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Thursday, 07 February 2013


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On the other upside, at halloween you will already have your costume done. You can go as a prototype Darth Vader. Complete with the breathing sounds.
My youngets brother has worn one for years. When he was tested in the sleep lab, he was recorded with the loudest snoring to date. His wife was going deaf on that side. He sleeps better now.

I went through this a few years ago and have been using a CPAP machine. It is difficult to get used to at first but eventually you will be happy to use it and won't be able to get a decent night's sleep without it. Best wishes to you.

Mike, I was diagnosed with OSA in my mid- thirties. An overnight sleep study showed that I was, apparently, waking up out of deep sleep due to blocked breathing over 200 times a night. I got fitted out with a CPAP machine and all is well. Every three years or so, I've gone for a follow-up study so that they can adjust the air pressure or try different masks. I'm on my second CPAP machine; the first one I got in the mid-90s was kinda loud, but the newer ones are quieter and issue a kind of white noise that masks sounds that might otherwise wake me up (I've always been a light sleeper, easily roused by things that go bump in the night). My significant other is so used to the sound that she doesn't sleep well when I'm out of town - it's harder to fall asleep when she's constantly woken up by little noises normally hidden by the CPAP.

Your technician probably told you that the beard might pose a problem. Guys with beards have to use a nose appliance, but depending on the pressure and whether your mouth falls open when you sleep, you might have to go with a full mouth-and-nose mask, and those don't work with beards - at least not your style of full beard; it might work with the "Abraham Lincoln". But what's a few facial hairs compared to a good night's sleep?

Anyway, best of luck. Sleep deprivation is a life-sucking misery and can be fatal. Before the diagnosis, I felt like my brain had been stored in a cotton-lined box for five years. I hope this does the trick for you.

Welcome to the Over-the-hill-gang...the next stage is...well you'll see, but don't worry.


I have several friends with sleep apnea and all are now using CPAP devices and all report stellar results. Good luck.
If I may make a slightly OT observation, the neighborhood pharmacy where I buy my monthly load load of cholesterol and blood pressure meds sells CPAP equipment. Some time back I suggested they might sell more if the styrofoam display heads weren't blue.
These pharmacists are the same guys who did the political ad you like so much and a little kidding around is usually part of a visit for restocking the medicine chest.

Mike, I'm going through the same process right now. One of the key challenges has been finding a CPAP mask design that works well for me. There are a lot of them, and I think I've found one that works (crossing fingers). It might take you more than a month to get to where you are comfortable, but keep it at and you will!

It gets worse as you get older and fatter.
Have a nice day.

Yep. In the days when I took a drink I used to suffer from that, amongst other things. Drove my wife mad waiting to hear me start breathing again

"It's alive! IT'S ALIIIIIIVE!"

CPAP Machine?

Some years ago I too did a nocturnal polysomnography test. Alas, this was in the pre-phone-camera days, so I didn't get a photo. It was negative for OSA. I acquired a CPAP anyway, mainly so my wife wouldn't have to listen to my snoring. I found that it didn't help me sleep better, and gave it up after a year or so. I've lost a bit of weight since, and thus my snoring isn't so bad.

One aspect of the test puzzled me a bit: the tech insisted that I sleep on my back. I don't know how that could be a good test, since I never sleep that way. Midway through the night, she had me don a CPAP and continued to monitor me.

Good luck with the CPAP. I know it can really improve lives, even save them.

Any plans to resign?

Hi Mike,

As soon as I saw your photo, I knew what the rest of your post was about. I was also recently diagnosed with OSA and have been using a CPAP machine now for about 4 months.

The diagnosis and treatment has changed my life for the better. I no longer require a nap during the day, or copious amounts of caffeine to function. I no longer walk around like a zombie. I can think clearly. I can remember things. I have way more energy throughout the day and I am much more productive.

I also wish I had known this 20 years ago, as it would have made school, jobs, and relationships a lot better and more manageable.

