After 32 years of going to bed wide awake, sleeping fitfully, then waking up tired, I'm finally ready to find a reliable solution. I did a sleep study years ago and the people at the sleep clinic determined that I had sleep apnea. For a while I found some decent ways to deal with it, but lately it's gotten much worse and I can't figure out how to cope with it. At this point I don't care if I have to wear a Darth Vader mask to get restful sleep -- I just want the problem solved.

So it's time to go back to the sleep clinic, right? I can't remember who I called before, so I did a Google search and found a local practice that specializes in sleep disorders. Perfect! I'll just call and make an appointment to see the doctor. Except nobody answers the phone at the doctor's office, and I hate leaving messages because it seems to me that they are rarely, if ever, returned. This particular office was a happy exception -- someone called me back about a half hour after I left the message.

You can't just schedule an appointment, because that's handled through the hospital's central scheduling service, even though I wouldn't be going to the hospital to see the doctor, and the practice is not located in the hospital. So the first call is to the billing department at the doctor's office to determine what my insurance supports. When I went for the sleep study years ago, I paid about $800 out of pocket, so I didn't have to screw with insurance, but that didn't matter anyway because I had a referral from a doctor, which is like a backstage pass that gets you an appointment to a specialist.

Some insurance companies require you to have a doctor's referral in order to see a specialist. Fortunately mine does not, but I had to call the billing office in order to figure this out. Good thing, too, because as I said in a previous post, my general practitioner doctor is an imbecile. So since I'm cleared to see the specialist, the next step is the appointment which, as I already said, I had to call the hospital for.

The hospital's scheduling office is a messy voice menu that of course does not have the option I need, so I have to wait until someone picks up the phone. Predictably, it goes to voicemail. Hang up, dial back a half hour later. Ah, now I've got someone! Unfortunately, she expects me to have every detail she needs in order to let me pass through the scheduling gate, when in fact I have no such details. I don't know which doctor I need to see because it's a practice with multiple doctors and I have no way of knowing which one needs to examine me... which is the fucking point of the consultation! But I can't schedule a consultation if I don't have details that I can't know until after the consultation.

"Just pick one and we'll figure it out later," I told the hospital scheduler. Well that is just not acceptable -- I need a referral or a "script," and that is Not My Job according to the scheduler. "I just talked to the billing office lady and she said my insurance doesn't require a referral. This is a self-referral," I assured her. Nope, can't schedule a sleep study without a "script," she insists. "This isn't a sleep study, it's a consultation," I tell her for the third time. Not My Job. Please hold while I transfer you to the sleep study office. Voice mail. Hang up.

So I call the billing lady back. Voice mail. Leave a message. Fortunately she calls back and says that yeah, hospital scheduling doesn't know what they're doing, but just call the sleep clinic office directly (a different office than the one the hospital scheduler transferred me to). This number is not listed on the practice Web site. She of course cannot schedule my appointment because it's Not My Job.

Sigh. Call the clinic office. Voice mail. Message. No one calls back. Jesus Fucking Christ. If these people can't manage basic communication, how can I trust them to be attentive to my medical needs?

Being a doctor is one of the few professions in the world that you don't have to be good at in order to keep getting paid. Patients just assume you're an expert and that you know what you're doing, but a lot of doctors are like the idiot I saw last week -- if pills can't fix you, then fuck off. A pharmacist could do that less expensively and more competently, and without shutting down the phones and locking the doors for an hour every day because of lunch. If you're a specialist, you don't have to worry about finding new clients and staying in business because patients have few or no alternatives. If you really screw things up, no skin off your nose -- you've got malpractice insurance.

So I'm back to square one, which is trying to solve my sleep problems on my own. Somehow I think, though, that I'm much better off this way.

I will never visit a doctor again. I'm fed up with what passes for medicine in the early 21st century.

Where do I even begin? How about with the phone call to set the appointment. Messages left after hours are rarely returned. If you call during lunch hour, nobody answers the phone because the whole office closes down while everyone eats for an hour with the doors locked and the phone off the hook. If you call on a Monday, nobody will answer because everyone calls on a Monday. If someone does answer, they will put you on hold for an indeterminate amount of time. Sometimes a long hold turns into a hangup.

