At the Sleep Clinic, an Overnight Sleep Apnea Test

Sleep Apnea, is a potentially serious sleep disorder in which breathing repeatedly stops and starts. You may have sleep apnea if you snore loudly and you feel tired even after a full night’s sleep. ~ Mayo Clinic

Many years ago my mother was diagnosed with sleep apnea and then about six years back my husband also was diagnosed. For several years now I’ve suspected that I might have sleep apnea as well. I was aware that the fact that my mom has it increases my chances. I wasn’t too shocked to have my husband tell me I snore like a lumber jack and will often just abruptly stop and then start up again. Also, I am always tired, infinitely tired. There are not enough naps in the world for how tired I am most days. Sure, part of that is the whole not sleeping for the past eight years because I have kids thing. However the thoughts that I might have sleep apnea, and the being always tired and able to fall asleep anywhere at any time, that predates the kids. So this year I finally buckled down and decided to get tested for sleep apnea. And this is what it was like…

The instructions I received said arrive at 8pm, bring your sleeping attire and some reading material. I am 15 minutes early. I get buzzed in and sit in a chair just out side of the elevator, waiting. Around 8-ish I meet Chelsea, my tech for the night. She sees me to my room. It’s nothing like I expected. For one, its private. Four walls, a door. I had in my minds eye something like in a movie, something with windows and people watching you (though later I do note there is a video camera along the one wall).

Double bed, and survey, await as I enter  my private room.

I’m also surprised by the size of the bed. I was expecting a hospital bed. Something narrow and clinical. This is a double bed with a soft brown comforter spread over it. I’ve never seen a hospital bed with a quilt on it. There are two pillows, piled one on top the other, off to one side of the bed. There’s a set of hooks on the wall, a full length mirror, and one chair.

That’s a lot of wires! This set of electrodes hangs on the wall, waiting for me to be hooked up to it.

Chelsea points out where the bathroom is, leaves me a short survey to fill out, and tells me she’ll be back in about an hour to hook me up. I’m nervous. I use the bathroom almost immediately and then sit and wait, trying to read the novel I brought with me. There is no wifi. The room is chilly. I’m glad I brought a cardigan.

A little after nine I hear Chelsea’s voice over the intercom telling me she’ll be in to hook me up shortly, and suggesting now would be a good time to use the bathroom. Second bathroom break done with I sit and wait. She comes in and directs me to sit in the chair. Then she makes marks on my body with some kind of red pencil, marking all the places the electrodes need to go. She wipes each area with a cotton swab coated it some sort of light bluish goo. Then she goes back over each spot with rubbing alcohol. And finally she starts to hook up the electrodes. She dips each electrode into a jar of opaque goop. She tells me it’s a petroleum based jelly, sort of like Vaseline and warns me that I’ll have a hard time getting it out of my hair. She tells me I will need to shower under the hottest water I can stand, and suggests using dish soap first, then regular shampoo and conditioner.

I’m surprised by just how many electrodes there are. Forehead, temple, chin, several in my hair, each symmetrically mirrored, left side, right side. None on my belly or on my chest, just one to each side near the very top of my chest, slipped just inside the neck of my PJ top. Two on each leg, below the knee, sort of shin height. Then a breathing tube is placed in my nose. Chelsea tells me it’s to measure my breath, or lack there of, while sleeping. A microphone is taped to my neck, to listen to my snoring. Finally two wide bands buckled around my chest. One above my breasts, just under my arms. The other around my waist, over my navel. I speculate that these are to keep the crazy tangle of wires in place while I sleep, but she tells me the bands have sensors built into them and will be monitoring the rise and fall of my chest to keep tabs on my breathing.

She’s patient and willing to answer any questions I might have. Will I still be able to use the bathroom? Yes, no worries. Once I’m hooked up I can just buzz and they will come unhook me to use the toilet. I don’t know what else to ask. I feel like I’m missing something.

