BREAKER ONE-NINE. Pull up a stool. This won't take long, and it might save your life, or the life of the family in the minivan next to you.

I'm Bart Quackenbush. I'm 38 years old and I've pulled a refrigerated trailer out of Terre Haute, Indiana, for sixteen years, mostly meat and produce, mostly east-west on I-70 and I-40, with a good bit of everywhere else. I've got a wife, Sheryl, two girls, Emily and Nikki, a mortgage, and a clean record. I'd never had so much as a fender-bender.

And in March of 1998 I fell asleep at the wheel of a loaded eighteen-wheeler at twelve noon on a sunny day.

My Story | What Sleep Apnea Is | The CPAP Machine | A Word to Drivers | CPAP On the Road

MY STORY

I was westbound on I-70 in western Kansas with a load of boxed beef for Denver. Flat, straight, nothing but wheat stubble and grain elevators. I'd had a full eight hours off the night before at a truck stop and figured I was fresh as a daisy. Truth is I'd felt tired every day for about five years, but I figured that was just the job. Everybody's tired. You drink another coffee and roll the window down.

Next thing I knew there was a noise like the whole trailer was coming apart, BRRRRRRAP, and I was on the rumble strip with my right wheels on the shoulder. I hadn't seen the last mile. Not one bit of it. I don't remember closing my eyes. I got it back in the lane, and my heart was going so hard I could hear it over the engine. I took the next exit and sat in a gas station lot for an hour with my hands shaking.

If that rumble strip hadn't been there, or if there'd been a car on the shoulder, or a bridge rail, I wouldn't be writing this. Somebody else might not be reading it. I think about that every single day. Every single day.

I called Sheryl from the pay phone. She was quiet a second, and then she said what she'd been saying for years and I'd never listened: "Bart, you snore like a chain saw, and then you stop. You just stop breathing. I lie there and count. Then you gasp like you came up out of a swimming pool and start snoring again. Go to the doctor."

So I went to the doctor.

THE SLEEP STUDY

My family doctor listened to the whole thing, looked down my throat, took my blood pressure (high, which surprised me and didn't surprise him), and sent me to the sleep lab at the hospital for an overnight study.

It's not bad. Don't let it scare you off. You show up in the evening with your pajamas and your toothbrush, and they've got a room like a motel room with a camera in the corner. A real nice tech named Trisha glued a bunch of little wires to my head and face, put a couple of stretchy belts around my chest and belly to measure breathing, a little clip on my finger for the oxygen, and a sensor under my nose. Then she said goodnight and watched me from the next room all night long on her screens. I was sure I'd never sleep with all that on. I was asleep in fifteen minutes. Of course I was. I'd been tired for five years.

A week later the sleep doctor sat me down with the results. I stopped breathing, or near enough, more than forty times an hour, all night. Each time my oxygen dropped, and my brain woke me up just enough to gasp and start breathing again, but not enough for me to remember it. So I'd been "sleeping" eight hours and getting maybe two hours of real sleep. For years. Behind the wheel of a truck.

Severe obstructive sleep apnea. That was the name. I'd never heard of it. Now I can't shut up about it.

WHAT SLEEP APNEA IS

I'm a truck driver, not a doctor, so here it is the way the sleep doctor explained it to me, in plain English.

When you fall asleep, the muscles in your throat relax. In most people the airway stays open anyway. In people with obstructive sleep apnea, the soft parts of the throat sag and close off the airway, like a wet paper straw. You keep trying to breathe but no air gets through. Your oxygen drops. After a few seconds, sometimes most of a minute, your brain panics and kicks you just awake enough to snort and gasp the airway open. Then you fall back asleep and it happens again. All night. You don't remember a bit of it. You just wake up tired and don't know why.

Warning signs. If you've got two or three of these, go get checked:

	Loud snoring. The kind people complain about through motel walls.
	Somebody's seen you stop breathing in your sleep, or heard you gasp or choke.
	Sleepy in the daytime even after a full night in the bunk. Nodding off when you're stopped, at the dock, in a waiting room, at a red light.
	Headaches in the morning.
	High blood pressure.
	Waking up with a dry mouth or a sore throat. Getting up a lot at night. Being cranky and foggy. (Sheryl says I was a bear for years. She was right.)

Carrying extra weight makes it more likely, and so does a thick neck, and it runs in families. But skinny guys get it, women get it, and I've met a couple of drivers in their twenties who've got it. Don't decide you don't have it because you don't look the part. Only a sleep study can tell you.

Untreated sleep apnea isn't just about being tired. The sleep doctor told me it's tied to high blood pressure and heart trouble, and of course to falling asleep at the wheel. The good news is that it's treatable, and the treatment works.