Let's say you do get through and you make an appointment. If you show up on time for the appointment, you will have to wait. Doesn't matter when the appointment is -- you must wait some amount of time. However, if you're more than 30 minutes late yourself, you get charged for a missed appointment. If you show up one minute before lunch hour is over -- I have personally verified this -- the door is locked and you must wait outside until lunch hour is officially over.

The payment or co-payment must be made before you see the doctor. The doctor could walk out the back door and get on a plane to China, and your non-refundable payment has already been made. The doctor could walk in drunk and tell you to fuck off, and you can't get your money back.

Before you see the doctor, data entirely irrelevant to your visit must be collected: weight, blood pressure, body temperature, and heart rate. Even if something is wrong here, nobody really cares.

"Now let's look at your medications. Are you still taking x, y, and z?" Now I have to stop and think about it. I don't even know what some of those drugs are -- an anti-inflammatory agent for when I broke my arm years ago? Obviously I am not "on" that "medication" still. I don't think I ever was. Did I even fill the prescription when it was given to me? Apparently I'm expected to "be on medication" at any given time, because that is what you do in American health care -- you go to the doctor and you get "medication" and you take it until you die.

Now it's time for the second part of the long wait, this time in the exam room. Eventually the doctor walks in and asks me how I am doing. This is the third person who has asked me this question during my visit, and it's just small-talk, not an actual question about what is ailing me. That bothers me.

"So why are you here today?" she asks. "Well, I have a very hard time getting restful sleep -- the only time I'm ever tired is when I wake up in the morning, and--" She looks at the computer in front of her. "I see you have a prescription for ambien." I tell her yes, but I rarely take it because it doesn't help me stay asleep or wake up feeling rested. She shrugs. "Would you like a different medication?" I stare blankly at her a moment, then reply: "You're the doctor. I'm here to be examined by you so that you can determine a course of treatment that will cure me. It isn't up to me whether I should try a different drug."

This offends her, and she takes an attitude with me. "Well I don't know how to help you if you don't want different medication. So what else is bothering you?" I tell her I have an irregular heartbeat. "Well your EKG that the nurse took a few minutes ago doesn't show anything wrong." "Well then," I say sarcastically, "I must be imagining the sense of unease and panic that happens when my damn heart stops beating for a moment." This upsets her even more, but let's be honest, she has every right to be upset when I'm being sarcastic. I'm never sarcastic unreasonably, though. I am sarcastic because someone is being obstructive or antagonistic. My relationship with my doctor is now adversarial; I feel I have wasted my time and money, and she feels that I'm being a pain in the ass because I don't have simple problems that can be solved with drugs.

"Have you seen a psychiatrist?" she asks coldly. "For what? Being sarcastic in the face of unreasonable customer service?" I ask. "For your sleep problems." "What has that got to do with sleep problems, and furthermore what has that got to do with my heart problems?" She purses her lips and squints at me. "It sounds to me like you have problems that a psychiatrist could help with." Alright, now she's insulting me. "A psychiatrist is not going to cure my heart arrhythmia, nor will he help me wake up feeling rested." She grumbles and proceeds to fuck around on her computer in silence for a few minutes. Doctors were so much more attentive to patients when they didn't have computers to type on.

Then it's time to examine my knees, because that's another reason I'm in there. When I bend my knees and put a lot of weight on them, they hurt a lot, but in normal activity -- walking, running, even kicking in Karate class -- they are fine. The doctor, unsurprisingly, finds nothing wrong with my knees. She prints out a referral to a cardiologist and an orthopedic surgeon and hands them to me. "Make sure they take your insurance before you make an appointment with them."

So I return home, $20 poorer, minus one hour of my life, still suffering from insomnia and sleep apnea, still suffering from what I have self-diagnosed as an atrial fibrillation, and still dependent on over-the-counter painkillers for what might be the early stages of a serious problem with my knees that could end up leaving me unable to walk someday. I may as well have gone to the grocery store, bought $10 worth of Aleve and $10 worth of beer. It would have taken less time and made me feel better about how my money had been spent.

My real problem is that there is no meaningful treatment in Western medicine for anything that isn't a cut, a bacterial infection, a broken bone, or a well-known life-threatening disease. Even the treatments for those things don't usually require a doctor to fix unless surgery is involved. So I will never go back to the "general practitioner" doctor again. Next time something in my body isn't working right, I'll attribute it to aging and entropy and get myself a shot of whiskey.

