Living with Sleep Apnea

Since young, I'd been living with a chronic sleep disorder that took a heavy toll on my daily function. This is an effort to share and celebrate an end to one of the most arduous chapters of my life

There is a common saying that goes: "fish discover water last". In most cases, it's used to convey that we aren't aware of the things we take for granted until they go missing. And it's usually intended as a forewarning against future disaster. In my case, the story goes a little differently.

In early June 2022, I was cured from a chronic disorder that hindered me from living a productive and fulfilled life for as long as I can remember. A condition that made me experience persistent tiredness during the day, rendered it almost impossible for me to follow conversations with others, prevented me from recalling anything more than fleeting details of everyday events, and drove me into depression twice. Over the past six months, it alienated me from friends and social activities. It made me question my values and abilities and feel like my entire life was a fraud. It briefly took away any sense of meaning and purpose I had in my life, and ultimately drove not only me but those closest to me to their breaking points.

That condition was sleep apnea.

It's hard to say what triggered the spiral - which seemed to take everything away at once - but in hindsight, it's clear to see that it was a combination of stressors in my life which triggered a bout of anxiety and insomnia towards the end of 2021. I'd recently ended a long-term relationship which was strained by poor communication and long distance. It was an emotionally trying period that prompted a lot of self-reflection, but I had a fairly stable routine, which helped to stymie some of the residual loneliness and longing I felt. At the same time, given that I had a lot more time on my hands, I also decided to take up further responsibilities within school and volunteering to challenge myself and meet new people. I applied to take an undergraduate research module in my upcoming semester, signed up as an education director for a mentorship program, and decided to devote a full day to volunteering on the weekends.

While I seemed to be coping fairly well in academics, I felt like I was regularly being pushed to the limit with my commitments, and I would end most days feeling mentally drained, even when I wasn't completing all the tasks I set out to accomplish. And while I'd completed my first summer internship as a software engineer, I was struggling to come to terms with the fact that I didn't really learn or accomplish all that much during that stint. I felt like my peers were doing much more - something that was difficult for me to accept, given my relatively good academic performance at the start of school. It was at this point that I started developing anxiety - arising in small moments of uncertainty and indecision - which further chipped away at my focus and resolve.

Due to a combination of poor planning and a lack of mentorship, coupled with an area of research that was far too technical, I wasn't able to complete my research module. In fact, by the end of the semester, I hadn't come up with any concrete deliverables at all. The final blow was coming to the realization - much later on in December - that many of my peers had already made preparations and were actively interviewing for tech internships for the next year - something that I'd completely missed out on. I felt the very same way that I did when I quit studying physiotherapy in 2018 - lost, alone, feeling like I was lacking in something, yet not knowing what exactly it was.

I remember that first night after the school term came to an end. I woke up in a cold sweat, checked my alarm, and realized that it was 3am in the morning - I had been asleep for barely 4 hours. My mind was in a haze, but my body refused to give me any further rest. I couldn't believe what I was experiencing. I devoted my time and effort regularly to journalling, meditation, gratitude, and exercise. I had an image of myself as someone who'd developed strong personal values after going through a period of mental illness in the past. Yet here I was, facing those very same demons I thought I'd vanquished in the past.

Blaming myself

The mind is an excellent storyteller. When faced with a contradiction, it tries its best to rewrite perceptions, cherry-pick from past memories, and come up with alternative explanations of events - all to form a coherent narrative and assure us that our lives are not spinning out of control. This was exactly what was happening for me in the beginning. I turned to journaling and self-reflection, trying to pinpoint what had gone wrong. I'd been a bad partner in my previous relationship - I was selfish and inconsiderate, and it was all my fault that it ended. I'd been too cold and unsociable around people, which caused me to miss out on opportunities to grow, learn and develop my skills. I'd taken the things I had for granted and didn't put in enough effort to treasure what I had. I didn't work hard enough.

I resolved to be better - to come up with a plan over the holidays and change my ways. I was going to work harder than ever before, implement more systems for accountability and habit-tracking, and put myself in more social situations. Only it didn't work. My anxiety was a huge weight on my mind, putting additional strain on something that was already close to breaking. I couldn't focus on any task for more than 5 minutes. No matter what I tried to do, there was a voice in my head casting doubt and indecision. I felt like I desperately needed a break, but I didn't want to fall further behind.

Spiralling

Eventually, the inner turmoil was too much to bear, and I went back for psychological counselling and psychiatric treatment. At first, I figured that I could just go back to my old dose of antidepressants, whilst seeing a psychologist on the side. After a month passed without any real signs of improvement, I began doing research on underlying conditions that could be responsible for my symptoms. My insomnia caused my memory, attention and cognitive capabilities to deteriorate further. I was incapable of making any long-term plans and woke up on most days not knowing how to spend my time. I didn't feel confident in going back to the school semester come January, so I applied for a leave of absence, citing mental health struggles. I became less involved in daily activities - gym, volunteering and keeping in touch with friends. On some occasions I'd reach out to some close friends and share my troubles - it made me feel a bit better, but the feeling was fleeting, and the next day I'd wake up feeling the same sense of anxiety and dread.

