Sleep Health

More and more people need to rely on ventilators to fall asleep.

At first, they thought they were just snoring and didn't take it seriously. Later, they would wake up frequently due to suffocation, so they chose to see a doctor and were diagnosed with sleep apnea syndrome.

Among every 100 people, 11 are patients with sleep apnea syndrome. In severe cases, the duration of apnea can exceed two minutes. In the long run, it seriously endangers physical health and may even cause sudden death. Currently, the treatment methods for sleep apnea are limited, and wearing a ventilator is one of them.

In order to sleep soundly, young patients choose to wear ventilators and rely on external force to maintain their breathing during sleep.

1. Sci-fi Sleep

Qu Ge couldn't fall asleep successfully on the first night he wore the ventilator.

The mask was firmly fixed on his nose and mouth by the tightened bandage. He carefully lay flat on the bed. Then, he turned on the machine, and a strong airflow began to fill in, surging into his throat along his nasal cavity. Qu Ge's airway obstruction was below his Adam's apple. The originally wide airway was squeezed into a narrow slit by the diseased throat wall here. Qu Ge felt that at the moment when the obstruction was opened by the airflow, sufficient air quickly filled his lungs, and he felt relieved.

Before the excitement brought by smooth breathing dissipated, Qu Ge began to feel a bit of pressure. The ventilator adjusts the gas pressure according to a person's breathing frequency, but when a person first falls asleep, their breathing is not uniform. Qu Ge forced himself to adjust his breathing, trying to make it uniform and match the frequency of the ventilator.

But the more he focused on breathing, the more rapid his breathing became, and he started to race against the airflow of the ventilator. In a short while, Qu Ge began to gasp for breath, and sweat broke out on his forehead.

Seeing Qu Ge's painful appearance, his wife couldn't help but take a few more glances: the mask on his face was connected to a plastic tube with black and gray metal wires with spiral patterns. His wife thought Qu Ge looked just like a science - fiction monster in the movie, "sleeping in a bit of a sci - fi way".

After tossing back and forth several times, Qu Ge finally felt a bit sleepy with his eyes tightly closed. He unconsciously turned over, and a gap appeared in the mask tightly covering his nose and mouth. The pressurized gas hissed out and sprayed on his face. Qu Ge woke up completely. He looked at the clock, and it pointed to three o'clock in the morning.

Qu Ge's ventilator was purchased based on the doctor's diagnosis to help him fall asleep.

In May 2021, after experiencing several episodes of being suffocated and awakened during sleep, 34 - year - old Qu Ge decided to see a doctor in the respiratory department. After the doctor's judgment, he was very likely to have sleep apnea syndrome. So, he was referred to the sleep clinic of a hospital. After sleep monitoring, the doctor found that Qu Ge had frequent episodes of apnea during sleep, with the longest one lasting 50 seconds. Due to insufficient breathing, the oxygen content in the blood of his brain was only 90% of that of a normal person.

After being diagnosed with apnea syndrome, the hospital arranged a general anesthetic surgery for Qu Ge to find the cause. A robotic arm with a camera was inserted into his airway and lungs through his nostril. As a result, it was found that there was a lesion in the throat below the Adam's apple, and the swollen throat wall squeezed the airway.

Generally speaking, airway obstruction is caused by polyps in the nasal cavity or throat, which can be removed through surgery. The throat wall is thin and fragile, and surgery cannot be performed. After careful consideration, the doctor advised Qu Ge to wear a ventilator to sleep to expand the airway and prevent suffocation.

With the memory of being suffocated and awakened during sleep, sweating profusely still fresh in his mind, Qu Ge decided to wear a ventilator. He chose a single - level home ventilator produced abroad. The whole machine was only the size of a sewing machine and weighed 1.21 kilograms. In order to moisten the airway, this ventilator also had a small water tank to provide water vapor. But now, the ventilator that was supposed to help him sleep completely ruined his sleepiness.

Different from Qu Ge's resistance, Andy regarded the ventilator as a kind of salvation for himself.

Eight years ago, 28 - year - old Andy was diagnosed with sleep apnea syndrome, and the doctor also advised Andy to wear a ventilator to sleep. At that time, his salary was not high, but he gritted his teeth and bought a machine worth more than six thousand yuan. He wore it for a year and then took a break for a year. By the fourth year, Andy felt that his physical condition was getting worse. Andy bought a brand - new ventilator and required himself to wear it at least six days a week.

The ventilator Andy used was equipped with a nasal mask. The triangular nasal mask only covered his nose completely, which reduced the situation of air leakage. After adapting for half a year and taking sleeping pills for a week as instructed by the doctor, he gradually got used to sleeping with the ventilator. After that, he felt that his body was a bit stronger with good sleep.

