Apnea

The Fall of the Rebel Angels, 1562
(Oil on panel, 117 x 162 cm)
BY Pieter Bruegel the Elder
Royal Museums of Fine Arts of Belgium

Most people are far more adventurous in their waking state than in sleep, but I belong to the group of approximately 10% of the population whose behavior in sleep is riskier than in wakefulness. In sleep, I go through phases of drowning, murder, or near murder, and I risk heart attack probably more than someone having a party on cocaine. Actually, I was at a war with bad and loud sleepers until I discovered I was one myself.

Late one night in a graduate student dorm I was hitting my sleeping roommate with a tennis racket. I had been barely awake myself. Every night his explosive snoring kept me awake. He woke up and screamed. He was furious and though I apologized, I was, too.

But then a strange thing happened, he was waking me up by the same method. I have news for you buddy; your snoring has kept me awake for hours.

In the morning we were both miserable and tired and he recommended that we jog, but neither of us could do more than three circles around the Longhorn stadium. I blamed it on his keeping me up, but when he was gone for the weekend, I kept waking up tired. In fact, all my life I had been a poor sleeper, and a terrible grouch in the morning. I simply took that as a temperamental trait, until one night after wine tasting in San Louis Obispo. I woke up unable to draw a breath. My heart beat wildly. Electrical shock waves were coursing through my tingling body. I tried to move and I couldn’t. I saw blue light although I was sure there was no light on in the room.

What the hell is going on? I thought. Am I dying? Heart attack? Stroke? When I managed to inhale, I almost asphyxiated because a gagging reflex was triggered by my stuck throat.

I got up, gasping, and I felt fortunate to be alive.

My heart beat arrhytmically in the morning, and my hosts, freaky Californian health fanatics who ate everything with flax-seed oil, looked at me, and said, My God, you look terrible.

My arrhythmia went on for a couple of days. I attributed that to the chemicals in the red wines but still, it was excessive, so I went to see my doctor, who, because of my family history of heart attacks, immediately ordered isotope and sonogram tests of my heart. To my surprise, my heart tested all right and my arrhythmia went away. My doctor was puzzled, and he wanted me to kick the only habit I could never kick: coffee. In the morning, waking up groggy and grouchy, I can clear my head, or at least attempt to, with coffee best of all. A friend of mine worked in a sleep clinic and when I described to her what was going on, she suggested that I undergo a test at the clinic. My head and body were all wired to EKG and other monitoring machines. Naturally, I slept badly. Who could sleep well with sticky tapes pulling hairs all over your body?

The test result was that I stopped breathing up to forty times an hour, and up to a minute at a time: Obstructive sleep apnea, borderline severe. I was asked to answer questions such as whether I felt fresh upon waking up, what my dreams were like, and so on. I told the sleep clinic doctor that I had a dream I was drowning and trying to come up to the surface for some air. He said, that’s the most typical sleep apnea dream. You probably have many nightmares every night.

Doesn’t everybody?

No.

That puzzled me — how could you live without nightmares? What kind of life is that?

He gave me a continuous positive air pressure machine. Now the air was blasted into my throat, through my nose, and if my tongue by any chance collapsed into the air passage, the air pressure would blast through.

So, for the first time in my life, I could breathe in sleep for more than a few minutes without quitting. The air felt cool, liquid, and I had the sensation that I was drinking it. Life would be good from now on. I would be more alert, more intelligent, I would write more, I would be thinner, I wouldn’t need to sleep much.

At first I slept only four hours a night that way, and felt fresher than after sleeping nine hours left alone to my devices. But, putting the mask cup over my nose, strapping it across my face to the back of my head, was uncomfortable, especially when I traveled. I needed an extra laptop suitcase for the machine, and at every border crossing, the police would puzzle over what this was. In the morning, I would have lines cutting across my face where the strap had been, and my forehead skin would be scrunched up.

Now, I have found out that nearly everybody has his medical hazards and that these are a great cause for fraternizing.

Another problem was that with the sound the machine made, I scared my little children, son and daughter, who were about seven and three. With the tube hooked up to my face over a mask, I looked like a space alien. My wife didn’t like the look and the sound of it either, and they liked it even less when I occasionally got drunk and slept without the machine, snoring and snorting like a monster, even worse than previous to using my machine, and so I was kicked out of the house to sleep on my own in my studio.

Now, I have found out that nearly everybody has his medical hazards and that these are a great cause for fraternizing. I have made friends with a writer, Bob, through discovering that he had sleep apnea, too. We were having breakfast in St. Petersburg, Russia, and I saw lines running across his cheeks. He looked like a football player, with a big rib cage, a frequent adaptive technique the body comes up with to fight with oxygen insufficiency — the body builds you extra large lungs. So, seeing the lines, I said, You have apnea, don’t you? Soon we were exchanging anecdotes about sleep and sleeplessness. He occasionally stopped breathing for two minutes at a time, and he couldn’t be without the machine.

For me, the effect of using the machine wore off. I didn’t like all that strapping. I thought I would learn how to sleep on my belly if necessary, but no monstrous machines for me. After two years of using it, I quit. Apparently, that’s the most usual course of using the machine.

You could also have a dental device placed into your mouth, to make your lower jaw protrude forward, which would create more space in your throat. I tried that — it was so tight that it felt like it was crunching my teeth. Actually, it did crack one of my teeth and its bed in the maxillary bone which had to be rebuilt after a surgery. Although I was already an American citizen, I didn’t sue the dentist. I realize that’s not very patriotic of me. For revenge, I simply imagine that the dentist has accumulated enough bad karma.

Hell, from the triptych
The Garden of Earthly Delights, c. 1504
(Oil on wood, right panel, 220 x 97 cm)
BY Hieronymus Bosch
Museo Nacional del Prado, Madrid

I suppose the oral device could be done better. And you could go the surgery route. Either have your nose knocked into shape or part of your throat cut out. I visited a surgeon, and he claimed that surgery wouldn’t do much good. My tongue was too thick and loose — I was a very reticent child, who knows, maybe I failed to develop the muscle — and it worked as a plug. If I had laser surgery to make it thinner, I would bleed quite a bit, and then, the tongue tissue would regenerate itself within two years, and I’d be back at square one. It was not worth it according to him. My nose didn’t deviate enough to be considered a cause but merely a contributing factor. Weight? He claimed it was pretty normal. Should I become as thin as a yogi? He didn’t think that would eliminate the cause of the apnea. My tongue would be the last to get thin, and the same mechanics would be taking place. My niece, a nose and throat specialist in Croatia, thought that he wasn’t right — that if I became extra thin, I would be all right.

For the time being, I like my nightmares. I think I wrote better a couple of years ago when I wasn’t using the machine and had lots of nightmares. The thing about apnea is that it keeps you dangling in that zone between wakefulness and sleep, where you dream. Sure, you go without the deep sleep and you might go insane from that, but at the same time, your mind is constantly blasted with nightmares, which may be a good pattern for the day and imagination. I wouldn’t be surprised if apnea turned out to be a particularly artistic disease. Balzac, by all the symptoms — big chest, severe coffee addiction, peculiar sleep hours, great appetite, heart attack — must have had sleep apnea, and probably, so did Beethoven and Brahms. I’m not sure at the moment whether my own medical hazard, apnea, is so much part of me that I need it, or whether I should try once again to eliminate it.

I’m writing this at 1:45 a.m., so this is a sort of dream I have, that apnea is good for me. Even the dream I had before waking up, a thousand rattlesnakes advancing upon me, was probably the consequence of the rattle my throat made, but it was so vivid that I don’t need to see a movie.

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