The first real friend I ever had was also my best friend for a long time. We met on the bus in first or second grade, and spent many afternoons and weekends together. Over time we grew apart; while I was introverted and shy, he was outgoing. In high school, "outgoing" turned into "a loud and obnoxious liar." He lied about anything and everything -- he simply said whatever he had to say in order to impress whomever he was speaking with. His library of lies continually unshelved on his head throughout high school, and probably continues to this day for all I know. He stole both of my guitars and my father's wood router while lying to me about them being stolen from him. He was a real mess.

I should be glad to be rid of the guy, and actually I am -- he was not a very good friend, but for a long time he was the only friend I had. He was also the only social life I had. So when he got himself a steady girlfriend when we were 15 or 16, I was pretty devastated when he stopped calling me to hang out. No more after-school adventures, no more pizza party sleepovers, no more watching violent R-rated movies together. At first I was hurt -- I felt abandoned. Then I was angry -- I met his girlfriend and she expressed immediate and unrestrained contempt for me. I don't recall her even talking to me despite my efforts to involve her in some of the regular topics of conversation for my friend and me. So she did not like me and that was the end of the three of us spending any time together. My friend belonged to her, and she did not allow him any spare time for other people.

Now that was a pretty rotten thing for her to do, but she was 16 years old and felt threatened by the person who used to take up all of her boyfriend's time. Weeks would go by and I'd hear nothing from my friend. I'd call him and leave a message, or talk to him for a few minutes, but I wasn't able to arrange much time with him. Suddenly I was the one doing all of the calling and planning; it was no longer a 50/50 effort. He wasn't opposed to hanging out with me, but his social needs were more than met by his girlfriend, and since we were now in high school (different schools, though), he had other friends whom he saw on a daily basis, and he didn't need to make time for any of them because they were in his classes with him.

For years afterward, I hated his girlfriend for stealing my best friend. It sounds petty and melodramatic, but I had a very hard time making friends when I was kid, so losing my one best friend was a huge loss for me.

Over the years I have faced many similar situations, though they were much less polarized, and I was usually on the other side of them. I was often the third wheel hanging out with couples. Sometimes I was even the fifth wheel with two couples. I didn't particularly mind this -- it didn't make me feel lonely or left out -- but in retrospect, I was a real pain in the ass for a lot of my friends who had girlfriends. A lot of the time that they would have spent together, they ended up spending with me as well. In one case, a friend of mine broke up with his girlfriend and though it was hard for him to go through, I felt great about it because I thought his girlfriend was an asshole. Actually, all of his friends thought she was an asshole. I'm surprised they were together as long as they were, and everyone was glad when she was finally out of his life. But still, I should have felt badly for him for having to go through that nasty breakup.

I wish I could say that my single adventures during my teens and 20s were in the style of What About Bob or some other cute, comedic story, but they weren't. I wasn't the greatest friend to a lot of people because I was selfish and possessive. I've long outgrown these social shortcomings and have a much better sense of when I'm not wanted and when I'm taking up too much of someone's time, but I still see people around me trying to pull the same racket that I did when I was a teenager. Men and women of all ages get possessive over their grown children, friends, and siblings. Girlfriends are possessive of their boyfriends and vice-versa. It really bugs some people that the person they love and cherish can have separate but equal platonic relationships with others. Occasionally this leads to sabotage -- of friendships, of romances, and of families. The most toxic kind of "friend" I've ever encountered sabotaged the romantic relationships of her female friends so that she could have more time with them, then ditched all the same (now-single) pals when she found a boyfriend.

Stop and ask yourself if you're sabotaging someone's relationship. Are you forbidding your daughter to see her boyfriend? Making it difficult for your wife to play tennis with her friends? Trying to get the girl you have a crush on to dump her boyfriend? Making perpetual plans with your best friend because you don't want to lose her to her new boyfriend? Destroying or hiding heirlooms that belonged to your wife's previous husband? There is no end to the ways that you can poison other people's relationships, but when it's all over, whether you are successful or not, you end up taking the same poison you unleashed on others. Your efforts are always discovered, and you will henceforth be known as an evil manipulator. If you are involved in any of this bullshit, do yourself and your friend/partner/family member a favor and quit being petty and selfish.