It may take you a bit of time to get used to the machine, the mask, and the new bedtime routine. I think that mask fit is key, so make sure to try different types, especially since you cultivate much facial hair :). Also, my kids think I sound like Darth Vader and look like Bane when I use it (which is actually a good thing!)

Note that when travelling with your machine, some airlines will allow you to take it as a free carry-on item. You'll have to check their policy on medical devices.

Good luck with the CPAP and enjoy your new life!

Since this is becoming a health blog, let me just contribute that in my 40s I had lymes disease; in my 50s kidney cancer and a mild stroke; now in my 60s parkinsons. Oh, and I have had vision problems for over 40 years. You learn to deal with it and carry on, but I rarely feel the urge to read about someone else's trouble sleeping.

Can't wait for the posts on heartburn, gas and colonoscopies! Afterall, us old guys have to stick together...

Well I'm 30-something and this week I've got a bad case of housemaid's knee, so it reall is middle-aged-guy week!

I suppose sustained episodes of sleep deprivation may result in an irrational desire to move through the world under the herniating weight of "The Big Dragoon" - 'Course, there may be deeper issues!
Best wishes for a short and successful adjustment period.

Using a CPAP machine helped me get a good night's sleep for the first time in a long while. It also trained me like one of Pavlov's dogs. I found I could take short naps at will because putting on the mask means time to go to sleep-- and I do.

A strange case of turning a disadvantage into an advantage.

Cutting out gluten after lunch and reducing sugar after dinner took care of my sleep apnea according to my girlfriend, who gives me daily reports on how much I snored the night before.

One of our daughters turned out to have OSA, diagnosed around the time she got married. The CPAP made a world of difference for her, husband, and their numerous dogs and cats.

One odd side effect of the OSA, which seems to have started during college, was her waking up in the middle of the night with literal screaming terrors. Also sometimes woke up half the wing of the dorm where she was living at the time. All a thing of the past.

You'll feel much better.

My dad was recently diagnosed with apnea (might be a different variety, so caveat emptor). Sleeping on his back worsened the symptoms. To avoid doing so, he came up with a very simple, low-tech solution: have a velcro pocket stitched to the back of his pyama and put a tennis ball inside.

Might work for you if sleeping on your back is part of the problem : )

Mike just remember "growing old is mandatory, growing up is optional."

My dad got tested for for sleep apnea eight years ago. With his CPAP he sounds like Darth Vadar, but both he and my mother sleep better than they have in years (apparently she was doing the almost wake-up thing too when his breathing would pause). Hopefully it works as well for you.

Wishing you improved health Mike! Love your blog.

Good to know that your problems have been diagnosed to SA. This one, as your doctor says, is easy to manage. Have a great sleep for years to come, anurag

Thanks a lot for the photo, Mike. Now I won't be able to sleep at night!

I've had a CPAP for about 4 years now. I turned my situation into lemonade. I did a series of stock photos of myself posing as a sleeping man with the mask on and they have sold very well. The only problem is that on about four occasions now, I have been contacted by people who found me through my stock agency and were convinced the photos of the bearded overweight sleeping man in the mask were unauthorized photos of them taken in the sleep lab. Apparently apnea is an epidemic among balding bearded heavyset men!

As others have said above, a CPAP can make a real difference. I've been using one for over three years now and can attest to that. FWIW, I also have a beard, so I use a "nasal pillow".

There were several other options offered to me, but I went with the "nasal pillow" (a couple of soft tubes that insert into my nostrils) because that was what they used when they tested me - and it seemed to work well and be surprisingly comfortable. My only gripe with it so far is that it is easy to knock the "pillow" out of the mask when donning the mask in the dark and I have to turn on a light and snap the "pillow" back into the mask. (I know - I really ought to rearrange the room so the light is close to the head of the bed and the issue doesn't come up.) :-)

One suggestion - your CPAP will probably come with an optional-use humidifier. I found that it took some tuning before I had it where it did not provide liquid water to the mask due to condensate build-up in the tube that then carried through in spurts. Persevere with the humidifier, it is worth it. My nose and mouth feel much better in the morning than when I have not used the humidifier.