During the epidemic, Andy had a bad cold, and his nose was blocked for five or six days. This was what Andy was most worried about. The airflow of the ventilator passed through the nasal cavity, and if the nose was blocked, the machine would be useless.

Like Qu Ge and Andy, an increasingly large group is falling asleep with the help of ventilators. The report "Obstructive Sleep Apnea and the Global Economic Burden" published in 2019 by the internationally renowned medical academic journal The Lancet Respiratory Medicine showed that sleep apnea has affected the health of more than one billion people worldwide. Among adults aged 30 - 69, there are 936 million patients with mild - to - moderate symptoms and 425 million patients with moderate - to - severe symptoms.

The data is astonishing, but "Obstructive Sleep Apnea - Hypopnea Syndrome (OSAHS)" or "sleep apnea syndrome" is still a vague disease for most people. Suffocation during sleep can lead to insufficient oxygen in the blood of the whole body, especially the brain, inducing many diseases such as headaches and fatigue, and may even lead to sudden death.

After several painful nights, Qu Ge finally found a breathing rhythm that was compatible with the ventilator and finally managed to sleep until dawn. He found that after a sleep with sufficient breathing, the dry and bitter taste in his mouth disappeared, and the headaches that often bothered him before were also gone. He joked with his wife that "he had to be a bit sci - fi" for the sake of sleep.

2. The Suspected "Killer"

For five years, Qu Ge attributed all his physical discomforts to rhinitis and pharyngitis. In 2014, when he was 27 years old, he was transferred to work. When he first came to this city, it was often shrouded in smog. Like many southerners, he felt uncomfortable as soon as he took a breath.

Before long, something was wrong with his throat. Especially after starting his own business, he needed to talk every day and have in - depth conversations with a dozen or so groups of people every week to discuss projects and build relationships. Once, he recorded a course for someone until four o'clock in the morning. After coughing a few times, there was a smell of blood in his throat.

Gradually, Qu Ge would feel a dull pain in his head after getting up in the morning, which was a sequela of brain hypoxia. Not knowing what was going on, he could only ask a massage therapist to press the Fengchi acupoint below the back of his head. He would scream in pain but only then would he feel a bit better. He also quit smoking and drinking and bought many kinds of medicines to treat rhinitis and pharyngitis.

These were the treatment methods he could think of on his own, but they were all wrong.

The condition did not improve. By the end of May last year, Qu Ge took a leave and went to the hospital. In the respiratory department outpatient clinic, people waiting to see this disease lined up in the corridor. In the ward, a 21 - year - old male college student shared the room with Qu Ge. The boy was in his junior year. He snored very loudly in the dormitory. After being disliked by his roommates, he came to the hospital specifically to see a doctor.

At first, Andy didn't take the diagnosis result seriously either and didn't wear the ventilator properly. He used to be the person in charge of an auto show for a certain car brand. He had five or six periods of high - intensity and intensive work every year, each lasting for half a month and more than 12 hours a day. He had strong communication skills and was gentle - natured. But in those years, he suddenly became irritable and lost his temper with customers, colleagues, and family members several times.

In others' eyes, Andy seemed to have changed. His memory also declined a lot. He couldn't remember the names of the people he was talking to. After several work mistakes, he thought it was because he couldn't bear the work pressure, so he transferred to the back - office and became a supervisor engineer.

While losing control of his temper, Andy would always feel sleepy during the day and fall asleep instantly. During that period, as long as he got out of the busy work and got in the car, he would start snoring loudly within 5 to 10 minutes. Once when he went back to his parents' house, Andy fell asleep on the sofa. His father took a video of him. He was in a light sleep, and his breathing kept pausing during the snoring. He was urged by his parents to go to the hospital for an examination and spent a night in the ward with a sleep monitoring device.

The next day, the examination report showed that Andy had severe sleep apnea syndrome. He had more than 200 episodes of apnea in one night, and the longest one lasted more than two minutes. Generally speaking, if apnea lasts more than four minutes, irreversible brain damage will occur, followed by brain death.

After truly understanding sleep apnea syndrome, Andy finally realized that being irritable, having memory loss, and even having high blood sugar were all caused by low - quality sleep due to snoring at night and long - term insufficient blood supply to the brain.

Snoring at night is quite common, but most people don't know what it means and ignore its harm. Professor Ye Jingying from Tsinghua Changgeng Hospital believes that snoring and insomnia are the two major sleep problems faced by humans. Obesity, a small jaw, and genetic factors are the main causes of snoring. For women, a decrease in estrogen and progesterone levels can also cause snoring.

Andy was puzzled as to why he couldn't catch his breath while snoring.

