Holding her breath, my niece swam the length of the pool underwater.  She popped up like an otter.  Slick, water rolling off of her like nothing in the world would bother her.  Click!  The timer showed her that she beat her record.  She was gasping but smiling like an olympian.

My niece would have liked to have added another lap before coming up for air but her body wouldn’t let her.  She needed to breath!  Have you seen the same thing happen in your spouse when they are sleeping?  They look like they are holding their breath doing laps and need to come up for air?  Gasp!  Ah!  Oxygen!  Sweet Oxygen!  Nothing like it.  This event when someone stops breathing for more than 10 seconds during sleep is called apnea.  When it happens more than 30 times in a night it is called Obstructive Sleep Apnea.  The gold standard for treatment is a machine that pushes air into the airway to keep it open – either bipap or cpap.

My patient is young, not obese, exercises regularly and looks healthy.  However, he has tested positive for Obstructive Sleep Apnea during a sleep study and has been prescribed cpap.  My patient used to wear it but frankly doesn’t feel sexy in it.  He feels like he’s wearing a jock-strap on his face.  My patient prefers to snore loudly, go silent, then gasp, over and over through his sleep rather than wear cpap.  No one had told my patient why he must wear cpap, nor did he look it up. We talked a little about his marriage and how he was happy at home.  We talked about school and how well he was performing.  Then we talked again about sleep apnea.  My patient didn’t know.  He didn’t know that he was gifting his wife with a future impotent man.  He didn’t know he was enjoying fewer an fewer functioning brain cells every day.  He didn’t know that he was gifting his children with his early death from heart attack.  He didn’t know that his anxiety might not be responding to his medications because his brain is screaming for oxygen.

Just thinking about his story made me take a deep breath and pray a prayer of gratitude for the air, oxygen, and life.  He did too.   We’ll see if he decides to use cpap or not over time.

In medicine, we can’t diagnose a primary emotional illness if someone has an ongoing medical disease that may be causing similar symptoms.  We need to be as sure as we can about where symptoms are coming from.  I liken it to a steam engine train chugging along, steam blowing out of the chimney.  The steam is what we see, but the onward movement of the train is the disease process.  Obstructive Sleep Apnea affects every cell, organ, system in our body because as it turns out, every bit of us needs oxygen to survive.  I’ve seen people after heart surgery, with no idea that they could have avoided all of that by simply using cpap.  I have been treating one woman now for 7 years for severe treatment resistant depression who is still not using cpap.

So many of the people I work with have sleep apnea.  They feel embarrassed and ashamed by it.  I’m not sure how to help them better but I’ll keep trying because their lives depend upon it.  To feel the sense of accomplishment my niece felt when she came up for air, “Ahhh!!”  Accepting treatment is that wonderful.  We could celebrate.  It’s all perspective.

Question:  Do you have any recommendations for those of us suffering and ashamed?

Self Care Tip #47 – Celebrate treatment and live.  Be a friend to yourself.