With best wishes,
- Tom -

I concur that CPAP is great. I've been using it for 15 years and it changed (and probably saved) my life.

To get things back on topic - what equipment was used for the photo of the cyborg above?

What was the ISO?
What was the f-stop?
What was the shutter speed?
What did you do to the image in post-processing?

You left all of this vital info out of your posting. :-)

With best wishes - and a lump in my cheek,
- Tom -

Growing old isn't what it's cracked up to be. Now I use a BiPAP (different pressures for inhalation and exhalation) machine for sleep apnea. Sleeping well is good.

I've been on a CPAP for almost five years now. I can't even imagine not using it. I love it. 21 days. That's how long it takes to establish a habit. Force yourself to use it for 21 days straight, and you will be hooked. It will be hard at first. Just do it.


My dad had a similar thing done several years ago. Now he uses a BPAP nightly. He even has it rigged for DC power while camping. I'll tell you what, I'd rather he sleep like a log than saw them in the next tent all night. The noise of the machine is nothing compared how loud he used to be.

I bet you would have had a better sleep if Michelle had cuddled up with you ;)

Been there, done that about two years ago.

Wired for Sleep

I had to laugh, as soon as I saw that picture of you wired, I 'says' "here comes the CPAP machine"!
I can only repeat some of the other good suggestions from other readers, and that is stick with it, its worth it in more ways then one!

You should also look into the clinical trials of Inspire Medical, which produces an implantable device:

Mike wrote: "... All we need is a lightning bolt and we should be in business."

A little childish fun was had...

I've been using a CPAP since 2007. I had severe sleep apnea, but it didn't really bother me all that much and I felt pretty much okay. However, now my wife sleeps much better.

Welcome in the club! I love my CPAP and my wife loves it even more. She can relax and does not fear that I´m dying every night. If you think it´s not sexy, you don´t know what a relaxed wife can do.

Mike - one thing that seems to have worked for me is a mouthguard-like device that I got from my dentist. It was about $300 and really works. The idea is to keep your jaw slightly jutted forward, which can keep your airway open.

If that hadn't worked, I would've gone the CPAP route. It may be worth a try for you.

best regards,

Hey Mike,
been using a CPAP for a little more than a decade, It does take some getting use to but it does make a difference in your day, I still only sleep 4 hours a night but I don't have to nap like I did. I also had a UPP before I went to the Cpap, it works much better than the surgery did. I recommend the nasal "Pillows" over the face mask if you can get away with it. I just replaced my OLD Cpap with a new model it is dramatically better. Good luck and give it some time to get use to it.

Hi mike - a (happy) CPAP user (7 years) myself - feel free to ask me anything you need.

Glad you caught it.

And your Doctor is right.

Those symptoms can be explained by a wide range of conditions, and some of them are very ugly.

Medicine is not about knowing things. For example, exactly why this happens to you may not ever be precisely known.

Medicine is about doing things. Knowing you have this condition, there is something the Doctor can do to improve the situation. So, he is happy.

So dwell on this. He was hoping you would have a condition he could do something about, versus a condition he could not help you with.....

I'm 50 and I still sleep like a log most nights. I've been told I snore, but this is not an every night kind of thing.....and at least one person (besides me) insists that I do not ever stop breathing....I'm just sometimes noisy....

Count yourself lucky. It is treatable, easily and cheaply, and the treatment is usually very effective.

Live long and prosper..... :)


Glad to hear so many of you are doing well with CPAP. I'll confess to having avoided dealing with my sleep issues because I dread the thought of depending on yet another device or drug. But a good night's sleep does sound wonderful. Mike, I hope you'll be sleeping better soon. Your writing has been a great help on many a restless night.

My wife says it's like sleeping with Darth Vader for her, but at least she doesn't stay up all night waking me up to breathe. Seriously though, I can't sleep without it anymore!