That's the last thing I'd have thought would cause depression, but this Reddit thread seems to indicate that at least three women who have been depressed and suicidal have found respite in ceasing birth control treatment. And they were using three different methods!

I have been reading up on what women find attractive in men, and the collection of findings I have come up with is pretty surprising to me. It turns out that women who have a higher than normal testosterone level tend to be attracted to high-testosterone men -- bald/balding, hairy, physically large in some way. I always thought those kind of men were universally regarded as gross. Now that I think about it, though, most of the women I have met over the course of my lifetime have been attracted to that archetype.

And the rest of them have been attracted to me. Clearly I do not fit the high-testosterone image. I am youthful, pretty, and generally well-groomed -- what you might call boyish, which, when you think about it, is not really that much different from girlish. Many gay men and women have openly expressed attraction for me, but the women I tend to like don't usually go for my type. Thinking back on my attraction history, the women I have most desired have fit two categories:

• Older than me, sometimes by a significant margin.
• Thin. I have never been in the least bit attracted to women with fat rolls or a puffy face.
• Tall, as in 5'6" or taller.
• A low-pitched voice, though this is not something I actively seek out -- it's just an observation of preference.
• "Striking-looking" -- some feature about her face that really intrigues me. Oddly-colored eyes, a pretty smile, or something like that.
• Small-breasted, though again, not by my preference necessarily -- it just happens to be a common trait among them.

And the other, less common type:

• Younger than me, or the same age.
• Short, as in 5' or so.
• Large-breasted (well, larger than the first type, but not huge, you know?).
• Big-eyed, as in large, round, intoxicating eyes.
• Not quite thin, but not fat... Unlike men, there are some female body types that can wear a little extra fat quite well.

In terms of personality, my preference has always been:

• Tough, as in someone who doesn't lose their shit in a crisis or emergency. As much fun as it is to role-play the romantic savior from time to time, I think of someone who needs constant saving as being high-maintenance.
• Intelligent -- I am strongly attracted to women whom I can discuss ideas and theories with. Moreso than any single physical trait, this is what primarily attracts me.

You could say that the first type is generally a lower-estrogen type than the second. That is interesting because I've also come across some research that suggests that men's preference in women changes with their own testosterone levels, which can be affected by environmental and emotional factors. What it boils down to is, when men are doing well in their lives, they tend to prefer women who are high-estrogen types, and when they are feeling down or doing poorly, they prefer older women with less estrogen-suggestive features. Women, it seems, do not unconsciously change their preference under any such conditions.

Furthermore, the second type of woman is rarely attracted to me, except in unusual circumstances. For instance when I was an interactive Renaissance performer and had some facial hair (a sign of higher testosterone), I found more of the high-estrogen types attracted to me.

Interestingly, young girls -- even under the age of 10 -- have been openly attracted to me. That's no surprise, considering the popularity of boy bands among the same demographic. I have even seen girls lose their attraction to me as they get older; that makes me think that as their level of estrogen increases to adult levels, they start to be more attracted to high-testosterone men.

What's really got me thinking, though, is the exceptions, not the rules. We are a highly evolved species that came from a simple, brutal existence in which physical traits subconsciously told us which members of the opposite sex would make the best children with us. We have come so far from that, and today's subconscious indicators are undoubtedly different. The most intelligent people I've ever met have the fewest children, and the stupidest and least educated people I am aware of seem to reproduce like crazy. There are many possible theories for why this is true, but at the core of all of them is one ugly truth: The exceptions seem to be more highly evolved, but are less likely to reproduce.

I think of myself as an exception in many ways. I am not a high-testosterone type. My personality is not in line with most men's, or even most people's. I have a relatively new (in terms of human evolution) blood type. I never formed any wisdom teeth. I do not feel a deep hunger to be married and have children. When I find someone I want to have sex with, I want to have a lot of sex with them, but I don't actively seek out girlfriends and have little interest in dating a variety of women.

I am clearly an exception, but the question is: Are the exceptions highly evolved, or are they genetic throwaways? After much thought and reading, I am leaning toward "highly evolved" (as arrogant as that surely sounds). I think that the selfish human need to pass on one's genetics to another generation is gradually receding. In its place is self-selection, which considers the future of the species itself rather than that particular individual's genes. A single human being's need to pass on his genes to future generations is not necessarily the best way for the species as a whole to evolve. What if some guiding force were to make breeding decisions for us, like farmers and biologists do with plants and animals? We'd evolve really positive traits very quickly!

