I’m a male in his 40s who is about a month out from realizing I suffered from obstructive sleep apnea and doing something about it. Thought I’d share my story in case it might resonate with others who haven’t taken the plunge yet or wonder how far-reaching lack of good sleep can affect your life and just how badly it can screw up your mental health.
I’ve had people tell me that I snore for a good 10-15 years and I’ve always been slightly overweight (maybe 20-25 BMI). In the last year or so I’ve crept up closer to 30 BMI, which isn’t a good accomplishment.
In July/August of 2020 I started having problems sleeping due to significant stresses in my life (or so I thought) and was treating that with Trazodone (an old prescription from years ago that I’d held onto).
At first the insomnia seemed to be caused by anxiety at night that without the trazodone would eventually get me to get out of bed to find comfort and pace around, go for a walk, or do some other distracting task until I finally gave in and took the trazodone. I don’t normally experience a lot of anxiety in my life, but I was still convinced this was caused by life stressors.
I kept at it, taking more trazodone and getting my dose bumped up, and was able to get 5-6 hours of sleep a night, but as time went on the sleep would get more and more broken with me having to get up to pee every hour. It wasn’t so much that I had to pee, as I had a compulsion to get out of bed and once I did I noticed that I could pee before laying back down.
Over time the anxiety expanded from just at night to affecting me during the day. I’d find myself extremely anxious in the morning (just as the trazodone was wearing off, I suspected) to the point where I wasn’t functional and would have to talk myself down and remind myself “this will eventually pass” since usually around 9AM or 10AM the anxiety would lift and I could function again. I wasn’t suicidal, but I did question how much longer I could go on in my current state. I didn’t really feel tired, but I was just constantly on edge emotionally and felt like I was going off of adrenaline. The anxiety would wax and wane throughout the rest of the day, but usually not as bad as first thing in the morning.
Doing something about it:
It really didn’t occur to me that the source of my problems could ultimately be sleep apnea. I knew nothing about it other than a couple people around me had mentioned it to me in the past related to my snoring and commented on how it sounded like I would sometimes struggle to breath at night. For some reason I’d dismissed this previously.
A friend told me about how sleep apnea runs in his family and he didn’t know much about it, but that he finds he sleeps amazingly better with a mouth guard in, which led me to explore that and ultimately sleep apnea in general.
I ordered up a boil and bite mouthguard because I figured for $30 what could it hurt to try as well as a pulse oximeter to explore the possibility I might have sleep apnea.
First night with it I slept about 6 hours, but only woke up once during those 6 hours to pee and felt more rested than normal. It was hard to sleep since I couldn’t find a good neutral position for my jaw and eventually took some ibuprofen to ignore the pain from that and after a few days didn’t need the ibuprofen. The mouthguard definitely helped, but I wondered if it was helping enough or if CPAP treatment might be better. Also, it took about an hour in the morning for my jaw to settle back into place before chewing felt “normal” again and my teeth stopped feeling sensitive. My friend who swears by one insists that all that goes away in time.
When the oximeter arrived I wore it to sleep without the mouthguard in and forced myself to go without until about 4 hours into the night and then wore the mouthguard the last half of the night. The difference on the oximeter with VS without mouthguard was absolutely stunning. My O2 levels dipped below 90% so many times and so frequently it was hard to see any sort of average in the data. It just looked like a line bounding all over the place and never stabilizing! With the mouthguard there was still some of that, but my O2 moved in a much narrower range. There were still some occasional dips below 90%, but it was much more stable. It’s worth noting that an oximeter isn’t foolproof for detecting sleep apnea, especially if you’re younger, but in my case the sleep apnea was so severe it was glaringly obvious.
Mental Health Improvements:
Immediately after I started wearing the mouthguard to bed the anxiety melted away quite a bit. I was no longer suffering with it every morning for several hours, just at night and occasionally in the evening, but was managing that with the trazodone before bed. After about a week I noticed the anxiety before bed was mostly gone too.
A lot of people talk about how they feel much more rested after treatment and I felt that a little, but it wasn’t as pronounced since I never really felt super tired during the day before the treatment. I did notice that I felt a lot more calm in general, the world seemed like it was okay again, and when I tried to focus or problem solve it felt like my brain was comfortable taking time to do than rather than feeling a need to rush through it. My diet improved as well, but that was probably a mix of apnea scaring me straight and decreased lethargy and impulsivity making it less necessary to snack. I also found my memory improved a lot going from having trouble recalling events to being able to remember them again.
After a few days of using the mouthguard and noting the huge improvement that $30 investment made in my life I wondered if I could get an even more significant improvement from CPAP therapy and decided to order up a unit with a DIY approach. I wouldn’t really recommend this approach to others since if you have insurance, doing a proper sleep study and having professionals set it up for you is a whole lot easier when you’re trying to navigate something entirely new to you and it’s easy to get discouraged by the complexity of trying to figure everything out from hunting down info online and then being left still not knowing what you don’t know.
In my case I kind of get off on learning new stuff and with the new mental calm the mouthguard provided I was able to concentrate on solving this problem myself. I ordered up a ResMed Airsense S10 Autoset with a F20 facemask. When it arrived I found that like the mouthguard, it took several nights to get used to it. Fortunately, trazodone was there to help me out with that. I found that for me I needed to bump up the minimum pressure from 4 to 6 (4 was just too low and felt like I was using more effort to breath), max out the pressure relief setting, and bump the max up from 10 to 12, since the unit was frequently maxing out at 10 for long periods of time during the night.
In the end I’m sticking with the CPAP machine over the mouthguard for home use, but will hold onto the mouthguard to use when I travel or if the power goes out since it seems to be “good enough” to allow me to stay asleep.
A month out now I have full relief from anxiety, do not experience any during the day and no longer experience it in bed at night. I’m mostly sleeping through the night and not getting out of bed until I’m done sleeping. I feel calm and “normal” again. All the covid nonsense and lack of vacationing somewhere warm this year still sucks, but that sucked before my mental health and sleep deteriorated last year, and I’m sure will continue to suck for a while. Those things don’t really bother me in a significant way, though.
Advice to others:
Obviously, if any of this resonated with you, your best bet is to talk to your doctor and get a proper sleep study done rather than following my example and fumbling through an attempt at self-diagnosis. I’ll probably get one done at some point, but my reason for not doing it was that I was truly at my wit’s end and wanted relief as quickly as I could get it once I realized what the problem might be.
If you do insist on the DIY approach yourself, a “boil and bite” dental appliance (like I tried) really is the path of least resistance. It won’t solve obstructive sleep apnea for everyone, but for $30 to $40 without a steep learning curve probably doesn’t hurt to try along the way and if you do see even a minor improvement from it, that could be encouraging enough to give you that nudge to go further with diagnosis.