Sleep Study Consultation

I woke up today feeling really horrible.  I could not open my eyes.  It took an extraordinary amount of effort to move my arms or legs.  I wake up like this fairly often.  And without any known reason.  Even when I sleep for 7 or 8 hours I will feel like this.  And most of the time it will not improve after I shower, or after I eat breakfast, or any time in the afternoon.  I walk around like a complete zombie and look terrible. Terrible enough for multiple people to comment.

Two years ago I decided to see my doctor about this.  He tried me on medication after medication.  He sent me to specialist after specialist.  And two years later, I am even worse than I was before.  One of the options that was talked about but always moved to the bottom of the list was to get a sleep study done.  Well, we finally arrived at the bottom of the list.  I had a sleep study consultation done this past Monday morning, just after returning from vacation.  It was quite eye opening. 

I was fairly certain that I do not have sleep apnea, but figured there could be something else going on that a full sleep study might reveal.  I just felt like even when I would sleep (I suffer from pretty bad insomnia frequently) I never felt rested.  I felt like I never got into the deep stages of sleep -- for some reason that was totally unknown to me.  I had pretty much ruled out apnea because to the best of my knowledge I don't snore (I've checked with several people that should know if I did) and I don't seem to have any nasal or breathing issues. 

To my surprise, after a bunch of questions and a quick physical exam the doctor I saw on Monday seemed to think it was quite likely I do in fact have sleep apnea.  He said many people have apnea and don't snore at all.  He said the age at the onset of my symptoms matched as well.  Another thing I learned was that many people that have sleep apnea actually go to their doctor complaining of insomnia.  The thing that really got me though, was how the physical exam went.  He had me stick my tongue out and then gave a quick nod of his head and asked, "Have you ever noticed those ridges on the side of your tongue?"  I gave him a quizzical look and shook my head no.  He told me to check the next time I look in the mirror.  "They are actually quite pronounced," he said.  "You'll see them."  He explained that this was most likely caused by my teeth during the night and many people with apnea had them. 

Next, he had me open my mouth slowly.  He said to open slowly, not stick out my tongue and not make the noise every other doctor tells you to make when they look in your mouth -- "ahhhhhhhhh".  And then he had me do the usual routine (minus the little wooden depressor).  He again nodded his head knowingly.  "You have very constricted anatomy," he said.  He grabbed a laminated paper with some diagrams on it and explained what he was looking at and for.  There were 5 or 6 small pictures of open mouths at the bottom of the page.  In the one at the far left you could see everything at the back of the throat -- the tonsils, the uvula, all very clearly.  As you moved to the right from picture to picture the back of the throat was more and more obstructed by the tongue.  "You are waaaayyy over here," he said pointing to the picture farthest to the right.  "And when you go 'ahhhhhhhhh' you're still probably only about here," pointing to the one a couple to the left.  Apparently this is something else that a lot of people with apnea have.  (Now I keep going to the mirror and looking at my mouth.  Thinking that I must have somehow opened my mouth incorrectly, somehow.  I also keep asking my boyfriend to open his so I can compare and see if mine really is that different.)

I obviously did not get a diagnosis from this very quick exam, but it was more than enough for the doctor to want to do further testing.  I was scheduled to do a full overnight sleep study on August 29th.  I am pretty nervous, as the testing does not sound fun -- at all.  There will be oxygen in my nose, and probes attached all over the place to track muscle movement and brain activity.  There will be sleeping (attempted, anyway) all alone in a strange place.  But, I am anxious to find out if this really is the source of my sleep problems.  If it is, I won't need any medication and the treatment (c-pap machine) is 100% effective.  I should start feeling better immediately.     

So this last doctor visit was completely different for me.  I normally get blank stares and questioning looks.  And doctors telling me they aren't sure what to do or what to check next.  I may not have sleep apnea at all, but it was nice to see someone looking confident and like things made sense.  I didn't feel like a crazy person, and I had hope that I will be feeling better soon. Another thing that was different?  They already scheduled the follow-up appointment for the following week.