But there is no authority (sorry to ruin the parade, but there is no god), and so I think that we have accidentally evolved to become more self-selecting in our reproduction. This is evidenced in the exceptions, who are more strongly attracted by emotional, behavioral, and psychological traits than they are by purely physical traits. For instance, I have seen my own attraction for some women wane because of their personalities -- I've gone from strongly attracted to not at all attracted with no change in physical traits, and I have seen the same in others. There are some people, however -- what I might secretly call less evolved people -- who do not lose their attraction to their ideal mate no matter what their personality is like. I think most of them just blunder in to having children naturally; If having children is a conscious thought for you, and you hesitate because you question your abilities as a parent or the suitability of your genes, then you're in some way self-selecting and, I say, more evolved.

It's an interesting topic, and I will continue to read and think about it. If you have read this far, I'd appreciate your insight and observations -- leave a comment below.

A few weeks ago I took my motorcycle into a repair shop to have the rear tire replaced. The mechanic and I walked outside to the bike and we each crouched down on opposite sides to try to read the tire specifications written on the sidewall. He found it before I did, so we both stood up to walk back inside.

The moment I was fully upright, there was a searing pain in my chest, and I felt lightheaded. Then everything started to go gray. At first I thought it was a head rush, but when my arms began to go numb, I immediately assumed the worst. Somehow I made it back inside the shop. I leaned up against the service desk for a moment while I tried to will myself back to normalcy. The mechanic, not noticing my well-hidden distress, said we had to go over to the parts counter to look for a replacement tire. I managed to follow him the 20 or so feet to the parts department, all the while my arms losing feeling, my vision fading, and with a lingering chest pain.

The world began to seem unreal. It was at least 90 degrees outside and I was in full street riding gear; I was sweating, but shivering because I also felt unbearably cold. I leaned back against the parts counter, still hiding my impending doom from everyone around me, when I came to the realization that this was the end of my life. I'd torn an aorta, or had some heart defect, or through some crazy malfunction my heart had gone off rhythm and I was going to die within the next few moments.

I was sure that I was finished, but I did not feel sad, angry, or scared. My life did not flash before my eyes and I had no worries about how my end-of-life affairs would be taken care of. There was nothing but grim acceptance. I thought briefly about trying to make it out to the parking lot to see Suzanne one last time, but then figured that there was no need to cause her any added grief. I looked around me for a good place to fall, but I did not want to give up my last thread of consciousness yet. I did not want to see myself falling to the floor; I just wanted it to happen without my guidance.

But it didn't happen. Instead I turned around to face the parts guy, who took one look at me and said I was pale and clammy and looked like I was horribly ill. I told him I did not feel well, that perhaps I stood up too quickly while we were out looking at the old tire. I told him I was going to go and sit down in the waiting area. He offered a drink, but I refused -- I didn't figure it would help, and I wasn't sure I had any time to wait around for him to return with a drink. I concentrated hard on making it to the chair in the waiting room, and managed to get there without falling down.

I felt much better once I was sitting down, but much of my upper body still felt numb, I still had some lingering chest pain that occasionally spiked to nearly unbearable levels, and it felt like my head was filled with seltzer. By the time I'd agreed to the tire cost and the repair, left my key and got back to the car, I was in much better condition.

So what happened? The best I can figure is a combination of things... first of all, I really did stand up too quickly and got a head rush from it. In the process of standing up, I must have exacerbated a pulled muscle in my chest -- probably something that I'd done the night before when I was at the gym, but didn't really feel until I pulled it while standing up. Thirdly, the combination of the chest pain and the head rush made me think that I was having heart trouble and that I was going to die. While I did not panic or in any way lose my cool, it seems that I had a panic attack. Apparently panic attacks don't just happen as a result of layered, long-standing anxiety disorders, but also in moments of brief surprise or panic. Sometimes you can have a panic attack just by being alarmed or frightened for a moment. There's no reasonable explanation for it as far as I know -- it's just a weird glitch in some people's brains. Perhaps it is a side effect of synesthesia (a sort of internal mixing of the senses), which I definitely have.

Anyway, this little episode made me feel pretty good once it was all over, because I didn't panic. I held it together and kept going. Not many people can do that.

