I never had a problem sleeping before that, though I did have very bad snoring--I've had pillows thrown at me in hotel rooms before, and those I slept with eventually took to wearing ear plugs around me.
My apnea itself began in either late 2001 or early 2002. I can't pinpoint quite when, but at some point in there I started noticing I couldn't seem to fall asleep on my back, which was and still is my preferred sleeping position. I was waking up with sudden snorts and eventually had to roll to my side, where there were no such problems... for the time being.
After a few months of that, I got referred to an ENT and had my first sleep study. Results came back as marginal for sleep apnea--a diagnosis I still dispute, since it was already pretty much impossible by then for me to sleep on my back.
I had my first nose and throat surgery...
... in 2005, though for sinusitis instead of for apnea, getting my nasal passages enlarged and a (worthless) laser tonsilectomy which I still regret. I had hoped that might dent the apnea, but it had no effect. By 2006, it was getting worse, and I got referred for a second sleep study. As I recall, I was in that room for less than two hours before the attendant came in and said she couldn't stand it any more--my apneas were constant, and she immediately put me on a CPAP. The diagnosis then was severe, but positional, apnea--it only occurred when I was sleeping on my back, not my side. I got my first CPAP machine (a ResMed S-8 with an impossible-to-clean basin) shortly thereafter, and I was actually happy for a time--with it, and 9cm of water pressure, I could sleep on my back again. Even those who slept with me noticed the snoring had ceased entirely while using the thing.
It wasn't ideal, though, even as CPAPs go. First, I tend roll to my side during the night. The nasal pillows wouldn't stay on properly when I did so, and I had a tendency to throw them off and not remember it later. Second--and this is my fault--nobody told me that I could get regular reorders of the tube and mask. As a result, I used the same ones for years, well past their intended service life. After a year or so, it was hard to get an air seal--an issue many sleep apnea sufferers can ruefully attest to--and I wasn't that happy anymore. Nevertheless, I muddled on.
The final straw...
...came in the spring of 2011, when my sleep was getting steadily worse and I realized that apnea episodes were starting to happen on my sides as well as my back. It was then I decided to attempt my first surgical correction with a local well-reviewed ENT. He gave me his 'blue-plate' special of four separate procedures at once on my nose and throat--UPPP, full tonsillectomy, septoplasty and turbinectomy--in other words, pretty much all the 'phase I' sleep apnea procedures. I had it done in May 2011. It was ten days of hell (a title soon to be tested) and I lost about fourteen pounds during that time. To be fair, the ENT did warn me that it was unlikely to cure the apnea, but he felt, given the amount of tissue he was removing, it was likely to dent it.
It did not. My post-operative RDI at a sleep study three months following surgery was 46, still showing severe apnea (normal RDI is <5, severe apnea is considered >30). And even worse... the apnea was now confirmed as non-positional--it was just as bad on my side as on my back. But, I did get a brand new and much better designed ResMed S-9 CPAP out of the deal, with a tub you could clean and nasal pillows that actually stayed on when I rolled to the side. Live it up, right?
They'd also reduced my water pressure from 9cm to 6cm based on the results of the sleep study. Wonderful as well--maybe the surgery *did* do some good, I figured.
Unfortunately, it didn't last. When I gained back the weight, I required the original 9cm again. For the record, I am not obese. A little overweight perhaps, but at 5'9" and 200lbs--180 when the apneas first started--I work out a lot and hike about twelve miles a week. Except for a spare tire that I know lack of sleep doesn't help, I've got a lot of muscle on my frame and am in decent shape. No, the problem was and is, quite simply, my tongue falling backwards and blocking my throat--the hardest possible thing to address.
So as 2012 rolled around, with my sleep getting ever worse and now completely dependent on my CPAP machine for sleep I could have, I had to ask the question...
Now what?
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