My own doctor has suggested I take a sleep study (again) and she suspects the same results shall be observed. One of the problems is I tend to be very violent when attempting sleep. Not just moving legs, bed clothes, sheets and pillows all end up somewhere other than the bed.
During one of the tests (as recently as two years ago) it was also noted my brain activity never slowed one bit while sleep was being attempted.
The observers were at a loss as to describe why my increased brain activity as opposed to waking/daytime acitivity. I also wore a similar monitor for 72 hours during the course of some days and the results were similar, if not moreso.
My brain kept electrical impulses in many more directions than the actual thought process and activity illustrated. No wonder my head aches and my sleep pattern/general activity pattern can be just a wee bit odd.

Yes, I do have sleep apenea however with my other medical issues including Lupus, Cancer, and a continuing battle with the after effects of Celulitus
was decided I'd best not try a CPAP machine, and perhaps rely upon mind-calming drugs. Hence my daily dose
of chemicals resembles a chemist's
back room. 12 pills and a puffer in the morning, four mid-day and 17 pills including a very heavy sleep inducer at night. BTW the latter does not always work, sometimes, such as now (February 8/13at 04:00) can be easily awake for hours on end and then doze for ten minutes and start my daily routine as if nothing was differet.

And the periods when I don't sleep at night are followed by periods of intense activity and sometimes too,

Dear Mike, I have been following your blog almost daily for many years and I would much like to be able to continue that routine. Based on that, rather than an intention to be rude, and judging by the photos you have presented of yourself on TOP, it is obvious even from my side of the Atlantic Ocean that one cause that at least contributes to your condition, in addition to being a middle-aged male, is overweight. Weight reduction is cheaper (maybe not easier) than CPAP and a fringe benefit may be reduced spendings on food. Whatever you chose to do, good luck!

Hi Mike,
I think all this points to the fact, that you seriously have to slim down.
The experience is telling me, that in order to get there, you do not need a fad diet - if anything, the advice I would give you, and most people living in industrialized societies, is to eat a varied diet, made as much as possible of unprocessed foods: i.e. avoid supermarkets in favour of buying fresh produce from farmers and the like. Remember to avoid ANY processed, or extracted with help of heat or chemical agents fat (that by and large leaves you with virgin olive and coconut oils, plus butter).
The caveat, is to move more, without destroying your articulations.

In your situation, the obvious solution would consist of a raised desk for your computer, positioned in such a way, that you could place a tapis roulant underneath, and spend an increasingly large portion of your working day simply walking...
And when you will become rich and famous, build a heated pool in the garden...



At least you know what's been wrong with you all this time. I've been on CPAP for 10 years and its made a great difference to me. Persevere with the thing and you will get used it. Your sleep doctor will advise you on makes and models of machine but, if you ever sleep in cold conditions, I would advise you to get one with not only a heated humidifier but a heated tube as well. I didn't and the warm moist air condenses in the tube leading to my mask whenever the temperature drops, leading to a loud gurgling after a few hours and the need to get up and empty it out.

Funnily enough, MarkB, my CPAP mask is branded as the Mirage, presumably after the French fighter jet.

Mike I have used CPAP for nearly 10 years now. I credit that device for keeping me alive this long. It may take some getting used to but keep with it. The results are worth it.

Had a CPAP machine for one week. Impossible--at least for me. I cannot believe people put up with that thing. UVPPP surgery immediately followed, and all has been perfect now for 19 years. I do agree that it is very good news to have this (relatively speaking) benign diagnosis. Best Wishes.


I've always snored, my younger brother snores and my dad's snoring could have woken the neighbors. It didn't take very long into my marriage for my wife to demand I do something about it.

So, I was referred to a sleep study. That diagnosed me with moderate sleep apnea requiring a CPAP-type machine, and led to a second night of sleep study to determine the level of pressure needed; they also tried me with a BiPAP system but it felt like I was suffocating. Your mileage, of course, will vary.

I do find that I sleep much better with it, though it takes some getting used to. One thing which helps me with the machine I have is that you can set it to gradually ramp in the pressure when first switched on.

I rebelled against using it for a while, but after getting back to it I do feel much more rested most of the time and wouldn't go without it now.

My brother, just like me, has been ordered by the missus to get his snoring sorted out. He went through a sleep study recently and will probably end up with a CPAP of his own.