3. Coexisting with the Ventilator

According to the doctor, after Qu Ge's throat lesion, his throat wall collapsed, squeezing the space for air to pass through smoothly; the narrowest part of Andy's airway was only 3 millimeters, and his small jaw easily led to poor breathing during sleep. Andy considered having surgery to expand the airway, but he wasn't very confident. He then found an expert in the respiratory department, who told him that having surgery wouldn't solve the problem once and for all, and there was a high possibility of a recurrence.

In mid - March 2021, the "2021 World Sleep Day Series Live Events" were planned by The Physician. Professor Wang Hanqiao from the Sleep Medicine Center of the Third Hospital of Hebei Medical University said that sleep apnea syndrome is closely related to many chronic diseases such as cardiovascular and cerebrovascular diseases, hypertension, and diabetes.

"The data shows that 60% of sudden deaths that occur in the early morning are caused by sleep apnea; among patients with ischemic heart disease, previous stroke, and transient ischemic attack, 25% - 60% have sleep apnea; the incidence of hypertension among sleep apnea patients is 49.3%; among patients with refractory hypertension, 83% have sleep apnea."

"A lot of people think of the life - saving ventilator in the ICU (Intensive Care Unit) as soon as they hear about a ventilator. They think that if they wear it, they're done for. What will others think of me?" said Deng Wenli, who sells ventilators. He has contacted thousands of sleep apnea syndrome patients. Among these people, those aged 20 - 50 are in the majority, and there are more men than women. 60% of the causes are obesity, which leads to airway stenosis, and the other is that as people get older, their muscle tension decreases.

After contacting more patients, Deng Wenli sometimes feels helpless. "Some people have had this disease for a long time but didn't pay attention to it. They only think of wearing a ventilator until apnea threatens their lives."

After wearing the ventilator, having a good sleep has become more and more particular for Andy. First of all, it's about the pillow. It can't be too high or too low. He always keeps three pillows at home. One is a hard pillow filled with buckwheat husks, and the other two are soft pillows filled with cotton, which he uses alternately.

Andy thinks that wearing the ventilator makes cold air enter his intestines, causing gastrointestinal discomfort. He can't help but want to hug the pillow and sleep on his side wrapped in the quilt, but this sleeping position is contrary to the habit of wearing the ventilator mask. In the end, Andy can only try to turn over as little as possible and place pillows on both sides of his body. In the past two years, whether he is on a business trip or going back to his parents' house, Andy will arrange the pillows in the room in advance.

Secondly, it's about the position of the bed. Andy has found a pattern that he can only fall asleep when he lies on the right side of the bed with his head on the headboard. Also, a cold is a big enemy in his life because it can block his nose. So Andy is very careful. He has quit smoking and drinking. When it's cold, he takes a taxi to and from work to avoid catching a cold.

Once, Andy's boss explicitly asked him to drink at a banquet. He could only quietly tell the boss that he wears a ventilator to sleep at night. The boss didn't say anything more. Most of the time, he chooses to keep it a secret. He never takes a lunch break at the company for fear of snoring when he sleeps. He also can't bring the ventilator to his desk to arouse his colleagues' curiosity. He is worried that in the competitive workplace, if someone knows he has this disease, challenging work opportunities may slip away from him.

After wearing a cheap ventilator for three years, Andy bought a relatively expensive new machine as recommended by the hospital. After trying it on for one night, Andy sent the usage data of the machine to the manufacturer and then received new parameter suggestions from the manufacturer. He is constantly exploring how to use the machine more comfortably and how to improve his physical condition.

Last year, he joined a WeChat group for patients. Some people in the group shared their newly - bought masks, pillows, and their usage effects. Andy thought this was a new starting point. He finally found an organization where he could exchange information. Here, everyone is discussing how to coexist harmoniously with this disease.

Qu Ge's ventilator is still in the stage where it's difficult to use. He doesn't ask others for help and tries to figure it out on his own. Generally, around midnight, when the WeChat work group becomes quiet, his day finally relaxes. If he is very sleepy that night, he will put on the ventilator before 12 o'clock at night and can fall asleep. If not, he will turn off the ventilator, put a pillow behind his back, and try not to snore.

Out of a sense of shame about the disease, 35 - year - old Qu Ge is very reluctant to accept that he is a patient with moderate sleep apnea syndrome. Sometimes, he deliberately doesn't wear the ventilator for fear of becoming dependent on the machine. He is losing weight. He walks to the company from home every morning, which takes more than an hour. In winter mornings, when the temperature is below zero, he still persists, hoping to lose weight as soon as possible and get rid of the excess fat on his neck.

During this one - hour walk, Qu Ge doesn't think about breathing. He listens to some audio courses to make the journey less monotonous. It's not easy to stick to exercise, but he has a firm wish: to get rid of the ventilator.