back in increments of 10 minutes. This gives you time to get to sleep before the full pressure comes on. It's a gentle pressure at first, so that you can acclimate yourself. It is also fairly quiet, like a fan on low.

Unfortunately, my husband was called out to work in New England and we were leaving in our RV for 10 days. Instead of a calm, serene setting for the first time without Gary's monitoring, I was faced with seven hours on the road, a broken water line and cold weather. It seemed I was really going to be put to the test!

My husband and I got everything together and the mask on. Then came the moment of terror again. No Gary in the next room monitoring. Fortunately, I had a husband who slept with a light on all night to monitor my breathing and to help ease my fears. I was especially grateful since he had to get up and go to work the next day. I feared that I wouldn't be able to get the mask off with my weak hands in the dark if I couldn't breathe.

Just about the time the pressure was to increase, the oxygen machine conked out. The salesman had had some problems when he was testing it but had thought everything was okay when he left. We had to proceed without the oxygen. Again, the chin strap did not do its job but I got over the terror and was able to sleep the rest of the night with the CPAP. More adjustments were necessary until it was the most comfortable for me.

After the second night with the mask, I started sneezing and my nose started to run constantly during the day. Even pills didn't touch it. It was all right at night when I slept, but as soon as I took the mask off, I would get the tickling in the nose, the sneezing, and the constantly running nose. My face became chapped and hurt a lot. It was intolerable!

When we returned, they brought out the new oxygen machine and it worked fine but the runny nose continued. The doctor suggested Afrin nose spray, first at night and then first thing in the morning. I was sent to a specialist who suggested I take Nasacort twice a day for a month, and if that didn't help, I would go back to the Contac when needed.

I finished up my month just as we arrived in California for a month's stay. I only took one Contac pill and never had any problems the rest of the month. Maybe it just takes time, for me, about three months.

I'm doing really well; I'm feeling more alive and I'm awake all day! It makes a big improvement to my life. It wasn't easy getting used to, especially the drippy nose and I still have that every now and then, but the CPAP really changed my life.