CPAP is effective, but at higher pressures you might find BIPAP to be more tolerable.

CPAP: constant positive airway pressure

BIPAP: bilevel positive airway pressure. This mode drops the expiratory pressure so that the user senses less resistance to exhalation

Regarding the weight issue:
I have OSA and when I started using a CPAP, I weighed about 195. I started using a treadmill and cut out all the junk food and snacks, and brought it down to 165. I was able to stop the CPAP for a while, but the symptoms returned and I now (like an earlier post mentioned)use a dental device to hold my lower jaw forward and that seems to work pretty well.
When I WAS using the CPAP machine, I would pull the mask off almost every night in my sleep. When I went in for a second sleep study, my anxiety level was so high I had to call them in to get all those wires and stuff OFF of me. Hopefully the dental device will continue to work, because after 5 years of the CPAP machine, it was STILL claustrophobic.
That is not discourage you Mike...the CPAP DID work, I just couldn't tolerate it.

Well, my 4.5 year-old son just had his *third* sleep study so I wouldn't complain too much.

Good luck to all.

As an aside, I've been using a free iPhone app that monitors my sleep using the gyro in the phone. It's called Sleep Time. You just set the alarm time, put the phone on the mattress and as you toss and turn throughout the night it charts the movement.

I'd be curious to see how you chart before and after CPAP.


Mike, perhaps when the spring arrives, you need to pop the EM-5 over your shoulder and take the Rivendell out for a gentle wander round the neighbourhood to see what the new season has revealed, and feel surprisingly better for it, too. All the very best, we need you in good fettle.

Love the Lightning Bolt treatment by William Schneider and second the recommendation of a heated tube by Allan Jackson. My new one, a ResMed S9, has one and it helps tremendously in an unexpected way:

I live in Montana, and it can get cold at night. With my old device, if I got up in the middle of the night for reasons the CPAP machine wasn't really designed to address, and stayed up long enough for the water in the humidifier to cool down, I'd rather sleep without the CPAP than be kept awake by breathing cold air through it.

With the heated tube, that's no longer an issue, as it only seems to take moments for it to bring the air to a comfortable level.

Whatever you choose to do, I hope it works well for you.


Seeing a picture of the real you for the first time was a shock to my system, not unlike what one experiences upon seeing a picture of an on-air radio personality. You have developed a mental image of the person based on the quality of his or her voice and manner of speaking. And so it is with writers, only in their case, the mental image that develops is based on that person's writing.

I had always envisioned you as a bit of a nerd (and I mean that in a good way)--thin, smallish, black framed glasses, intense eyes--the stereotypical bookish, really smart, introverted kind of guy. And then I see this photograph of you looking like an aging NFL linebacker. So now I have to completely adjust how I envision you when I am reading one of your essays, and it isn't going to be easy, because I had grown so comfortable with my old mental image. Obviously, I will somehow manage.

Which brings up the subject of your weight. I am sure that your doctors have told you of the contribution that being overweight makes to sleep apnea. If you can lose weight, your OSA should improve, even if it does not resolve completely. And you don't have to lose all the extra poundage to derive some benefit. Even modest weight loss can help. Good luck with that and with the more difficult challenge of maintaining the lower weight. It can be done, but only with real vigilance and effort.

I've been on a CPAP for 15 years. I call it my sleep turbocharger. I was a zombie before I got one, in danger of losing my job and my marriage. I was reborn. Do not let them cut the back of your throat until you've given the CPAP 6months or more to get acclimated. I got the UPPP surgery, adn it was a complete failure and really limited my mask choices to full-face only.

Good luck with the CPAP machine! They are uncomfortable and a pain in the neck (literally) - but they do work! The first few times it works properly you can wake up dizzy and feeling like you are drunk - its a side effect of oxygen! You will also become a slave to trapped wind (flatulence or more commonly know as farting! The air that misses your lungs has to go somewhere).

That's the bad news! Once you get it tuned in properly your life will slowly change - its not any miracle cure but little by little you notice things changing...

Good luck!

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