Sleep Lab

by Joseph Bardin

Sleep lab and staged readings are two dates I cannot control and they end up falling on the same night.  The reading goes great—strong turnout, good actors, positive responses, plus some useful critiques. I’m pretty high on it all as I drive around this dark office park area looking for the sleep lab place. My GPS is confused, or I am, and I circle the block a couple times before finding the right building.

I still feel dramatic buzzing on a call box, as instructed, looking in the window of an empty office lobby in shadows, as if on some clandestine mission. A technician in scrubs appears and leads me through an unmarked door to the sleep lab, passing a heavy-set guy in a sleep gown covered in wires flowing down from his head and face over his substantial belly walking to the bathroom. He looks like a high-tech Lord of the Rings dwarf with hair and beard replaced by wires.

The creepy simulated bedroom is like a stage set with a king bed, bedside lamps, and a TV mounted on the wall opposite, and a camera in one corner of the ceiling trained on me, and I suddenly feel as if I’m staying in one of those Moscow hotels the Russians use to trap VIPs. Like the kind that likely rendered Donald Trump an asset of Russian intelligence. Except this camera is in plain view.  

Horror is not my genre, but walking that fluorescent lit hallway to this ersatz bedroom in this office park at night with high tech dwarves going to pee seems like a pretty good setup.

Still, I have to do something. My sleep has become a listing vessel, constantly tilting me overboard into unwanted wakefulness. I toss and turn, not just in the second part of the night, but an hour after turning out the light. I roll left, I roll right, waking up to pee, not once but three times, sometimes four, and in the morning I hardly feel rested, much less ready to write. 

Our most difficult times with Bernie’s breast cancer have come in the night when her emotional defenses are down. Egoless in receiving encouragement, she often slips right back into sleep, leaving me awake, my mind racing with arguments for her life.

And I grew up a bad sleeper, waking in the night as a kid and staring out at streetlights, smelling the cold, dusty glass. The night’s emptiness spoke to something missing in me, and left me scanning its depths for some kind of solace, until I was exhausted enough to give up the search and sleep. Bernie had cured me of that nocturnal searching, and remedies like melatonin, gava, and theanine had helped me receive sleep’s arrival with less resistance.

But now sleep struggle is back like a malicious companion showed up uninvited out of the past.  The internet readily serves up convincing evidence of whatever illness you suspect is creeping up on you, and sure enough, I have all the symptoms of sleep apnea. I also discovered that bruxism, which is teeth grinding, can be caused by sleep apnea. Well, I’ve been grinding my teeth and sleeping with a night guard in my mouth for years.

Apparently, no one is sleeping because I had to schedule an appointment with a sleep doctor three months out. When I finally spoke with him he prescribed a sleep lab. I thought he could just give me some gear to plug in at home in my own bed, but he said it wouldn’t be definitive, so here I am two months after that appointment, which was the next available opening. They say sleep apnea is a serious medical condition but make me wait months to find out if I have it.

The tech in scrubs is friendly enough as he wires me up. Electrodes are stuck to my scalp in several places and attached to wires that drape down my chest and back. I’m shaggy with wires, and the play reading is still thrumming through me, and I’ve forgotten my book. I read before sleep, I always read before going to sleep.

I try watching TV instead, but it’s not the same, and the commercials feel more than usually moronic, so I just turn it off and try to sleep, but a bright band of light blazes in under the door from the horror film hallway, and I’m bound up in wires. There is nothing restful about sleep lab.

I don’t feel like I’ve slept at all when the tech walks in a few hours later with a CPAP machine—a motor about the size of a shoe box, with an air hose and nose attachment. Chipper earlier, we’re both grumpy now. I protest that I’ve hardly slept, and he chuckles dismissively, saying they got plenty of data on me. I complain about the wires and the light and that I don’t have my book to help me fall asleep, but the problem is, when the CPAP starts pumping air into me, I immediately relax and fall into a much more satisfying sleep; if the cure for the condition cures you, you probably have the condition.

Apnea literally means a pause in breathing. Sleep apnea increases risk of heart disease, stroke, and diabetes, and all the bad things that come with not enough sleep, which is probably every ailment in existence. Good sleep may be the single best thing you can do for your health and longevity, and I’m not getting it.

Obstructive sleep apnea is the more common variety, which happens when the muscles in the throat relax too much, narrowing the airway until breathing is momentarily cut off; your brain wakes you up to start breathing again. Central sleep apnea, the other kind, happens when the brain fails to signal the body to breath. This can be caused by heart failure and stroke, neurological disorders and opioids and other drugs.

But I don’t do those drugs or have those conditions. I’m not overweight and I and don’t even drink much alcohol, so why the do I have sleep apnea?

I realize this is what Bernie must feel about breast cancer a thousand times over. Why the hell do I have this?  There is no definitive answer for either of us, just our own speculations. In my case, I read sleep apnea can affect people with big necks, and my neck is sort of big.

