By Dennis Higman, 12-24-10

Like a lot of people, I don’t sleep very well. It certainly isn’t traffic noise, low-flying airplanes or police sirens. Our nearest neighbor on this high mountain ranch is 20 miles away. The only lights are the moon and a spectacular cover of stars, occasionally interrupted by a lonely satellite blinking its way across the night sky. “Can you hear me, Major Tom?”

There are coyotes, of course, that set the dogs to barking, and when they don’t howl that’s even more worrisome because there might be a wolf in the neighborhood. Or nothing howls or yowls and I just ache from old football injuries and broken ribs sustained when a cow knocked me silly. Or it’s a black train of doubts and fears chugging its way through the night.

Whatever it is, after drifting off to sleep reading something stimulating like “The Reluctant Mr. Darwin,” something wakes me. And, after staring at the ceiling for a period of time, I get up (so I don’t disturb my soundly sleeping wife), bundle up, take the dogs and go out to take a look around.

I usually wander around in the moonlight among the grazing cows and horses for a while.  Being surrounded by methodically chewing livestock has a calming effect, but doesn’t put me to sleep. So I go down to the creek and spotlight the army of beavers at work on their latest Grand Coulee in our pasture. Wide awake, I go back inside, make myself a sandwich and settle down to watch reruns on the NFL Network or attempt to make sense out of Charles Darwin for the rest of the night.

Finally, just before dawn, if I’m lucky, I may actually fall into a restless sleep for an hour or two. I always assumed this was nothing out of the ordinary. After all, I know a lot of people who don’t sleep well. But my doctor thinks otherwise. He thinks I’m suffering from something called sleep apnea, a Greek word meaning “without breath.”

I had—and have—my doubts. To paraphrase P.T. Barnum (and as pharmaceutical companies know full well) you’ll never go broke providing ways to help people lose weight, stop smoking, have better sex, or relieve headaches and other bodily pains, even during the worst downturn since the Great Depression.

And this being America, a group of modern Barnums—entrepreneurial medical doctors, gathered under the banner of the American Academy of Sleep Medicine—have come up with a way to tackle all these problems and more by helping restless souls like me get a better night’s sleep.

Getting to sleep and staying there is not as simple as it sounds, of course. I’ve tried sleeping pills, switching mattresses and pillows, and turning up white noise. While these things seem to help, they don’t help all the time. They are not a cure for what ails me.

That’s because, at least according to these sleep disorder specialists, I am only treating symptoms, not the cause, which they claim is a widespread, serious, even life-threatening disease. They claim sleep apnea affects millions of Americans (estimates range from 20 million to 75 million) and they apparently have extensive research to back them up. 

Sleep apnea occurs when your windpipe becomes blocked while you sleep, cutting off your oxygen supply for anywhere from a few seconds to over a minute. The New England Journal of Medicine calls it a “major health problem equivalent to smoking.”

As you might imagine, this lack of oxygen is not good, particularly when these violent choking episodes may occur many times during the night and you’re not even aware of it. Which is why, despite my skepticism, I came down off my remote mountain hideaway in a snowstorm at 9 p.m. one night to attend the nearest “sleep clinic.”

Most good-sized towns and all major hospitals in Idaho have such a place these days, along with MD “sleep specialists” and a raft of scary literature that goes like this: The multiple traumatic spasms of sleep apnea can send your heart rate skyrocketing, and this repeated stress can cause or contribute to a long list of physical and mental problems including high blood pressure, heart attack, stroke, diabetes, chronic fatigue, moods swings, and depression.

Oh, yes, and it may also contribute to obesity, make you crave a cigarette, lose interest in sex and prolong chronic pain, all due to chemical imbalances created by severe disturbances of normal, healthy sleep patterns involving REM (rapid eye movement) and non-REM sleep (which has three stages, “shallow,” “medium/light” and “deep body sleep”).

My local sleep lady is no country doctor. Educated in California and trained in the East, she holds degrees in physiology and pharmacology and is board certified in anesthesiology, pain management and sleep disorder medicine. She runs multiple Idaho clinics, which probably means she’s a pretty fair businesswoman as well.

So, dazzled by these qualifications and at least willing give anything to a try, I parked my truck, collected the required “sleeping clothes” I would not normally wear and went in to meet my “qualified technician.” A friendly single mother of two from Idaho Falls, she was there to wire me up and monitor my sleeping patterns for the next eight hours.

The doctor in charge had posted her own smiling picture on the wall, as well as her multiple medical degrees and honors. But she was there only in spirit. Her role was to analyze the reams of data resulting from my overnight stay. So it was just my technician and me.

Although this little sleepover is portrayed in the handouts as a simple, straightforward process, it wasn’t quite that easy. The literature says the technician “will gently attach a few different sensors to your body … to collect data while you sleep. … The process takes only a couple of minutes.”

She was gentle enough, but it was more than a few sensors. They are stuck to your head, around your middle and even on your legs, and it takes more than a few minutes. Just before I fell into my drug-induced sleep, I told the technician it was a good thing I wasn’t one of those paranoids who think the CIA is trying to steal their brain waves. She gave me a forced smile and told me she’d be right next door monitoring the computer if I had any problems. 

Mercifully, I didn’t, although I did have a restless night in spite of the sleeping pills, primarily because of the dull pain from my cow collision, and was glad when the test was over. After this, the doctor entered the picture, so to speak. Wherever she was, she reviewed the 700 pages of raw data collected—oxygen levels, eye movement, brain waves, restless legs, and God knows what else—and, in a few days, sent me a detailed report and recommendations.

The news was grim: The patient is suffering from “severe obstructive sleep apena syndrome.” This meant yet another overnight visit to the clinic to be fitted with a mask that delivers continuous positive airway pressure (CPAP) treatment. This requires small, fairly quiet machines which pneumatically split the airway, thus ensuing normal breathing throughout the sleep cycle. They come in various configurations ranging from a simple system inserted in the nose to full masks.

After trying out several models, I was forced to wear a full mask, not an easy thing for someone who suffers from mild bouts of claustrophobia. When I jokingly told my friendly technician that it felt like I was on life support, she urged me to hang in there and see if I could get used to it. I followed her advice and, to my amazement, after only two hours, felt mildly refreshed.

At this point, however, the plot thickens. Soon after my trips to the sleep clinic, I went to the coast for an extended stay to visit relatives. Lo and behold, at sea level, I slept like a rock despite traffic noise, sirens, screaming kids and an uncomfortable bed.

After that, I had more questions than answers. Was it possible that after living at 7,300 feet for 16 years I developed some variety of high-altitude sickness?

No, say the learned doctors, it’s not the same thing, not at all. The data doesn’t lie.

Maybe not. But should I forge ahead with treatment despite my misgivings, put my trust in a person I’ve never actually met and be fitted with a mask—the ever-popular “ResMed S9 AutoSet CPAP at 13cm water with ClimateLine and heated humidifier utilizing a ResMed Mirage Quattro, size medium”?

I don’t know about you, but the ResMed Mirage doesn’t sound like something I want to sleep with on a regular basis. So, back up at the ranch with winter closing in, still feeling pretty good from all that oxygen at sea level, I’ve decided to hunker down and see what happens. 

If nothing else, I can give Major Tom some company as he passes overhead.