She asks when I normally go to bed. I sheepishly admit that my usual bedtime is 11, or 12, or 1. She says I can go to bed at my regular time, then adds 11 is the latest they allow. So I agree that 11 sounds fine. She carefully tucks up all my tubes and wires so I can move around, walk, head to the bathroom again if need be, climb into bed. After she leaves I take some awkward selfies of me covered in tubes. With all these wires attached to my face putting my eye glasses back on is out of the question. Reading is problematic, with the tubes hanging over my chest and getting in my line of site, plus my vision blurry from lack of glasses. I find breathing with the tube in my nose difficult. It feels like I can’t get enough air. I feel a full fledged panic attack coming on and wonder if I shouldn’t have opted for an earlier bedtime. I breath through my mouth and distract myself with board game apps on the tablet I packed. I count the number of electrodes hooked up to me, 28.

I am nervous. scared I will botch this somehow. Worried they will find something, worried they will find nothing. Worried they should find something but won’t because I will some how mess up the test. Worried about falling asleep, waking up, or being restless. Just anxious in general. Normally I can fall asleep anywhere, anytime, at a moments notice. Hooked up to two dozen wires, plus tubes, bands and other assorted bits, I am slightly concerned that I wont be able to fall asleep. I self-consciously wonder if they are watching me over the video camera, if they saw me taking awkward selfies in the mirror, if they are watching me type this. Ugh. Apparently I have a nervous bladder because I find myself needing to go for the third time since arriving. I watch the clock on my tablet. Counting down the minutes until lights out. At 10:54 the voice over the intercom warns me she’ll be back to put me to bed “in a few minutes”, and that I should use the bathroom. Having just got back from the washroom, I sit and wait.

Sitting on the bed waiting, this is my view when I look down.

Chelsea comes into the room and tells me to get into bed. I climb under the covers. There is this big cabinet built around the bed, to both sides, up and over, like a sort of cupboard/headboard. Presumably it hides all the equipment they are hooking me up to. She opens a cabinet door. I lay still on my back while she hooks everything in. She tapes a monitor to my right index finger. She tells me that she needs to go check and make sure I’m hooked up right, and once she’s verified that she’ll run me through a few tests. In the meantime I’m to lay on my back and be still. I stare at the ceiling and wait. She comes back and tells me the one electrode on my leg isn’t registering. She wipes the spot down and reattaches it. Then she leaves the room.

I am laying in bed, flat on my back, trying to breath calmly through this tube and be as still as I can be. There is a small light at the headboard which it still turned on. Chelsea’s voice comes over the intercom and gives me directions. It goes something like this: Raise your hands in the air. Now place them flat at your side, with your eyes open stare straight above you at the ceiling and be as still as you can. Now without moving your head look to the right, now the left, back to the right and to the left again. Now close your eyes, remain as still as you can. Breath three times through your mouth. Now through your nose, deep breaths. Without opening your eyes or moving your head look to the right, to the left, back right and left again. Swallow deeply three times, like you’re swallowing food, and again. Now grind your teeth back and forth. Now make a snoring sound three times. (I couldn’t make pretend snores on command, she said no problem, just cough for me.) Now, without moving the rest of your body pivot your foot and point the toes on your right foot towards your head, now the left, right again and left again.

Then she tells me I can roll over to my side or get into whatever position I want, and to go to sleep. She comes to the door, hits a switch to turn off the light, says good night and shuts the door. I lay there trying to get comfortable with all his crap pressed to various parts of my face. There is no clock. I have no idea what time it is. It feels like I’ve been trying to fall asleep for approximately a million years, though I suspect it has probably been more like ten to fifteen minutes. Since I am all hooked up and know I can’t go to the bathroom I find myself worrying I need to go. I flirt with the idea of pushing the button to summon the tech to detach me so I can use the bathroom. I worry I will never fall asleep. I hear one of the techs talking to the gentleman in the room next door telling him in a stern voice that he MUST go to sleep. I worry I will never fall asleep. I worry my tech is going to come in my room and give me heck for fidgeting. I wonder if I shouldn’t have laid down earlier, to give me more time to try and fall asleep. I wonder if I should have brought a sleeping pill. I try to lay as still as still can be. Then I find myself worrying they will think I am sleeping when I am not, and get the wrong readings.