I don’t want to sleep attached to a CPAP machine every night forever, but some of the alternatives sound much worse, like a tracheostomy, which is surgically creating a wider opening in the throat to allow for breathing. I learn my former dentist, now retired, makes oral appliances for sleep apnea. I imagine some elaborate metallic gadgetry, like the old orthodontic headgear, to hold my airways open—don’t ask me how—but it sounds better than a CPAP or surgery.

The retired dentist, a talker, used to go on and on about adventurous fishing trips he’d taken and his enthusiasm for his Christian afterlife. Now he tells me how his best friend died of a sleep apnea event, and he wants to help make sure that doesn’t happen to others. How his will to save others from death jives with his blissful belief in meeting Jesus in heaven after death is a narrative I don’t have time to invite upon myself, so I try to keep it about the oral appliance.

But in reviewing the report from the sleep lab, he questions the data on some statistical grounds I don’t follow, and wants me to get a sleep evaluation from a different doc.

Another sleep lab?

The recommended sleep doctor is busy too, and schedules me for seven weeks out, and I feel myself starting to waver. I’m trying to do the responsible thing by getting myself diagnosed and treated for an apparent sleep disorder, but I may be losing interest.

I come from a long line of ailment ignorers and was raised on the assumption that discounting the problem is often the best way to make it go away, at least from your awareness. I’m trying to evolve to a more proactive posture—I have ambitious longevity goals my family doesn’t hold—but being reactive is looking better and better now.

Meanwhile, Bernie begins using this ultrasound at night that’s supposed to support her overall wellness and maybe it’s helping me sleep better too. I mean I’m asleep, so I’m not sure, but I don’t think I’m tossing and turning as much. This is how ailment ignoring works—you start to downplay the condition, not all at once, but incrementally, step by step, so that it can dwindle in your consciousness over time, as you either get used to it, and the discomfort feels less acute, or in fact, it goes away.  

But I’m not entirely committed to complacency either. I start this thing called myofunctional therapy, which works on your face, mouth and tongue, that is supposed to help with sleep apnea by keeping your airways clear. I meet with the myo therapist online, and she gives me truly strange exercises to do with my tongue and mouth, difficult to coordinate but easy to practice, if you don’t mind looking idiotic to yourself in the mirror.

I’m supposed to do like two reps of each exercise, but that hardly seems enough to me, so I repeat them over and over throughout the day, until my jaw starts popping, and I can’t bite down on food without feeling like I’m cracking something essential inside my mouth. So I have another condition to downplay or ignore, which in a weird way confirms my inclination to downplay or ignore the alleged sleep apnea, because if I engaged fully with that problem, and this jaw thing now, whatever it is, that would be a lot.

Sure enough the myo therapist helps me correct the clicking, and almost another month into not doing another sleep lab, I seem to be sleeping better. The good news is that they scheduled me so far out I’ve got plenty of time to keep downplaying what I may or may not have. But unlike my ailment ignoring forebearers, I’m living in the era of data, so I stop researching sleep apnea and start researching biometric devices to tell me how well I am sleeping.

The Apple Watch is supposedly really good, but I have enough Apple in my life, and really don’t want to get emails on my arm. So I buy this device called a Whoop. You wear it on your wrist and it collects biometric data. It knows if you’re awake or asleep, and calculates how much REM sleep you get, and deep sleep and light sleep, and your respiratory rate, blood oxygen levels, heart rate, etc.

You can’t fake sleep and you can’t force it. Begging for it like Macbeth after murdering Duncan won’t do any good either. The sleep drugs apparently add very little actual sleep per night and leave people drowsy in the morning. Michael Jackson died trying to manipulate himself to sleep with stronger stuff, a drug used for anesthesia procured from a crooked doctor,— so you can’t buy sleep either.

Truth is you don’t conquer sleep, sleep conquers you and you let it. Sleep is surrender, but consciousness won’t let go, or can’t, without the nervous system’s say so. The brain may be the interpreter of life, but however much it might seek to rationalize and reign it in, the nervous system mediates life itself washing over and through us. I suppose that’s the real sleep lab every single night. 

I start tracking my sleep. I don’t always get a perfect night’s sleep, but it hardly amounts to a sleep disorder—more like sometimes disordered sleep. But most nights my sleep stats are good. Good numbers of hours asleep. Good amount of REM and deep sleep. Good oxygen levels.

My reactive self feels more justified than ever. What should you do to address what looks like sleep apnea? Nothing, as always, may be your best bet. I realize this is not very responsible advice to share with others, but the data speaks for itself.

BIO

Joe Bardin is an essayist and playwright based in Arizona by way of Trenton, NJ, Washington DC, and Tel Aviv. He is the author of the essay collection Outlier Heart, (IFERS Press). His essays have appeared in numerous publications including Interim, Louisville Review, Superstition Review, Vol. 1 Brooklyn, and Rock & Sling, and been anthologized in the Transhumanism Handbook (Springer). His plays have been performed both domestically and abroad. A scholarship alumni of the Valley Community of Writers, he is a member of the Dramatists Guild. (http://www.josephbardin.com) / (www.josephbardin.com). @joebardin.