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Hernando Today

Getting Wired

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By TONY HOLT Hernando Today

The Tampa Tribune

Published: October 13, 2008

BROOKSVILLE - Nearly two dozen wires were glued to my scalp, face, chin, shoulder blades and legs.

All of them connected to a small box that hung from my neck.

Had there been any flashing red lights or beeping noises, or had I seen Dennis Hopper hanging around somewhere near my hospital suite, I would have thought a bomb was strapped to me.

Instead, I was less than an hour from beginning an all-night sleep study at the newly opened clinic at Brooksville Regional Hospital.

Mason Hulis is a sleep study technician. Before getting wired up, he spent nearly an hour explaining to me some of the thousands of medical terms he must know to do his job.

"This test looks for sleep apnea," he said as he pointed to his computer monitor.

Given the number of wires strapped to me, it's impossible to imagine how the test could miss something like that.

We both stared at his computer monitor, which contained a stream of everlasting red, blue and green lines. Wherever there was a stoppage in breathing or a jerking limb, there would be a spike - much like a polygraph, only more technologically advanced.

Hulis was as polite as my mother always wanted me to be. Nothing he said had an ominous tone, but every time I heard him say "sleep apnea," my throat swelled.

I was about to go to sleep for six hours and wake up only to find out my worst anxieties had become realities - a) I snore like a moose and b) I'm not as healthy as I thought.

My feelings were confused on this night, but when someone at the hospital asked me a week earlier whether I would write a story about the new clinic, my "yes" response was automatic.

It changes your life

Four years ago a bartender I knew told me he was about to take part in a sleep study of his own.

"When you get this thing done, you lose weight, you're not tired during the day anymore and you feel a lot better," I remember him telling me.

"It changes your life," he said.

A few years later, I met a friend who had a sleep study done on her.

After being diagnosed with sleep apnea, my friend was prescribed a continuous positive airway pressure (CPAP) machine.

It is a device that includes a box, hose and mask that wraps around your nose and face. When you wear it to bed, it feels like you're sleeping in a room that you know will inevitably have a radiation leak. From the neck up, it feels like you're wearing a Hazmat suit.

It requires you to breathe through your nose and the air flow can be adjusted to Category 1 hurricane level.

That's only a slight exaggeration.

"I never wear that thing," was her answer to me when I asked her about the CPAP. She preferred to snore rather than look silly while sleeping.

Getting wired

I had no idea how difficult it would be falling asleep at Brooksville Regional.

It had absolutely nothing to do with the facility itself. In fact, those who designed the rooms inside the clinic did their best to make it feel like spending a night at the Marriott.

The room I used included a queen-sized bed, armoire and a flat-screen television. The bathroom reminded you of a hospital, but at least it was private.

I sat in a chair while Hulis did his work.

"So what are you going to shave me, now?" I asked him as he rubbed a course pad over my right calf muscle.

"Fortunately, no," he quipped.

He then started rubbing alcohol along my left temple.

"So what are you doing?" I asked him.

He paused before answering.

"I'm removing the dead skin," he said.

"So it's sort of like a spa treatment?"

"Yeah."

It was more like getting prepped for a torture chamber. "A Clockwork Orange" came to mind more than once during the process.

Hulis, to his immense credit, did his best to keep it light-hearted.

Then he began rubbing alcohol along my upper back and I wondered why.

"It's less hair back there," he told me.

"There's no hair back there, thank you," I thought to myself.

The following morning, when he ripped the pads off my hairy legs, I appreciated his decision to apply the heart monitor to my back rather than chest. He spared me even greater pain.

I warned him I was a night owl. He was fine letting me sit up and watch "SportsCenter" and "Late Night with Conan O'Brien" well beyond 1 a.m. He didn't begin putting wires on me until almost midnight.

Sleeping in discomfort

When you tell the sleep technician you're tired and ready to go to sleep, he must test each and every one of the 23 wires to make sure it's working.

He spends the night seated at a computer monitoring everything from the number of apnea-caused awakenings to limb movements. He also checks the important stats - namely brain waves and heart rate.

