It is hard to know the truth about this story, but there may be a lesson in it with wide applicability. I will just write the truth as I know it, then pose a few questions at the end that you may be able to answer—or at least guess at—on the spot, or at least develop an informed opinion that may be helpful in your particular situation.
My Particular Situation
While we were living in Lincoln, Nebraska, about 1997, my wife Ellen began to complain about my snoring waking her up, keeping her awake, and causing her to get up to face the day without a full charge of restful sleep. So I made an appointment with my internist to explain the situation and he referred me to a pulmonologist, a specialist in lungs and the respiratory tract. This includes that little flap near the back of the throat called the uvula that is often blamed for the noise-making during snoring.
My new pulmonologist was a lively and interesting guy. He was a little older than I was at the time, so he seemed to have a wealth of useful experience that supplemented his medical education. After explaining my wife’s increasing fatigue and growing irritation with my snoring, sometimes involving a sharp elbow to my ribs that disturbed my own sleep, he knowingly nodded his head.
After he examined me, asked as many relevant questions as he could conjure up, and fully sized up my story, he said the first step was to undergo an overnight sleep test in a lab. While not a comfortable night’s sleep, the test was definitive in that I did not have sleep apnea and, therefore, would not have to learn to sleep with a mask to aid breathing and halt my snoring. The cause of my snoring was something else, but it wasn’t clear to me what it was.
Be a Guinea Pig?
In the next breath, the doctor reached in a desk drawer and handed me a business card of a pulmonologist in New York City who had developed an experimental surgery that was helping patients with symptoms similar to mine. My first reaction was, “I love New York City and this would give me a good excuse to go back!”
The pulmonologist’s next comment surprised me a bit, “Well, if you go to this New York surgeon, let me know how the surgery works for you because my wife complains about my snoring the way your wife does and I may decide to go there for the same procedure!”
My instant, laughing rejoinder was, “So you want me to be your guinea pig?” He laughed and paused a bit, apparently realizing what he had said to me sounded a bit out of the ordinary for doctor-to-patient advice.
Finding Other Options
Then I said, “Well, I just might get this new surgery, depending on my wife’s reaction, but before I do, would you refer me to Mayo Clinic in Rochester for a second opinion?” He of course made the referral and soon I made an appointment at Mayo to get my snoring problem checked out there. Rochester, Minnesota, is only about 500 miles from Lincoln, so Ellen and I headed up there for what turned out to be a series of related appointments over a 3-day period. I soon learned something about why Mayo Clinic in Rochester is an internationally-renowned medical center.
A decisive appointment, near the end of my visit, with a young otolaryngologist—who I already knew from my long history of sinus infections was a specialist in ear, nose, and throat (ENT) issues—turned the earlier thinking in Lincoln about my snoring problem on its head. After looking over my sleep test results from Lincoln, my X-rays and blood work, and the doctors’ summaries of my previous appointments on this visit to Mayo, she began an extensive line of questioning about my snoring history.
Then she asked, “Has your wife ever had a sleep test?” I replied that she had not since I had known her.
She then said, “Well, it’s possible that something else wakes your wife up at night and while she is awake, she then notices your snoring and focuses on that as the cause. A sleep test for her should be the next step. Surgery for you now would be premature.”
Apart from the divergent but sensible thinking this young doctor brought to the consideration of my case, I was impressed that neither she nor any of the other specialists I saw at Mayo for my snoring problem, including one similarly thoughtful pulmonologist, had recommended surgery. I had heard that Mayo Clinic was generally known for not rushing anyone into surgery unless there was a compelling reason for it.
Breaking the News!
As soon as I saw Ellen in the waiting room outside that young otolaryngologist’s office, I broke the news to her that surgery was not recommended in my case, at least until after she gets a sleep test as well. Her reaction was not so much one of relief that I did not need surgery, but distress with the news that she needed an overnight sleep test in a lab, as I had done.
A strange thing happened over the next few nights back home in Lincoln. I began to sleep soundly through the night without a sharp elbow to my ribs. Ellen began reporting that she was sleeping better, too. Amazingly, she reported that I was no longer snoring and keeping her awake. More amazingly, no medical treatment had been prescribed for me at Mayo Clinic.
The Plot Thickens
Here are some questions I still have about this story after over fifteen years have passed:
- Did my conversations with Mayo medical personnel “cure” my snoring? I doubt it, but maybe my psychological reaction to those discussions reacted inside my head in something akin to the Hawthorne effect in which I modified my sleeping behavior just because it was then a subject of deep scrutiny.
- Did Ellen have such a guttural reaction to the idea that something besides my snoring may have caused her waking up in the middle of the night that she became reluctant to blame me for her waking? That’s possible, I guess.
- Or did the idea of undergoing her own sleep test seem so repulsive that she didn’t any longer mind my snoring, or that she blocked it out during the night? I suppose that’s possible, too.
Now, after the passage of all these years, things have changed somewhat. About three years ago Ellen saw a physician at an Austin sleep clinic after ongoing issues with sleep disturbances. Her diagnosis then was restless legs syndrome, or RLS, and she took prescription medications for it for a time, trying different ones to find tolerable side effects.
When she takes a medication for RLS, she doesn’t complain about my snoring. When she does not take one of those meds, she sometimes mentions my snoring. But she has stopped throwing a sharp elbow into my ribs when I snore, even before I recently broke a couple of them.
So What Does All This Mean?
One moral of this story is that when a seemingly wise doctor advises you to get an experimental surgery, get a second opinion before going under the knife. Another moral is when you think you know what’s bugging you, day or night, it could be something besides what you think. Our bodies are complicated, as are the often-mysterious workings of the brain, so we should be reluctant to diagnose ourselves and act on our own diagnoses.
That young otolaryngologist at Mayo Clinic was right when she said something besides my snoring might have caused Ellen’s sleeplessness. But it took a dozen years before a different doctor convinced Ellen that she needed a sleep test to know it was RLS instead of my uvula.
I urge you to check out Mike Hooker’s website on insomnia. He has been writing about it for years and I encourage you to see his blog, articles, reviews, and other resources.
Coming Full Circle
Life can be mysterious. It’s usually complicated. That’s why medical specialists often disagree, like judges in courtrooms, or economists in think tanks, or farmers in coffee shops. This is partly why people in general are so fascinating.
Now I’m solely responsible for leading you through all these inconclusive meanderings. I hope it was worth your time. Read it again when needed to induce sleep.
Sleep tight tonight.