Eric Fields, an attorney living in Hartsdale, N.Y., finally gets answers about his poor sleep and disruptive snoring
After his sleep study, Eric (here with his wife and daughter) was surprised to hear how loud his snoring really was.(ERIC FIELDS)My wife has trouble sleeping because of snoring, irregular breathing, and teeth grinding: mine. I've been reluctant to address my problems, though I'm often tired due to poor-quality sleep; I sometimes doze on the couch like my dad did when I was growing up. Recently I decided to get help after reading that untreated sleep conditions can cause heart disease. Plus, I don't want to get banished from the bedroom.
The initial appointment
I visited a certified sleep center in New York City, where my new doctor, Omar Burschtin, MD, looked into my mouth and told me I have a “floppy palate,” which can cause snoring. My wife had written down a description of my nighttime noises ahead of time, because she knew I wouldn't be able to explain them myself. Here's what she wrote: "When you are asleep and lying on your back, sometimes you make a loud snoring noise that tapers off to a quieter snoring noise (with shorter inhales) with subsequent breaths. Eventually, you seem like you are barely breathing in any air at all, your breaths are so short. Then you make a quick snorting noise (maybe to get air) that seems to wake you a little because it makes you shift positions."
When I read that to the doctor, he agreed that it sounded like obstructive sleep apneaa collapse of the upper airway during sleep that leads to interrupted breathing.
Dr. Burschtin recommended an overnight sleep study for an official diagnosis. I was hesitant because my father complained about a sleep study he'd done once; his doctor prescribed an uncomfortable continuous positive airway pressure (CPAP) mask to correct his sleep apnea by opening his airway with pressurized air. He'd tried to wear it a few times, but gave up quickly because he said it was too difficult to sleep.
Where to Start: Family Doctor or Sleep Specialist?It's important to see a physician who is familiar with sleep problems Read moreMore about sleep doctors and diagnoses
Since I have my dad's sleep habits, I worried about needing a mask. But Dr. Burschtin explained that CPAP wasn't the only possible solution: Surgery and dental appliances were options, depending on my symptoms. So I agreed to give it a try.
Spending the night
The day of the study, I felt anxious about sleeping in front of a video camera, but I showed up for my 10 p.m. appointment, answered a sleep-habit questionnaire, and entered my room. It looked like a simple three-star hotel room, minus the TV and clock. “We wanted to reproduce normal life as much as possible,” Dr. Burschtin told me. The video camera aimed at the bed reminded me I wasn't at the Hilton.
[ pagebreak ]After I changed into my pajamas, technicians attached electrodes and belts to my chest, head, and ankles to measure my heart rate, breathing, brain activity, and eye and leg movements. Equipment ran up and down my body, and multicolored wires dangled from my head, making me feel like a lab rat. Luckily, no one I knew could see me.
When I got into bed, a technician on an intercom asked me to blink and make snoring sounds to ensure that they could observe me properly. Then a technician attached oxygen monitors to my nose and mouth, a pulse monitor to my forefinger, and the monitoring box (containing all of my wires) to the wall. As he left, the lights went out, and although the wires were a bit uncomfortable, I drifted off to sleep easier than expected.
Lying on my back isn't my usual position, but I'd been told that it would ensure proper results. I slept that way until 5:30 a.m., when I needed to use the bathroom. As instructed, I buzzed for help, and a technician came to undo and then reconnect some monitors. Around 7 a.m., another technician woke me and removed my equipment. I was a bit tired, but I'd survived.
Getting my results
Once my test results came back the following week, Dr. Burschtin told me that my sleep study showed intermittent sleep apnea and teeth grinding. To demonstrate, he turned on my audio, and I heard the familiar sound of my father snoring in the living room. Was that really me? My charts showed that my breathing plateaued before I snored, which led to awakenings. I saw on the video that I stirred for a few seconds, which meant that I wasn't getting a completely restful night. I wasn't really surprisedit confirmed what my wife had been telling mebut it was worse than I'd expected, and I felt bad for waking her up so often!
Dr. Burschtin said my sleep apnea was mild, according to my respiratory disturbance index, which was based on the frequency of my airway obstructions, airflow reductions, and breathing increases. If I'd had more than 45 respiratory arousals per hour, my sleep apnea would have been considered severe, but I'd had only about 23. My treatment options were a CPAP mask, a dental appliance, nasal steroids, or an appointment with an otolaryngologist. Dr. Burschtin recommended the dental appliance, which was a relief.
Overall, my experience went better than anticipated. I was glad to learn that my apnea isn't severe and I don't need a CPAP. I'm hopeful that soon I can get a dental appliance that's covered by insurance, and that it will help meand my wifesleep more soundly.