- The Loneliest Moon
Click for larger view
View full resolution
One of the most pernicious stages of insomnia is when it becomes an opponent. You want to outfox, outflank, out-smart it (lots of adversarial synonyms go through your head at three am). You spend much of your waking day plotting what tactics to use against it. In your head, you readjust your bedtime. If I wait until one am, I might sleep through the night. You calculate how much sleep you got [End Page 53] the night before as a prognostication of how much you’ll get tonight. It’s like an eating disorder, except the obsession is with hours slept instead of pounds lost. You strategize, you negotiate, you bargain to game an impenetrable system. And then, in the middle of the night when you’re wide awake, you realize that endeavoring to trick yourself back to sleep means the trick is on you. The insomnia has set a trap by making you believe it has a menacing existence outside your own conspiring mind.
I made an appointment for an overnight sleep study because, according to my wife, Emily, my snoring was becoming louder. Hooked up to a nest of wires running from head to toe, I took two hours and thirteen minutes to fall asleep. Eighty-two minutes later, the tech woke me up, found a mask that worked for me, and turned on the CPAP machine. I nodded off for another eighty minutes until the tech woke me at five am. She undid the belt monitor around my chest and peeled off the electrodes from my face and legs.
“Did I sleep enough?” I asked her. She’d been understanding about my trouble getting to sleep, about my requests for an extra blanket and (I’m embarrassed to admit) a night-light.
“Yes, we can get the data needed from even a few hours.”
“How did I do?”
“The doctor will let you know,” she said, smiling but noncommittal.
A week later the results came back. I had moderate sleep apnea. Most of my score was made up of hypopneas—slow or shallow breathing due to partial obstruction—rather than apneas—a complete blockage of the breathing. But neither was good. My throat closed enough during sleep that breathing was compromised. The treatment: CPAP, the gold standard for preventing future cognitive impairment, high blood pressure, heart attacks, arrhythmia, diabetes, and strokes.
CPAP at work on my nightstand, I fall asleep but take off the mask after an hour. Wearing the CPAP mask has been compared to sticking your head out a car window at sixty miles an hour. Not exactly conducive to that floaty feeling of sleep, especially if, like me, you tend toward claustrophobia.
When I explain that I’m having trouble adjusting to the machine, the doctor lowers the pressure. I also get fitted for a more comfortable mask. But that night, just as I’m drifting off, I jerk awake. It happens over and over, a sensation of being snapped back to consciousness by [End Page 54] the suspenders. Or being on the edge of a cliff and scaring yourself awake.
In two weeks I’m scheduled to teach at a ten-day writing conference. I start to mull over how little sleep I’ve gotten at this conference in the past. What if I really can’t sleep? Not the usual poor-me whine of martyred sleeplessness, hyperbolic in its cri de coeur over forfeited hours, but an absolute inability to stop being awake.
I listen to the whooshing of the CPAP mask—its battering ram of forced air to prevent the soft tissue in the back of my throat from collapsing. But I can’t stop thinking about going without sleep at the conference. Though I know it’s ridiculous to worry about it now, the worry grows tumid, feeding off some gathering force on the horizon that won’t let me fall asleep the remainder of the night.
I decide to put off using the CPAP until I get back from the conference. I should have known the pressure of trying...