This week I was diagnosed with severe obstructive sleep apnea and sleep related hypoventilation.

I am feeling a lot of things around this diagnosis. A little fear (untreated, sleep apnea can lead to serious things like heart attacks and strokes), a little anger, but mostly relief and gratitude.

Relief that we finally know the reason I feel more tired than other people my age, even given my good lifestyle habits.  Relief that it is treatable and that I will likely feel better very soon.

Gratitude that it was found now, in my 30s, before it lead to a heart attack or stroke later in life.

Gratitude for the person who pointed out to me that I had symptoms of sleep apnea, which led me to tell my doctor and have her order a test.  Prior to this person saying something, I had no idea that what I was experiencing were symptoms of anything. I thought it was normal to get up and pee at night….I’ve done it for as long as I can remember. I didn’t realize tooth grinding could be a sign of breathing issues at night. I didn’t realize I snored so much because my husband is polite and never complains. I thought I just wasn’t a morning person. I thought I was just more  tired than other people because my kid was a poor sleeper for the first couple years of his life, or because I don’t drink coffee regularly. My doctor had tested my cortisol levels (which were too low) and various hormone and nutrient levels and thyroid hormones (which were all normal, other than Vitamin D deficiency).

Gratitude that I kept following up with my doctor’s office until my insurance company FINALLY  agreed to pay for the test.

Anger that my doctor’s office had to fight with my insurance company to pay for the test. The insurance company denied it at first, because I don’t currently have a serious condition such as heart failure. Really. That’s what the denial letter said. See why I am angry?

Gratitude for the fact that I focused on developing consistent healthy habits for the last year, instead of trying to change a bunch of habits all at once in order to lose weight. People who don’t sleep well often have weight gain or difficulty losing weight as a symptom, and if I was focused on my weight, I would have made myself crazy. Instead, my health and energy levels have improved dramatically over the past year. I still feel like I am more tired than the average person my age, and now I am excited to know that there is a treatable medical reason for this.  I am optimistic this means I will feel even better soon. That once I can breathe well while I sleep, I have many habits in place that will allow me to feel well rested and healthy.

Gratitude that I listened to my body when intense workouts made me exhausted. That I backed off instead of buckling down. That I rested and recovered as much as I needed instead of sucking down stimulants like extra caffeine or pre-workout drinks. I was already pushing the limit without knowing it, just by doing my everyday life on very poor sleep. Forcing myself to do even more would have backfired, big time.

Gratitude that I stopped with the “I am tired, so there must be something wrong with my diet” mentality. I eat reasonably well. No amount of paleoing or raw fooding or WestonAPricing or or clean eating or GAPsing or AIPing or veganing whatever other crazy restrictive plan I tried would have solved my breathing issues. Turns out I don’t need a diet or a supplement. I need a CPAP machine.

Anger…at the TV show “The Biggest Loser,” of all things. Why? When it was first suggested to me that I get tested for sleep apnea, my first thought was embarrassment and that “I don’t want my kid to see me using a breathing machine.” Back in the days I used to watch that harmful show, I saw people crying because they had to use a breathing machine. You were supposed to feel sorry for / disgusted by the poor sad fatties who had medical conditions. I internalized the belief that using a breathing machine is shameful.

And then I told myself “wait a minute. That is fucked up that I would actually consider not finding out if I have a medical condition so I don’t have to show my son that I am getting treatment for it. There is NO shame in getting medical help for a serious medical condition and I will gladly tell my son THAT. Fuck TBL.”

Fear/Dread that I will be judged by scared friends or family who think I should panic and go on a diet. “Isn’t sleep apnea linked with being fat? Shouldn’t you try to lose weight?” For friends and family who may be worried about me in this department, a few points to consider, in no particular order:

1. The fact that 95% of people don’t sustain weight loss over a 5 year period, according to research, which means that any weight loss achieved has a 95% chance of being only a temporary way of managing sleep apnea. This fact doesn’t change because someone receives a diagnosis of a condition that is linked to being fat.
2. While apnea is linked with being fat (and correlation does not equal causation), it is also linked with traits beyond one’s control, such as narrowness of the airway and certain facial structures.
3. Poor sleep negatively effects every function in the body, including metabolism, hunger signals, insulin levels, absorption, and more. As such, some (many?) people with sleep apnea experience weight gain or difficulty with weight loss as a symptom of the condition.
4. It’s important not to panic and and do things to take care of this condition that compromise my mental health. It’s ALL health, and I’ve experienced such a quality of life difference from improving my mental health. I’m not willing to sacrifice what I’ve worked so hard for.
5. For those who agree that diets don’t work but think that weight loss has a better chance of being sustained if caused by health-promoting habits that are practiced consistently over a long period of time (and I’m not aware of any data that shows this is the case, but I would LOVE to see some, so if you know any, please please send it to me!)…..then, you don’t need to worry about me.  My habits are pretty darn healthy. I’m learning to eat more intuitively and be attuned to my hunger and satiety signals, I lift weights and walk regularly, I’m working on habits that improve my sleep (and it turns out that getting a CPAP machine might have the biggest impact of all in that department). I’m adopting healthy habits at a reasonable pace that I know I can sustain. If I was a smoker or a sedentary person, I might benefit from some more drastic changes. However, my lifestyle is already on the right track and so the right thing to do is to stay the course and keep up the consistency, not panic and start a diet that causes me to crash and burn.
6. For whatever it’s worth, my husband says my snoring was at its worst between the time I had my son and the time when I started lifting weights again. He says it is MUCH better now than it has been. And since I’m actually heavier now than I was in my first year postpartum, we know that my apnea was likely improved by lifestyle habits, even though my weight has gone up. Now, my condition is classified as severe and so yes, it might benefit from some weight loss…..but, re-read points 1-5.

I know that my personal health choices are really none of anyone’s business, but I still have this fear a bit. So I’ve listed those items mainly for my own self, not because I owe anyone an explanation for my own health choices.

Optimism. I’m excited to get my CPAP and start feeling even better!