THE CPAP MACHINE

CPAP stands for Continuous Positive Airway Pressure. It's a little box about the size of a lunch pail with a quiet fan in it. A hose runs from the box to a mask you wear over your nose (some folks use a mask over the nose and mouth both). The machine blows a steady stream of air into your nose at a pressure your sleep doctor sets, and that air pressure holds your throat open like air in a balloon, so it can't collapse. No collapse, no stopping breathing, no gasping, no waking up forty times an hour.

My sleep doctor had me come back to the lab for a second night with the machine on, so they could find the right pressure for me. Then the equipment company set me up with my own machine and showed me how to work it.

Getting used to it. I'm going to be honest, because the guy who set me up wasn't. The first week was miserable. It felt like sticking my head out the window at sixty-five. The mask leaked and blew air in my eyes. I pulled it off in my sleep and woke up with it on the floor. My nose dried out. Sheryl said I looked like a fighter pilot. (I told her thank you. She said it wasn't a compliment.)

Here's what fixed it: the equipment company swapped my mask for a different size, twice, until one fit right. They added a heated humidifier to the machine for the dry nose. And I made myself wear it every single night, even when I hated it, even for naps.

And then. About the tenth night, I woke up at five in the morning before the alarm, and I didn't know what was wrong with me. Nothing was wrong with me. I was rested. I hadn't felt that way since I was about twenty-five. I sat on the edge of the bed and laughed out loud and Sheryl thought I'd lost my mind. My morning headaches quit. My blood pressure came down. I quit drinking a pot of coffee a day. I have not drifted onto a rumble strip since, not once, not even close.

Sheryl sleeps through the night now too. She says the CPAP is the quietest I've been in fifteen years of marriage.

CPAP isn't the only treatment. Some people do well losing weight, some get a mouthpiece from a dentist that holds the jaw forward, and some have surgery on the throat. What's right for you is between you and your doctor. CPAP was right for me.

I run my machine every night in the sleeper off a power inverter. If you're a driver wondering how that works, or what to do about distilled water and cold nights, I wrote a whole page on it: CPAP On the Road.

A WORD TO DRIVERS

Driver to driver, no preaching. Just this.

Drowsy driving kills people. You know it, I know it. We've all seen the wrecks at three in the morning with nobody else involved. A lot of those aren't drunk drivers and they aren't bad drivers. They're tired drivers.

Know your hours, and know they're not enough by themselves. Under the federal hours-of-service rules, you can drive ten hours, and then you need eight hours off duty before you drive again. Those rules are the law and you ought to keep a straight logbook. But here's what nobody told me: eight hours off duty doesn't mean eight hours of sleep, and if you've got sleep apnea, even eight hours in the bunk might give you two hours of real rest. I was legal every mile and I still fell asleep at noon.

Warning signs on the road: you can't remember the last few miles, you miss your exit, you drift onto the rumble strip, your eyes burn, you keep yawning, you catch your head bobbing. Any one of those and you need to get off the road. Not at the next truck stop forty miles up. Now. Ramp, rest area, wide shoulder if you have to. A load can be late. A dead driver can't be on time either.

Coffee and the window and the radio don't fix it. They buy you a few minutes, maybe. The only thing that fixes tired is sleep.

If you snore, get checked. Ask your wife. Ask your team driver. Ask the guy in the next bunk at the terminal. Then go see your doctor and ask about a sleep study.

About your medical card. I know what you're thinking, because I thought it too: if I tell the doctor, I'll lose my job. I was scared to death of that. I told my doctor everything anyway, and here's what he told me: a driver who's been diagnosed and is using his machine every night is a whole lot safer than one who's falling asleep and hiding it. I passed my DOT physical this summer with no trouble. Rules and situations are different, so talk to your own doctor straight. But don't let fear keep you from getting help. The fear of losing your license is nothing next to the fear of what I almost did on I-70.

WHERE TO GET HELP

Your family doctor. Start there. Tell them about the snoring and the sleepiness and ask about a sleep study.

A sleep center. A lot of hospitals have a sleep lab now. Your doctor can refer you.

The American Sleep Apnea Association. A national group for people with sleep apnea. They have information for patients and families, and they can tell you about support groups for CPAP users.

Me. I'm not a doctor and I won't pretend to be. But if you want to know what the sleep study is like, or how a mask feels after eleven hours at the wheel, write me. I check my e-mail at home on weekends and sometimes from the library at the terminal.

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visitors since October 1998. Keep the shiny side up.

Last updated Wednesday, September 22, 1999, from home in Terre Haute
I'm a driver, not a doctor. This page is my experience. See your own doctor.