The Dream Machine

It's scary looking, isn't it?

It's pretty damn wonderful though. It has transformed my life, both waking and sleeping. I swear to God it restored 15 points to my IQ the first week I used it.

Along with Type II diabetes, sleep apnea is one of the common medical conditions that is accompanying America's "obesity epidemic." Not that you need be obese, or even overweight, to suffer from obstructed breathing during sleep, but... if you get fat enough, you will develop sleep apnea, I guarantee.

An estimated 12 million Americans have been diagnosed with sleep apnea. Many more go undiagnosed and untreated. You may know some of them: I do. These are the spouses, friends, and neighbors whose snoring, you swear, could rouse the dead. It's not just the snoring... it's the way they occasionally stop breathing: zzz... zzz... zzzzz.... [SILENCE]. You count the seconds, holding your own breath in sympathetic suspense. After a second or two, or ten, the sleeper gasps and groans with a sharp intake -- hyuhhhh! -- and the rhythmic torturous buzz resumes.

People had been complaining about my snoring for years. The Turkish Engineer called it "thunderous." Evan used to worry the neighbors would complain (I thought, at the time, he must be exaggerating). Mostly, of course, I have slept without a human companion, and the dogs have never said a peep. Although I'll admit, for reasons they have not yet chosen to divulge, they sometimes relocate en masse to the living room in the wee hours.

For the past decade, my mantra had been, I'm so tired. I blamed this chronic fatigue on disappointments in love, professional frustrations, gynecological issues galore, and a steady weight gain that sent me from "extra large" to "super sized." In retrospect, I see the real twin culprits were insulin resistance and sleep apnea. Since getting some control over both in the past year, I am hardly ever so tired. I mean, I am hardly ever "too tired" to do something I want to do. For example, I am never too tired to head out to a club with Max to listen to a band. I am never too tired to stay up all night drinking and engaging in idle conversation with friends (or strangers). I'm never too tired to watch Jimmy Kimmel's monologue, even when I have to get up at six the next day. I am never too tired for sex (as long as I'm on the bottom).

Used to be that Max would come by after work to follow a trail of corn flakes from the kitchen to me, prostrate across my bed. If he was lucky, I might rouse myself enough to drag my carcass to the couch and watch a little TV. I was a real drag!

I famously fell asleep everywhere. I fell asleep in movie theatres, even during the good parts. My older sister quit offering to treat me to Saturday matinees at the ballet; I would be snoozing in the overheated balcony before the second act. I even fell asleep during meetings at work, which was embarrassing. It made me look like I didn't really care (which I didn't, usually, but still...).

The worst and most dangerous situation was driving. Yes, I used to fall asleep while I was driving. Used to people! I can attest to the fact that it's indeed possible to fall asleep with your eyes wide open. I never dozed off for more than a few seconds; when my head started to wobble, I came to right sharp. I wasn't drunk, but I might as well have been three sheets to the wind most of the time I was behind the wheel. And I'm not even a very good driver at my most alert.

That's how I finally got diagnosed. Three years ago, I was driving home at 7:00 am after a sleepless night with my erstwhile lover, Mr. B. I had just dropped Mr. B. off at the hospital where he worked, and was making my way across an unfamiliar part of town, Starbucks in hand. I hadn't really slept the night before, primarily because I was so self-conscious about my snoring I couldn't allow myself to fall asleep in front of a lover. I wasn't really the insatiable nympho I acted during our nights together -- it's just that I was afraid if we stopped f***king, I'd fall asleep and give the game away!

Anyway, I was heading straight to class that morning, hazily pulling some kind of lesson plan together in my head, when I must have... passed out for about two seconds. The next thing I knew, I was sailing under a red light. I slammed on my brakes, skidded, and my Honda Civic did a neat 360 degree spin into the intersection, clipping the back of an SUV.

The roar of impact was incredible. My tiny vehicle was (conveniently) knocked to the side of the street. Radiator fluid spewed like a geyser. I sat stunned, and fortunately buckled up, while passersby flocked to the dramatic scene. Omigod lady are you all right?

Every single day I thank God, or whatever powers there be, that I didn't manage to kill someone that morning. If there had been pedestrians in that crosswalk, I would have plowed right through them. What if I had hit a child? How could I have lived with that? I honestly don't think I could have.

So in the end, it was all a kind of blessing, a reason to be enduringly grateful and humble, because if I learned one thing that day, it is that even "smart" and "good" people can make very stupid and potentially tragic mistakes.

