Visions of Sleep

This was originally posted to my blog, Diabetes Odyssey.

I had three medical appointments today. I swear I live at the doctor’s office.

Sleep Study

The first appointment was for a class on preparation for my sleep study tonight. Several of my doctors have asked me in the past if I have ever been tested for sleep apnea. Apparently I have a ton of risk factors. I never even suspected that I might have sleep apnea primarily because I rarely snore, and when I do it’s very quiet and doesn’t last long. But my new primary doctor thought it was worth testing, so here I am.

Symptoms of sleep apnea:

  • Snoring (usually loud and persistent)
  • Episodes of not breathing followed by gasping for air and/or snorting
  • waking a lot during the night (may be accompanied by shortness of breath)
  • waking with a dry mouth and/or sore throat
  • headaches (especially in the morning)
  • insomnia
  • sleepiness and fatigue during the day
    -trouble paying attention
  • moodiness

Risk factors for sleep apnea (obstructive and central types):

-Obesity
-large neck size

  • narrow airway
    -males
    -older persons
    -family history
    • drinking alcohol, using sedatives and/or tranquilizers, smokers
    • nasal congestion
    • Heart conditions
      -Using narcotic/ pain medications
      -stroke
    • Diabetes

There were four of us in the class. We first filled out a quick questionnaire that asked about risk factors and symptoms. Then we went over what sleep apnea is, how it works, what the test is for, and what the treatment is and how it works. Then the technician showed us the test machine we were to take home, how it works, how to put it on and start it, and how to take it off.

I was a bit surprised when I saw the machine; I was expecting the same machine my husband had been tested with, the one you strap on your chest and have to lay on your back all night and can’t get up during the test. This machine I was being sent home with is like a huge watch you strap on your wrist with a finger shell (just like a pulse oximeter). I was happy to find out I can sleep just like normal (I hate sleeping on my back) and if I have to pee during the night it’s OK to get up. WOOT!


The sleep study machine you wear like a watch

Retinal Scan

My second appointment of the day was at ophthalmology for an eye scan in preparation for my first visit with my new retina specialist. This appointment was nothing special or new to me, I’ve had this same scan a million times. Just look straight ahead at the blue light and cross while they run the scan. Of course they had to dilate my eyes first. The point of this test is to get good pictures of your retina.

Retina Specialist

My last appointment of the day was with my new retina specialist. He’s a nice guy, has a mildly comedic personality that sets you at ease. But most importantly he seems knowledgeable and willing to listen. I told him about my past surgeries, laser treatments, Avastin injections, etc.

“You get Avastin injections in both eyes?”

“Yes.”

“Do you want it in your right eye?”

I understood immediately why he asked this. I have virtually no vision left in my right eye and am fully aware there is nothing that can be done to improve this eye. It’s done, I know. I told him I really didn’t care either way about the injection in my right eye, but I know I really need it in my left.

He examined both my eyes and agreed I need Avastin in my left to keep it stable.

As he was examining my right eye he made a comment that made me smile a bit. “The doctor that did your scleral buckle did a great job.” I smiled because it brought memories of Dr. Hunter, a truly excellent retina specialist.

“OK, then I’ll do the Avastin in your left eye now, and no more Avastin for your right.”

“Sounds good.”

He did the injection and asked to see me again in eight weeks for my next injection. Then he asked me if I had any questions. I did.

“I know my right eye has shrunk…”

“Yes it has…”

“Is it going to?..”

“No, it’s done, the oil will keep it from shrinking any more.”

“OK, so is there anything I can do about my droopy eyelid? I know it doesn’t cause any problems but…for vanity’s sake…” I’ve been reluctant to leave my house, and very insecure, because of my droopy eyelid (often called a “winking eye”). I used to be so proud of my big, bright, beautiful eyes, but now I just want to hide the right side of my face.

“I’ll refer you to a plastic surgeon.”

“Thank you.”

So on the way out I made an appointment to consult a plastic surgeon, and an eight week appointment for my precious Avastin.


My right eye has shrunk due to retinopathy, causing a “winking eye”

Busy day, but all good.

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I wish the sleep study I did had such a small machine! I had the big one on my chest. I’d like to get re-tested eventually as the results showed I have mild sleep apnea but don’t need treatment, and I want to make sure it doesn’t get worse, especially since now I have additional health conditions. Hope your study goes well, and glad you had a good eye appointment.

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Thanks for writing about sleep apnea. It can be very serious and can cause a whole range of health problems including making your diabetes worse (potentially much worse).

I’ve had diagnosed sleep apnea for about 5 years. I treat it with a machine called a CPAP. Before treatment I was waking over 30 times an hour and my breathing stopped, at one point for 3 minutes. One of the effects of sleep apnea is certainly that you don’t get a good sleep, but it also causes your oxygen to drop. The sleep test you will be taking will measure whether your oxygen drops too low overnight. This test doesn’t cost much and if it does show apnea they will likely do a full sleep study. The full study is more expensive and they usually have you sleep in a room (like a hotel) where they have equipment to monitor you and will try out and adjust CPAP machines.

If you have sleep apnea, getting it diagnosed and treated can make a big difference and you do really feel better when you are treated.

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