To make sure he is getting his readings in the other room, he talks to you through a microphone and asks you to do a series of muscle and breathing exercises.

Breathe deeply through your nose. Then do it through your mouth. Pretend you're snoring. Pretend you're yawning. Move each foot like you're pressing down on the gas pedal. Flex your stomach muscles. And so on and so on.

After all of that - and once you get beyond the eerie feeling of being watched through an infrared camera - you are free to fall asleep.

You can roll over if need be, just be careful. You don't want to roll over the box of wires, nor do you want to pull something loose.

I don't know how long it took before I dozed off, but it must have taken longer than an hour.

"You've got something to read in there, right?" I asked Hulis.

"No," he said.

"You just sit in there and wait for me (to fall asleep?)"

"It's OK, I have some work to do."

Morning comes

"If a doctor saw this, he would no doubt write you a prescription for a CPAP titrations study," Hulis told me the next morning - after a hearty breakfast and shower.

I didn't sleep all that well. Not only that, but the paste he used in my hair to glue the wires to my scalp didn't completely come out until three showers later.

Nonetheless, the benefits make it impossible to bemoan the process too much.

If Hulis' prediction is correct (it always is), I will have the opportunity to return for a CPAP study - which is designed to help the technician set the device's air flow to the right setting.

Not only that, but my "moderate to severe" sleep apnea will be treated. Any chance of it causing long-term health problems (heart disease, stroke, etc.) will be sharply reduced, if not eliminated.

There are bona fide complaints about the CPAP, mainly with how it looks. The friend who told me she didn't wear it seemed especially concerned with that. When you're sharing a bed, your partner is going to be more perturbed with the snoring that the bulky mask.

Forget breathing strips or over-the-counter sprays, Hulis said. They don't work.

An operation to remove the palatine uvula - the flap of skin that hangs down in the rear of the throat - could solve the snoring problem, but it's only a 50 percent chance. There's also the painful healing process to consider.

The CPAP is simply the best cure for sleep apnea, he assured me. I did my research. He was right.

My final results were shown to me before I left, but a physician will review it and make the appropriate recommendation in the coming weeks. I can expect to visit Hulis again for the CPAP study.

I don't care whether I look like I'm walking into a radiation chamber while wearing the mask. I want it "to change my life."

No more grogginess. No more hypertension.

If you think you have sleep apnea, make an appointment. If you live in Hernando County, pick up the phone and call Brooksville Regional Hospital.

Maybe you'll sleep better than me. Even if you don't, you will almost certainly spend the rest of your life sleeping better after one diagnostic test.

"This is not at the top of people's list of things to do," Hulis admitted.

Everyone has come through his clinic, from overweight, middle-aged men to children. The moods also vary - from cranky to enthusiastic.

"It really runs the gamut," Hulis said. "A lot of people are here by the order of their doctors, so they're not all that happy. Some come in and they're so sleep-deprived for so long, they're just relieved to find some resolution."

For me, relief set in the moment the wires came off.
Sleep apnea facts:

What is sleep apnea? Sleep apnea is a sleeping disorder that causes stoppage in breathing during sleep.

Do all snorers have sleep apnea? No. It's not 100 percent you would have sleep apnea if you snore. However, everyone who snores has the potential of sleep apnea.

What are the effects of sleep apnea? Grogginess, hypertension, high-blood pressure, headaches, heart disease and strokes are some of the symptoms.

What can you do if you have sleep apnea? Call your doctor and request a sleep study. If the tests confirm you have sleep apnea, a physician will prescribe a CPAP study. Most insurance companies, as well as Medicare, cover both studies as well as the purchase of the machine. Both studies can be done during the same night.

How do I learn more? Visit the American Sleep Apnea Association (ASAA) Web site at www.sleepapnea.net, the American Academy of Sleep Medicine (AASM) Web site at www.aasmnet.org, or call Brooksville Regional Hospital at 352-796-5111.

Reporter Tony Holt can be reached at 352-544-5283 or wholt@hernandotoday.com.

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