At the moment, of course, it was a disaster. In fact, when the cop arrived at the scene, he found me banging my head against a utility pole. I wasn't trying to punish myself, I was trying to wake up. The nightmare was compounded when I learned I had somehow let my insurance lapse. The police officer, a beefy young black guy, was unaccountably kind to me. He gently led me away from the pole, and asked me repeatedly what had happened. Had the sun blinded me? Did I need to go to the hospital? Did I want a taxi? No, no, yes.

It must have been apparent I was delirious, but not DUI. He cited me for running a light, but not for lack of insurance, a $600 fine in Washington. Financially, it was a minor catastrophe for me, who habitually lives on the margin of poverty: I paid $2500 out of pocket to replace the panel of the damaged SUV, and I didn't have another car for several months, when finally a friend-of-a-friend sold me her mother-in-law's 85 Nissan for $1500. My insurance rates tripled, as suddenly -- after an unblemished 30 year driving record -- I became a "high risk driver."

Yeah, I'm still feeling the fallout of that day. But, you know, it's just money, so what the hell.

What was important was I realized I had a problem. And by then there was enough information out there for me to figure I probably suffered from sleep apnea. I hauled myself into a sleep clinic at the local hospital and spent a very long, weird night connected to a hundred electronic sensors while my fitful slumber was scrutinized through the unblinking eye of an infrared camera.

The doctor confirmed I suffered from "moderate" sleep apnea, with an average of 27 "episodes" (interrupted breathing) per hour. A week later, I came back in and was fitted with a C pap device. This machine works by blowing air into your throat so that your airway does not collapse when you breathe in. It's pretty simple, really, although it needs to be calibrated to your individual specifications. And if you try to talk while it's on, you sound like you've swallowed helium.

Under observation, I was allowed to sleep with the device for about four hours. When I was awakened, I sprang to my feet. How can I describe how alive I felt? Dazzled, thrumming with energy, my senses almost chemically enhanced. Clarity. Focus. Ability.

It's amazing what oxygen will do for the brain.

C pap machines are expensive: I think mine cost $1500, of which I personally forked over several hundred dollars. The accessories are pricey too: a new mask costs over $60, and they seem to be designed along "planned obsolescence" lines since, no matter how tenderly I handle mine, the plastic clips break within a few months of use. You're supposed to clean the filter every day and replace it regularly (which I remember to do about once a month).

Insurance companies and physicians complain about lack of compliance among sleep apnea patients. A lot of folks who get prescriptions for C pap machines never use them. The mask is not comfortable to wear. Although the sides are constructed of soft, pliable vinyl, it's hard to get a really good seal. If the mask leaks, you've got wind whistling up your ears or, even worse, into your eyes, all night. The only way for me to get it to work is to tighten the straps until the edges of the mask are actually biting into my flesh, and I often wear the marks for hours. In fact, I think I've developed a permanent depression across my forehead.

For me, it's a small price to pay. I took my machine home from the doctor's cradled in my arms like a baby, and spent the next six months catching up on lost REMs. My dreams were initially amazing: long, linear, cinematic, technicolor, epic in scope and complexity. I started to keep a dream journal to capture them. I felt like I'd been granted an unexpected periscope into my own psyche. I even, briefly, got interested in dream analysis.

Three years later, my sleep patterns and dreaming have settled down. I still have occasional interesting dreams, but they have lost their hallucinogenic "significant" quality and I no longer have a compulsion to record each detail on awakening. Catching 40 winks is no longer a spiritual experience.

The good news is I do sleep now. I have occasional bouts of insomnia, but that's an unrelated phenomenon and I don't worry about it because I can rest assured that, sooner or later, I'll get those essential eight hours -- in bed, not in my car or at my desk.

The other good news is that I am pretty confident if I can drop another fifty pounds, I won't need the C pap machine anymore. Since last December, I have fallen asleep a couple of times without "plugging in," and I was pretty sure I wasn't snoring -- at least not badly enough to wake myself up. I'd love to bid adieu to the C pap machine, despite my debt of gratitude to it, because it is kind of a nuisance when traveling. And it definitely isn't a hot look when and if I should ever be in an, uhm, ongoing relationship again.

I remember Mr. B. waking me up one morning to say goodbye. It wasn't easy, since I had just gotten the C pap and was prone to sleeping very deeply at the time. "Oh, you scared me!" I cried, when he finally managed to shake me awake.

"I scared you!" he scoffed. "I'm not the one who looks like Hannibel Lector."

Hmm, he had a point. Although I think it makes me look (and sound) more like Darth Vader. Actually, it makes me feel like a scuba diver as I dive under the covers and into the unfathomed depths of subconsciousness, connected to my vital oxygen supply by a flexible length of hose.