I am a Heretic!

You read the post title. I am not a believer in, nor a practitioner of…The One True Way!

That’s right. I refuse to use a CPAP. I “supposedly” have sleep apnea. I was tested back in the early 1990s at a local hospital. They declared I had sleep apnea. It was the first time I’d heard of the condition.

I’d gone to my family doc for something. During the session, he asked how I slept.  At that time, I was in a high stress job, worked long hours and, yes, I didn’t sleep well. I’d go to bed at 10pm and still be awake at midnight. When I did sleep, I’d wake frequently. I also had a lot of back pain. When the Doc asked if how I slept, I naturally said not well.

I do admit that on occasion, not frequent at all, I’d wake coughing and once gasping. When the hospital tech said I had obstructive sleep apnea and described the cause, I accepted it.

Then he tried to sell me a CPAP…a very expensive CPAP. I said I’d talk it over with my doc.  He, too, tried to sell me on the idea of a CPAP. In fact I tried one out.

It was pure torture.

For me, it didn’t work. I could not sleep with that infernal device strapped to my face.

I’m an engineer. Engineers have a peculiar mindset. When confronted with a problem, they tend devise solutions. I found one that works for me.

Sleep apnea, according to wiki, is…a condition when breathing is interrupted by a physical block to airflow despite respiratory effort, and snoring is common.

The CPAP is supposed to force air through the nasal passages forcing the palate aside and allowing air to reach the lungs. I’m sure there are more technical definitions but basically that is what is done. It’s one engineering solution to a physical condition. And, it works. It works for tens of thousands of people, maybe more.

It doesn’t work for me.

When I examined the problem with my engineer’s eye, I found an alternative. The blockage of air by the collapse of the palate in the back of the throat is caused by gravity. If there was no gravity the palate wouldn’t collapse.

For me, that condition occurred only when I slept, tried to sleep, flat on my back. Given the conditions necessary to cause sleep apnea, what could I do to change those conditions?

1. Don’t sleep flat on my back. Sleep on one side or the other.

2. Change the angle of the pull of gravity, Elevate my upper body. That would change the direction of the pull of gravity. I don’t have any blockage when I’m vertical, standing that is. What angle is required that does not block my breathing when my palate relaxes? For me that was 15°. A surgical wedge available at medical supply stores would, when slept  upon, raise my upper body and fulfill that requirement.

Alternately, sleep in a recliner…one that raises the upper body, not one that lays flat when extended. That would defeat the purpose of preventing blockages.

3. All of the above.

My engineered solution works—for me. I do not endorse it for anyone else. It is a customized solution only for me.

You would think my doc and others would appreciate my design. It’s cheap, not like a CPAP. It doesn’t require frequent cleaning nor filters as do some CPAPs. It doesn’t require battery nor a electrical power outlet. It works. Most of all, it doesn’t require a CPAP.

Instead of having my solution accepted I have been called by some CPAP proponents ignorant, stupid for defying orders to use a CPAP, a murderer for proposing there was a solution that didn’t require a CPAP, and then the responses got personal.

My doc was more polite. He just didn’t believe my solution worked. He still asks if I want to be retested.

It seems that I endangered some rice bowls. There is an entire industry in manufacturing CPAPs, selling and marketing CPAPs and sleep testing. They have their lobbyists and supporters. They have sold the medical community on the CPAP as the ONLY solution to sleep apnea. Naysayers beware!

It didn’t occur to me until later that the organizations that conducted the sleep testing were also the same ones selling CPAPs. Most people would see that as a conflict of interest.

I have, over the years, asked people if they had ever had sleep testing. Many, many have. Not one ever passed the test. Most use CPAPs. Those who don’t are being constantly badgered to buy and use CPAPs. I’ve yet to encounter anyone who has been tested and didn’t have sleep apnea!

I was first tested over twenty years ago. I bowed to my doc’s insistence a number of years ago and was tested again. I knew more about the condition when I was tested the second time.

I arrived, was conducted to the test room and hooked up with all the expected sensors and told to lay flat on the bed. There wasn’t a pillow. I have bone spurs in my neck. I need some head support.

I asked for a pillow. One, a small flat pillow, barely a cushion, was provided. I asked for another because the single pillow didn’t provide enough support. At first the technician refused saying there wasn’t any more. At my insistence he found another.

Then he left.

I wasn’t sleepy. I’d had a full day working a problem for my employer. Like many, I continued to work the problem in my head. It’s one reason why I have difficulty sleeping.

I glanced at my watch from time to time. Thirty minutes passed. An hour. The tech looked in at one time. My back began to hurt. I couldn’t get comfortable. I tried to shift my position to relieve the pain. I rolled on one side. The tech rushed in. He said I had to lay flat for the test. My suspicions rose. The pain continued, growing. I still couldn’t get comfortable.

By now, over two hours had passed. I still hadn’t slept. The tech was supposed to be video taping the session. He came into the room every fifteen minutes or so. I made a game of waving at him whenever he entered.

At the three hour mark, the tech entered again and said the reading proved I had sleep apnea and that I’d stopped breathing, one time for over a minute.

What! How could that happen when I’d never been asleep?

He proceeded then to fix me up with a CPAP. They had a new model, he said. This one covered both my nose, like the old style CPAPs and my mouth. He tightened the straps—TIGHT!. The CPAP sealed my mouth and nose. I could get no air. That was the purpose of the design. Then the tech turned on the regulator and left.

My lungs blew up like two balloons! The tech must have put the regulator on high. The pressure was so great I had extreme difficulty exhaling. It was work to exhale every breath. At the slightest relaxation my lungs expanded again under the pressure of the CPAP.

I fought trying to breath for several minutes and was getting desperate. I was finally able to get the CPAP off. The tech was enraged. I’d ended his experiment. Now he would have to start it all over. He refused to listen to me.

I had had enough. I gathered my clothes put on my shirt and pants and walked out the door. When I looked in the mirror the next morning I had bruises around by nose, mouth and chin. I had large blue patches under both eyes like I’d had both blackened.

I called the testing company and spoke with the manager. He offered to test me again using another tech. I’d have to take a day off work to do so. I refused. I never went back. I wrote a letter to the testing company, copying my doc, and described by ordeal. I stated that I would not pay for the testing. They had run my credit card when I had arrived because my insurance wouldn’t pay. I was never billed.

I now have a note in my medical records. “Subject diagnosed with sleep apnea and has refused to use a CPAP.”

Every time I see my doc, he asks how I sleep. Much better now that I have a solution. I still wake frequently and like many my age, I have difficulty getting to sleep. Those conditions aside, I sleep reasonably well. The doc also asks if I wake with headaches? No. Do I wake gasping or dreaming of suffocating? No to both.

Will I use a CPAP? No. I don’t need one. I don’t have high-blood pressure, another symptom of sleep apnea. It was 121/72 at my last visit. I have no symptoms nor, according to my wife, do I snore when I sleep. I don’t gasp, nor stop breathing. She’s listened as instructed by my doc.

But that one statement is still in my medical records. My wife and I applied for some extended care health insurance recently. The insurance company had a nurse visit us. She weighed us. Had us fill out a medical questionnaire. Checked our blood pressure noting that mine was very good and gave us several tests to check our mental acuity. We both passed those tests with ease.

We received a note from the insurance company last week. My wife was accepted. I was not. Why? I was overweight and refused to use a CPAP. They would reconsider if I lost some weight and would use a CPAP.

I’m still a Heretic and the Powers that Be have not forgotten. I won’t bend nor bow to The One True Way.

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