I GOT A SLEEP STUDY IN MY 30S. IT PROBABLY SAVED MY LIFE

This story was featured in The Must Read, a newsletter in which our editors recommend one can’t-miss story every weekday. Sign up here to get it in your inbox.

For most of my adult life, I’ve been intermittently jolted awake by vivid hallucinations. My apparitions visit randomly and take various forms, ranging from a friendly colleague to a Lovecraftian horror. I once shook my wife awake to introduce her to the team of contractors who’d appeared at our bedside. “Babe, they’re here to fix the floor tiles,” I beamed. We don’t have tiled floors.

Another night, I bolted out of bed to engage in hand-to-hand combat with a six-point elk that had materialized on the couch. After a short battle, I flipped on the overhead lights to get a better look at the beast. He vanished, and I regained full consciousness in my tighty-whities, shaking from adrenaline. Not my finest moment.

In my twenties, I saw my episodes as a (mostly) harmless quirk, akin to sleep walking. They didn’t always keep me in my family’s good graces, but I felt otherwise fine. I brushed them off for years.

In reality, my body was slowly torturing itself. A doctor later suggested that my hallucinations were the product of sleep deprivation, brought on by a severe case of sleep apnea. It’s a disorder that causes you to stop breathing throughout the night, due either to an obstructed airway or faulty signals between your brain and your breathing muscles.

In my case, the tissue in my throat was relaxing during sleep and collapsing my airway. I’d stop breathing for five or ten seconds at a time, dozens of times per hour. My snoring was horrendous—I’ve woken up house guests sleeping on different floors from me—but the effects of sleep apnea were much worse for my brain and body. My blood wasn’t getting enough oxygen to feed my vital organs, and my brain was waking up every few minutes, so I wasn’t getting any of the reparative benefits of sleep. I lived without rest for more than 15 years. I didn’t feel it in the early days (your body can endure a hell of a lot of torture in your twenties, it turns out) but I was deteriorating rapidly.

I’m 36 now, and over the last year or two, the consequences of sleep deprivation revealed themselves in the same way that a glass window reveals itself to a seagull. Fatigue hung over me constantly. Waking myself up became an hours-long ritual of energy drinks and coffee. I napped during my lunch breaks instead of exercising or walking the dog. I was irritable and unmotivated, I generally looked like hell, and menial tasks began to feel like insurmountable hurdles. Worst of all, my short-term memory faded, to the point where I was jotting notes after everyday conversations to remember names and basic details.

My wife, who bore the brunt of my transformation into a grumpy badger, was the first to suggest I get a sleep study. She’d done her research: Most of my issues were common symptoms of sleep apnea, and ignoring them could lead to a cascading series of health problems.

I called a sleep doctor, who gave me the implications in plain terms: “If you don’t get this treated, you’re probably going to die early,” she said. Sleep apnea is no joke. It’s the catalyst to a laundry list of health issues, especially the ones that are killing middle-aged men at alarming rates. Studies have linked it to heart disease, high blood pressure, stroke, type 2 diabetes, and Alzheimers, among other maladies. Heart health problems in particular tend to come paired with sleep apnea: up to 80 percent of people with cardiovascular disease also suffer from sleep apnea, according to the American Heart Association (AHA). Left untreated, the disorder effectively triples your risk of dying.

Luckily, there’s a one-size-fits-all treatment for sleep apnea. The CPAP machine—which delivers constant air pressure to your nose and throat via a hose and facemask—has remained the primary treatment option since its advent in the ‘80s. It’s not the sexiest device you can introduce to the bedroom, unless looking like a Batman villain is your thing. But it’s affordable, widely available (at least in some countries, like the U.S.), and incredibly effective.

It completely turned my life around. All of my symptoms faded after my first few days with the CPAP, replaced by an energy I haven’t had since I was a teenager. My mood has improved dramatically, my short-term memory is coming back, and today I can endure a full shift at work without a nap or a gallon of coffee. I’ve been genuinely surprised to learn that someone in their 30s could feel this good without a martini in hand. At the same time, it’s unnerving to think about the dull, sluggish existence I’d resigned myself to for so long.

