Grrr! Having a hard time, today, and I'm going to work at home instead of risking driving. I'll try to make up for it by working at Keck tomorrow.

The problem seems to be my allergist's insistence on a new strategy for fighting my chronic nasal congestion. The congestion is at minimum a complicating factor for treating my sleep apnea with CPAP, and at worst a part of the fundamental cause. (The whole dust mite allergy/congestion thing arose around the same time in 2000/2001 as I started suffering from sleep apnea.)

Anywhoo... the last few months I'd given up on all the expensive nasal sprays and prescription antihistamines that don't seem to do much, and started using oxymetazoline HCl (Afrin). The stuff is an irritant and can increase your congestion after it wears off, especially if you use it regularly. I dealt with that by only using one spray in one nostril, alternating each night. The rebound effect didn't seem to get too bad. Breathing clearly in at least one nostril made a huge difference in my sleep, though: during those months I rarely pulled off my CPAP mask during the night. (This happens when I'm not breathing well; clearing obstructions from your mouth/nose is a subconscious reflex.)

Well, my allergist examined me a couple of weeks ago and observed "big, red, inflamed nasal turbinates" and blamed it on the Afrin. Apparently, forgetting that that's the exact observation she made a year, long before I started using the stuff. So she put me back on the expensive nasal sprays.

I had a horrible sore throat for a week, which may be from the obnoxious sprays, so now I'm trying them each one at a time to see how much they help and/or if they reduce my congestion. This week I'm on just Nasonex. And it's not doing much for my congestion, I have to say.

So last night it appears I screwed up my CPAP setup during the night somehow. I'm feeling logy today, and may work around the house rather than try things which require intellectual concentration.

Maybe wash the dog to reduce the dust mite count a tad...

So my sleep apnea treatment - CPAP therapy - works generally pretty well and I've felt a whole lot better over the last year than I did the previous one. There are still some glitches, though - occasionally I pull the mask off, occasionally it leaks or fails to work right for some other reason and I end up spending the next day as a space cadet. But, nothing even remotely like the awful days in 2002 when I was sleeping 16 hours every day.

I saw a new doctor for a second opinion recently, and he put me on a new medicine - the anti-narcoleptic Provigil - to give me back the last 5% of energy the CPAP hasn't provided. That's worked fairly well; it's a remarkably mild drug and I can barely even tell when I'm on it, except that I generally get more productive work done on days I take it, and I don't feel the need for caffeine anymore. Certainly better than the regulated doses of caffeine I took before, which made me jittery and gave me headaches when I stopped. Now I just have a cup of tea or coffee a couple times a week because I enjoy it.

I'm trying other new things. I tried a new mask last week, the Breeze SleepGear with Nasal Pillows. Many CPAP users swear by it. Well, for me it sucked. I could barely keep it on - it came off almost every time I rolled over - and my nose hurt like mad in the morning from the force of the mask seal against my nostrils. Ick.

Anyway, the nice people at the sleep lab have as of today loaned me an auto-titrating CPAP machine for a couple of weeks. This thing continually readjusts it's pressure range to suit the patient's breathing needs, and records information about the adjustments to memory. So at the end of two weeks, we'll have a nice set of data describing how much pressure I need, and to what extent it varies night-to-night. Should be interesting.

Argh. While CPAP has certainly turned my life around, this problem is by no mean conquered. I had a terrible training ride up the Angeles Crest Highway. Generally, it takes me 1:14 or so to get from my house to the intersection of the Angelest Crest Hwy and the Angeles Forest Hwy. Today it took 1:20, and I was fighting to stay awake the whole way.

Normally, in years past, I feel irritated nasal passages when the smog is bad. The last couple weeks, it's been worse - I'm even coughing up phlegm in the morning, and today I'm still coughing at 1:00pm. I don't have any other symptoms of a cold or flu, so that's not it.

Last night I was so congested, despite sudafed, nasonex, and astelin, that I had to use Afrin for fear of suffocating inside the CPAP mask. I hate doing that, because Afrin causes a rebound effect; unless i'm lucky tonight could be worse.

I don't know if it's the smog, something growing in my CPAP apparatus, or other irritants in the house. I did change out the old almost-HEPA A/C two weeks ago for a standard filter; maybe that was a mistake. I'm going to clean everything in the house, disinfect my CPAP hose with bleach, and put in a better A/C filter. Fingers crossed - if I get bad sleep the night before the big race in two weeks I'm gonna be really, really pissed off.

The evidence continues to build that apnea is, at least in many cases, a neurological condition more than a structural condition. This story describes new findings which show a correlation between adult apnea and childhood stuttering. Add this to last month's news that some antidepressant drugs can treat the disease.

Instead of posting another long article in the series describing the history of my sleep apnea problem, I present this article.

This is intriguing.

Attribution: T. (A best friend)

Allright, now that the first has settled, here's the second part of my medical story. I'd said before that my brain started going on hiatus sometime in late 2001, and it got worse. But it was gradual, so I wasn't confident a change had occurred for real until a close friend shook some sense into me in May 2002. Thank god for close friends.

I came home, and started hitting the doctor's offices and the 'net for explanations.

This is a new topic for my blog, one I've been meaning to add since I started it. One purpose for this blog is to chronicle my struggle with a medical condition that's quite rare for people of my age and fitness level: obstructive sleep apnea. I plan to write a few long entries to catch up to the current date and then follow along as things progress.

The beginning of it all: realizing that something was wrong took a while

Starting around the winter of 2001/2002, I began having frequent headaches and difficulty concentrating on work during the afternoon. Overall, my motivation level was dropping and I was getting a lot less done. It was quite mild at first, so I didn't even notice it much, and attributed the headaches variously to dehydration, electrolyte imbalance, or what-have-you. I drank a lot of water and later, gatorade. Well, it didn't help.