The sleep study

Well, that sucked. Friday night was my sleep study. First of all, I had a very different idea of what it would entail than was reality. When I called to book the study, I was told that I would be hooked up to the device at the hospital and would wear it home and sleep in my own bed. I was told not to put any products in my hair…no sweat, I shave my head. But of course I interpreted that to mean that I would have a bunch of electrical leads coming off my head like an EEG. I figured most of the stuff would be small leads attached around my body, and brought a t-shirt and a sock cap to cover it.

Once I got there, they hooked up a velcro belt around my chest and another around my waist. They placed two devices on these belts, one which attached to leads from the velcro belts as well as a pulse oximeter for my finger and oxygen tubing with nasal prongs. The other device was the recorder. They told me not to take it off but just to walk out of the building and go home. I could keep the pulse ox and the oxygen tubing off until sleep, then I was to tape both in place.

Unable to bring myself to walk out of the hospital looking like a suicide bomber, I stepped into the bathroom, took off the equipment (as it looked very easy to put back on), placed it in my back pack, and left the building. I stopped at the gym on the way home and crushed a workout, then went home. I had a nice hot shower, took my Sleep Cocktail around 2030, and put all the gear back on, taping the oxygen tubing and pulse ox in place.

The first few hours of sleep were the worst. While the equipment was a bit cumbersome and difficult to get used to, I did manage to fall asleep fairly quickly. But I kept waking up, especially in the initial hours of sleep, it seemed, short of breath, almost gasping. I am not sure if it was the equipment or just happenstance, but the symptoms seemed to be worse that night than most.

Turns out that I was right. My colleague Rob who runs the sleep lab just got back to me today and told me that I have an apnea-hypopnea index (AHI) of 16, which is moderate. When I am supine (on my back), that goes up to 32, which is severe. That tracks with what my wife tells me. It is not uncommon for her to wake me up and tell me to roll over because I am not breathing.

So I will be getting a CPAP machine in the next few weeks. While I once dreaded the thought of being diagnosed, I am actually quite hopeful. A direct quote from Rob’s email reads “At least this helps explain why you are tired and are having trouble losing weight.” I do not want to get my hopes up too high, but it is good to know that I have identified something that is getting in the way of the progress I intend to make and I have a means to defeat it.

Fast forward a couple weeks. I just picked up the CPAP machine yesterday. I took it home almost like a kid after Christmas. As I mentioned, I want to be realistic in my expectations, but I am honestly wondering if this will simplify getting the excess weight off. Maybe this is all that has stood between me and washboard abs! I may be crazy, but given how hard I have tried before to make a dent in my body composition only to be disappointed again and again, finding something that is fixable would be a welcome change.

As I have mentioned before, for a very long time I resisted being evaluated since I associate this diagnosis with obesity. Turns out that this is erroneous, but even if it is not, this is a mentality that I want to address because it is so damaging. It is as foolish as buying size 34 pants when you need a 38. Trying to cram yourself into tight clothes does not make you thinner…it just makes you miserable. And by the same token, not getting a sleep study that could diagnose a problem and provide a means to address it that would then improve my energy and ability to train is just plain foolish…and prideful. Oh, and stupid.

I try to point out principles as I go along. I think that this is an important one. So here it is.

Principle #4. Recognize and acknowledge your current situation. Be brutally honest with yourself. And be willing to do what it takes to make the change you need. If you plan to chart a course to any destination, you not only need the exact coordinates of where you are going, you must have the exact coordinates of where you currently are. Without both of these pieces of information, the course you chart will be incorrect and you will miss your target. So where I am right now is that I carry too much bodyfat and I have obstructive sleep apnea. The solution I have chosen is that I will be brutally honest with myself and my coaches about this and will seek out and use every tool at my disposal to change this situation. One of those tools is a means to achieve a completely restful night’s sleep, suppressing the stress response and the cortisol production that goes along with it, and hopefully reversing the tendency of depositing and sparing bodyfat by my metabolism.

This, however, is only one of many areas that I need to address. The other primary area that I am focusing on is nutrition. This time, however, I am taking a slightly different approach. Instead of making a wholesale change, I am slowly but steadily making improvements in my diet. My next post will discuss an outstanding book called The Slight Edge. It has immense implications for those trying to make any change in their life. I will discuss the application of this book to nutrition and fitness.

Getting back to the CPAP…I used it for the first time last night. I did not get to bed as early as I had hoped and wound up only getting 6.5 hours of sleep. In addition, the machine still recorded 12 episodes of apnea, much higher than I should be seeing. If this persists, as I understand it, I will require a higher pressure. But what this tells me is that I have not yet made it to that fully restful night’s sleep yet.

How is all of this affecting my fitness ability? Despite my nutrition still being marginal although slowly improving and my rest and recovery being reasonable but not perfect, I set another personal record yesterday on my deadlift, getting 355# for three reps. I tried to pull 365# for one, which would tie my lifetime PR, but I just missed getting it over my knees. So my strength is making slow and steady improvements. Chris then asked me to perform the multistage fitness test, on which I scored 28 laps, which is 5 shuttle runs in the 4th stage, for a VO2 Max of 28.02 mL/kg/min. That is considered poor for my age and gender. Thats about right. I feel like a slow, lumbering human right now. That definitely needs to improve. But the goal, as Chris has explained to me (multiple times…bless his patience), is that my biggest problems right now are core stability and overall strength. Once these improve, my ability to generate power will increase, and I will be able to work out harder and with more intensity. That will then begin to translate into body modification. He already has begun working me on the sled on weekends. High-intensity interval work has definitely been shown to be the key to improved body composition.

Anyway, we will see how the sleep and recovery goes over the next several weeks. I will have a follow up appointment with my pulmonologist in a month to discuss how things are working, so I will give an update after that occurs.


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