I was aware that I had sleep apnea as early as 2015, but I'd never sought any proper treatment for it prior, so at the start of 2022 I made an appointment with an ENT for a review. I was told it wasn't likely that sleep apnea was the cause of my insomnia - which often has a psychological root cause, and that the tissues in my airway didn't seem to have changed much since the last time I was assessed in 2018. The specialist ruled my condition as mild to moderate, and I was advised to try out a CPAP machine and see how I felt after a few weeks.

After two weeks of trialling a CPAP, I didn't feel any major improvements, so I decided to cease further usage. It was at this point that I basically ruled out sleep apnea as the underlying cause for my psychological and cognitive troubles, and started seeking out diagnostics and treatment options with different specialists.

I'll spare the more specific details, but I spent the next 6 months - January to June - in a state of limbo, seeking out specialists in the fields of endocrinology, neurology, psychiatry, scouring forums and articles on the web for information on conditions like ADHD, autism, hypothyroidism, borderline personality disorder and early-onset Alzheimers. I spent most of my days alone in my room. I tried to go back to volunteering and sought out some part-time work to keep me preoccupied, but my cognitive issues were so persistent that I could barely function in those contexts. While working part-time at a restaurant, I had to write down customers' orders immediately after they were mentioned, because I would have forgotten them otherwise. I felt anxious and uncomfortable when thrust into any social contexts, because I'd have to make up lies about how I was spending my time and living my life - to put up a facade that everything was fine when the reality couldn't be more different. I was cycling through cocktails of psychiatric medications - bupropion, valdoxan, lexapro, vortioxetine, clonazepam and more. And all this time, I was taking an emotional toll on my friends and family. I was completely dependent on my mum and grandma, and I felt so ashamed because I wanted nothing more than to be independent and to prove to them that I was capable of taking care of myself.

After spending so much time searching for an underlying condition to no avail, I wondered if I was just making excuses for myself - that there was nothing wrong with me, and all I needed was perhaps letting go of high expectations, pride, ego and emotional burdens. I felt gaslighted and was at my wits' end. I was actively contemplating suicide, because I couldn't see a single thing to look forward to in my future. I was convinced that I would remain as a recluse, locked away from the world physically and emotionally, living off my family's care until the day I died.

Faced with almost no other options and seemingly nothing left to lose, I decided to revisit my condition of sleep apnea, and made an appointment with a private ENT to seek out surgery this time. I figured that if I was eventually going to die, I might as well try every form of treatment available. I wanted to have hope that it would work, but I'd been disappointed by so many failed treatments before that I couldn't really bring myself to believe it. I told myself that if this procedure didn't work, I'd go ahead and end my life. At this juncture, I'd almost driven my mum to her breaking point as well. I didn’t want her to have to continue suffering - I wanted to bear the brunt of it all, and remove myself from this world along with all the pain and hurt. I couldn't bring myself to tell my grandma, knowing full well that it would break her heart. But in my mind, I was already hurting her to no end with the condition I was in. I convinced myself that she would suffer less without me around.

Post-op

To treat sleep apnea, I would be undergoing an operation for my upper nasal passage and throat. It was a combination of septoplasty, adenoidectomy, inferior turbinate reduction, uvulapalatopharyngoplasty and tonsil reduction. The day of the operation came, and I went in without any expectations. It was a day operation that only lasted for 4 hours in the morning, after which I was immediately discharged. I couldn't sleep at all on the first night, because of bleeding and the presence of two magnets placed in my nostrils to ensure that my nasal septum was straight. By the next day, however, the magnets were removed and most of bleeding had stopped.

Within just three days, I felt a complete difference in my energy levels. I woke up with vigour like I'd never felt before, feeling motivated do get things done, and looking forward to the day ahead. It didn't take long for me to get back in contact with old friends, pick up old hobbies and new ones, return to volunteering, and start making long-term plans for the rest of the year.

It's since been a month, and my life has changed completely. I feel more alert and dialed-in than I ever have my whole life. I've reconnected with friends from all my social circles and I'm actively involving myself in new activities to meet others. I can easily recall experiences and conversations from the past. I'm interested and curious about so many more things, and everywhere I look, I see opportunities to learn, grow, and develop friendships. I've since quit taking any psychiatric medications and other treatments. It's not a stretch to say that I feel like five times the person I was before. I feel like I finally know what it's like to be fully alive - something I've missed out on for the last 24 years of my life.

I could look back on all the things that sleep apnea took away from me - missed opportunities, strained relationships and poor health. I could be resentful for what I've been forced to endure through no fault of my own - the feelings of inadequacy which I coped with by being judgmental and critical of others, the lack of focus which made me feel like an observer in most social contexts, and the chronic tiredness which made me constantly question if I was just being lazy.

But that's all in the past now, and I'm just grateful to have had support from all the people who've helped me make it this far. If anything, this condition has made me a better person - because of what I've been through, I can have compassion for people struggling with debilitating conditions and mental illnesses, who have to exert a monumental amount of effort just to live a normal life. I'm going to spend the time that I have and the gifts I've been given to serve others as best I can. And if I can help it, I won't let anyone walk down the same path I did.

If you're reading this, and you know of someone going through a trying period in their life, please don't hesitate to reach out. I'm willing help in any way I can. I don't profess to know what they might be going through, but I know that it's always easier when you're not alone. And if you've made it this far, thank you for listening to my story.