In theory, I’ll reap the benefits of sleep therapy for the rest of my life. Treatment for sleep apnea can improve mental health, lower your risk of cardiovascular issues and cancer, and even revitalize your sex life: Studies suggest sleep apnea treatment can also improve symptoms of erectile dysfunction. The CPAP is something of a miracle, and we’ve had access to the technology for more than 40 years. You’d think after a few decades we’d have cured sleep apnea altogether, and put a dent in America’s heart health crisis as a bonus.

But the disorder is pervasive as ever. It affects hundreds of millions of people worldwide, the majority of whom may never get a diagnosis, let alone treatment: Studies estimate between 30 and 50 million Americans suffer from sleep apnea, only about six million have been clinically diagnosed, according to the American Medical Association. A hell of a lot of patients are falling through the cracks.

Part of the issue stems from an information gap between the medical community and patients. Health agencies have warned in recent years that sleep apnea is underdiagnosed, and that doctors may be overlooking treatment as a preventative measure altogether. In 2021, the American Heart Association issued an emergency bulletin describing sleep apnea as “unrecognized and undertreated” in cardiovascular practice, and called for “increased screening and greater awareness of obstructive sleep apnea” across the healthcare industry.

“The field [of sleep medicine] has only been around for 50 years, and it hasn’t yet become a big part of doctors’ training,” said Dr. David Kuhlmann, director of sleep medicine at Bothwell Regional Health Center in Missouri and spokesperson for the American Academy of Sleep Medicine. “Sleep apnea is becoming increasingly recognized, but it still has a long way to go in terms of integrating it into mainstream medical practice.”

For patients, sleep apnea can be difficult to self-diagnose and easy to ignore. “It’s not like a heart attack or stroke where one moment you’re fine and the next moment you’re not," said Dr. Kuhlmann. “It’s a gradual decline, so it may not gain the same attention as something that happens more suddenly.”

For what it’s worth, my experience trying to get treatment was consistent with the AHA’s concerns—getting sleep care is a surprisingly difficult and solitary process. I wouldn’t have thought to get a sleep study at all were it not for my wife’s intuition. No doctor has ever suggested sleep medicine as a possible treatment for my symptoms, and workers at the sleep clinic were genuinely surprised that I found the place without a referral. From the outset, I was navigating my condition alone, and seeking treatment based on a hunch—I may as well have looked for answers on an angsty WebMD forum.

Getting insurance approval for my first sleep study was an agonizing, months-long battle that I nearly gave up on. My provider didn’t want to cover the cost of the study—totaling about $500, which is cheaper than a mammogram at a New York hospital—because I don’t share many risk factors with the average sleep apnea patient: I’m not obese, I’m under 40, my blood pressure is fine, and my neck isn’t thick enough to crush my airway in my sleep—which is a thing, apparently.

These barriers to entry for basic sleep treatment seem counterintuitive. Sleep apnea affects people of all ages and body types, and obesity isn’t even a risk factor for central sleep apnea, which involves brain signals as opposed to airway obstructions. From an insurance provider’s perspective, covering a $500 sleep study as a preventative measure seems like a wise investment when compared to a lifetime of treatment for diabetes or heart disease.

After a series of declined claims and unsuccessful phone calls, I nearly paid for the study myself. But my provider relented in the end, after my doctor suggested that my hallucinations were a risk factor for sleep apnea.

I spent a mostly sleepless night at a small, ramshackle clinic in South Brooklyn, hooked up to several dozen wires and belts that monitored my breathing and movements. I wouldn’t get my official results for a few days, but the technician who monitored me said the results were clear from the start of my test: “You definitely have sleep apnea,” he said. “Without a doubt.”

My results were shocking. I knew I was a loud snorer, but I didn’t know I was on a fast-track toward an early grave. Over the course of about six hours, I’d stopped breathing 199 times, placing me well above the highest severity threshold for sleep apnea. Each time I stopped breathing, my blood oxygen level plummeted from 94 to 87 percent, a dangerously low level that causes brain and heart damage, if not death.

With those results in hand, my insurance provider became much more accommodating though the rest of treatment. I had a CPAP within weeks, and as long as I use it regularly for the first six months, the machine won’t cost me a dime.

The process of getting sleep treatment can be opaque and frustrating. It requires a fair deal of self-determination, education and advocacy. But the benefits of CPAP therapy—even the short-term improvements to your daily life—vastly outweigh the pain of the process. If you’re tired all day, or you keep your friends awake with your snoring, or you suffer from terrifying hallucinations, consider this your wake-up call: Get a sleep study.