Occam's Razor

We are such stuff
As dreams are made on

The Tempest Act 4, scene 1

Do you look forward to sleeping? The evidence suggests that most Americans do not. There are too many modern world temptations, like your smartphone. In a way, perhaps it is good that modern life is more tempting than sleep. It suggests that life, however harsh it may be at times, is engaging.

Like it or not, sleep (or attempting to sleep) is how we typically spend a quarter to a third of our lives. Arguably, sleep is not productive at all. During sleep we cannot create anything, except possibly in our subconscious, and you don’t get paid to sleep. Perhaps you can learn a foreign language in your sleep. It sounds iffy to me. I suspect like most of us that when I sleep I want to sleep deeply, dream vividly and wake up rested and reinvigorated.

I actually attempt to get eight hours of sleep a night. More typically it is seven, and that includes the time it takes to get to sleep, rising to use the bathroom and trying to tune out my wife’s snores three feet away (earplugs help). I’ve attributed some of my success in life to following this strategy. The only problem was I was fooling myself. It turned out that when I thought I was sleeping, I mostly was not. More specifically, I was not dreaming. I have sleep apnea. It’s a condition where your brain goes so far into hibernation during sleep that it forgets to tell your lungs to continue breathing. This cannot go on too long before other parts of your brain detect the rise in blood pressure and reduced oxygen. It then sends a mini-jolt of adrenaline through your endocrine system that restarts your breathing and wakes you up, or at least kicks you out of an attempt to get REM (rapid eye movement) sleep, the sleep where you actually dream. Waking up so often, even when most of the time I was not aware of it as such, had lots of side effects. I still don’t know all of them. It may have caused my arrhythmia. It has also meant rising to use the bathroom four to six times a night, a tendency to nod off in conference rooms in the afternoon and, perhaps most importantly, little in the way of dreaming. My dreams, when they occurred at all, tended to be short and full of untimely interruptions. I rarely felt rested, even after eight hours of “sleep”. No wonder: sixteen times an hour on average my body was kick-starting me awake.

That was then. Today I sleep with the help of a breathing machine, a common solution (but not a cure) for sleep apnea. It pushes measured amounts of air into my lungs when it detects I am done exhaling. To make it work, I wear a mask over my nose and mouth and then connect the mask via a tube to a machine next to my bed. Sleeping is not necessarily perfect with my BiPAP machine. There is the incessant noise, both the motor and hearing your breathing echoing inside the mask. After a month or so of struggling, I was able to get the mask working so that it does not usually leak air. It helps to clean my face and mask before bed so skin oils won’t interfere with the mask’s adhesion to the face. It also helps to have a flexible, clear plastic nose bridge so my nose does not become pinched by the mask. Just as I am aware of my wife’s snoring, I am also aware of the presence of my mask and the hose while I sleep. It’s hard not to brush against the hose when I turn in bed.

I can attach or detach a humidifier to my unit. I need it in the winter when the humidity is low. I don’t need it in the summer, except for now. Right now I am recovering from having my deviated septum fixed. My surgeon does not want high pressure air surging through my nose all night long, and possibly undoing my sutures. So I cover my nose with gauze and tape and breathe through my mouth instead. My mouth turns into the Sahara Desert anyhow, but less quickly with the humidifier plugged in.

As for dreaming, dreams are coming back, just slowly, almost with some prodding. I thought that once I was using the masks, my dreams would return automatically. Perhaps they have returned and I wasn’t aware of them. Instead, what I discovered is that my fragmentary dreams slowly became longer. Now nearly six months into treatment I often get long, languorous, florid, sometimes even glorious dreams. I also get the occasional nightmare. However, nightmares don’t hold the same terror that they used to. I find I can wrestle and talk back to my nightmares. As for my pleasant dreams, I am easily seduced to stay inside of them. Indeed, rising in the morning to plug into the Internet is often quite a letdown. It is so much more fun and nicer to stay in dreamland, if I can.

The effects of years of chronic sleep apnea are hard to measure. I coped as well as my body could while having little idea that I had an underlying condition. It’s not quite the same as torture, as no one was torturing me. However, in a way it is like being forced awake regularly all night. While now I hardly start the day with the energy I had in my youth, my days are definitely brighter now. I rarely feel the need for a middle of the day nap. I have more energy and can concentrate easier. In some ways I feel more connected with my soul. Sleep theory suggests we dream to incorporate experience into long term memory and to file away lessons learned during the day. REM sleep may be fantasy and nothing more than the mind unfettered, but having it again strikes me as fundamentally healthy and natural.

Do you have sleep apnea? Snoring can suggest sleep apnea, but many people snore without having sleep apnea. My experience suggests that if you awake three or more times a night, you have sleep apnea. If you find yourself falling asleep at your chair at work, it could suggest sleep apnea. (It could also be that you need a more stimulating job.) General tiredness and lethargy, particularly after getting what appears to be a good night’s sleep, could mean you have sleep apnea. Being overweight or obese are often associated with sleep apnea. In my case part of the problem is congenital: my throat is narrower that most people’s and my uvula is unnaturally large. Some health care specialists are suggesting that sleep apnea is being over-treated. Perhaps. I still think that if you have some of these symptoms and can afford it (sleep studies are not cheap, but usually are covered by insurance); it is worth the time, hassle and expense. It might save your life, as many cases of people dying during sleep can be attributed to sleep apnea. Perhaps the best reason is, to quote the Bard, perchance to dream. For me, this alone was worth the effort.