Eventually I drift off. I wake up to find I’m drooling, face pushed into the pillow. As I move to rearrange myself the light turns on. Chelsea walks in and explains she needs to reattach one of my electrodes. She adjusts one of the pieces pushed against my chin. Remembering how I had been thinking about the bathroom before drifting off, I ask if she can unhook me, since she’s already there. I use the bathroom. I wonder how the heck I can possibly be going for the fourth time since arriving at the clinic. I have no idea what time it is, but it feels like I never fell deeply asleep, like I couldn’t have been sleeping for any great length of time.

The tech hooks me back in and I lay there once again trying to be still, not fidget, not touch or move the cords. Must. Sleep. I doze back off, but wake half a dozen times through out the night. I think at home in my own bed I would just roll over, reposition myself and fall back into sleep. Here each time I half wake up to move I snap wide awake, remembering where I am and worrying about dislodging something.

Eventually I wake to the sound of voices in the hallway, the shower running, I roll over and try desperately to fall back asleep, but each time I start to doze off another sounds shakes me out of my sleep. I wish I knew what time it was. I wish I had brought a watch. Is it the middle of the night and someone is leaving early, or is it 6am and its time for me to leave? The door opens, the light comes on. Chelsea says “Good morning.”, and comes in and unhooks me from the electrodes, ripping off all the bits of medical tape scattered over my body. I ask her how I made out overnight and she is polite but non-committal, telling me only that the clinic will call with my results.

I feel groggy and tired. I get dressed. I pull the tablet out of my purse and read the time, 5:40. I sit down and fill in the short survey Chelsea left. I see one of the questions asks how long do you think it took you to fall asleep, which makes me think maybe the fact that there is no clock in the room is intentional. I wonder if they would have asked me to remove my watch, had I been wearing one.

They had told me ahead of time that they would wake me around 6am. I was also told that I could take a shower in the morning and to bring my own towel and toiletries. I didn’t bring anything with me, I had figured I would just head straight home and take a shower there. Now, getting ready to leave, I stand looking in the mirror. There is gel on my chin, my forehead. It wipes off easily, but leaves my face feeling oily. The goop from the electrodes is everywhere, dried to a wax like consistency, leaving yellowish white blobs in my hair. I rub at the bits I can see along the edge of my hairline, but they aren’t going anywhere. On my way out I hand my clip board over to a random tech. Looking past her into the open doorway I briefly see banks of monitors and computer screens with graphs.

This picture is from the night before, but gives you an idea of just how much goop was in my hair.

My hair’s a mess, even tied back in a ponytail it is sticking up every which way, with chunks of dried gunk in it. Making my way home via public transit people both stare at me and avoid making eye contact. I must look like a mad woman.

Chelsea had told me that to get the goo out I should take the hottest shower I could stand so I take a lengthy shower at skin melting temperatures, wash my hair twice, rinse everything thoroughly, and climb out of the bath thinking my hair must be squeaky clean, only to find small wax like flakes are still stubbornly clinging here and there. Another day, and another shower, later I’m still finding the odd bit I missed.

As I publish this it’s over a week later and I am still waiting for a phone call with my results. Overall the overnight test was both more and less invasive than I thought it would be. While I was being monitored the room felt somewhat private, and while they did attach over two dozen electrodes to me at no time did I need to strip. The get up was a bit uncomfortable for sleeping in, but I was allowed to roll around, and sleep on my side. For me the worst part was the tubes in my nose, which I found particularly uncomfortable. That and my long hair getting in my face, and down my neck, and me not being able to gather it up and get it out of my way to sleep, because of all the wires attached to my scalp.