I've struggled with sleep problems for years -- mostly insomnia and sleep apnea. In all of the research I have done over the past two years on sleep apnea, I have not found a single resource that offers more than a lengthy explanation and some cures and solutions that I find unappealing. So this post represents everything I have learned about sleep apnea, having suffered from it for an indeterminable amount of time.

Causes and symptoms

Let's start by defining the sources and results:

• It can be hereditary: I do not have sleep apnea in isolation. Both of my brothers and my father have suffered from sleep apnea as well.
• It's not just for fat people: People commonly think that only obese people get sleep apnea. While I think that my apnea is worse when I'm heavier, it is more likely that the apnea caused my temporary weight gains. In any event, I've had sleep apnea at 165 pounds, and at 210.
• It makes you gain weight: Related to the above point -- lack of restful sleep reduces your metabolism. A good friend of mine started on CPAP to cure his apnea and lost more than 20 pounds in a month.
• Smoking exacerbates it: Inhaling any kind of smoke, be it tobacco or marijuana or anything that affects your throat and lungs can cause slight inflammation that will lead to sleep apnea.
• It can be seasonal: For me, it's really bad in the winter.
• Alcohol doesn't help: Alcohol relaxes your muscles, including the ones in your throat.
• Sleeping aids can cause it: Like with alcohol, sleeping pills (both over-the-counter and prescription) will relax your muscles, potentially causing or worsening sleep apnea.
• Sleeping position can affect it: For some people, sleeping on their back is the worst possible thing for sleep apnea. For others, it's the only position that is immune to apnea.
• It's not always a throat problem: If your nasal cavities are clogged, too narrow, or in any other way have difficulty passing enough air to breathe comfortably, your body is forced to switch over to mouth breathing. Mouth breathing causes sleep apnea. It could also be a tongue problem, if your tongue relaxes back and covers your airway.
• It doesn't always happen right away: Sometimes sleep apnea can be latent in your sleep cycle. If you wake up with a really clogged nose, that's a good sign that you could have latent sleep apnea -- you sleep just fine for a few hours, until your nose gets clogged with dust and mucus and you switch over to mouth breathing.
• Caffeine can cause it: I find that if I have two cups of coffee at any time during the day (even in the morning), I have a lot of difficulty getting to sleep at night, and when I do get to sleep, it is not at all restful. I wake up the next day in that morning-after-sleep-apnea morass.

Treatments and cures

So in addition to the advice implied above, how do you make it go away?

• Breathe Right strips: These are the band aid-like strips that you frequently see professional football players wearing over the bridge of their noses during games. These strips make it much easier to breathe through your nose, even when you have a cold. They come in three sizes and you can pick up a package of Breathe Right strips from your local drugstore for a few dollars.
• Tone your throat muscles: Take up opera singing or playing a wind instrument. The didgeridoo specifically has been shown to reduce or eliminate sleep apnea symptoms if you play it regularly. You can pick up a really nice one from LA Outback for around $100.
• Massage the affected muscles before you go to sleep: When you get into bed, massage the muscles that line the underside of your jaw. Get your finger right up underneath the inside of your jawbone and work out the kinks. Then massage the area between your chin and neck. Then gently grip your neck with the tips of your fingers (kind of like you're going to choke yourself with one hand) and massage your neck. Feel around for tight muscles. After about five minutes of this massage routine, you should feel like your throat and tongue are much more agile. In addition to over-relaxed muscles, I think that cramped throat and neck muscles also contribute to sleep apnea.
• Continuous positive airway pressure (CPAP) machinery: People who use CPAP say that it works really well, but to me, being hooked up to a machine every night for the rest of my life is not an acceptable solution. I am not Darth Vader. How do you travel? How do you go camping? How do you get laid for cryin' out loud!? The machine needs extensive daily maintenance and costs anywhere from several hundred to a few thousand dollars upfront. This is the most common western medicine "cure" for sleep apnea.
• Chinese medicine: Where western medicine fails, traditional Chinese medicine often succeeds. In this case, many prominent Chinese herbalists/acupuncturists have effective cures for sleep apnea. Don't let a Chinese doctor's weird mystic talk about chi, heat, and phlegm disturb you -- just nod your head when they talk, and take the medicine they give you. The long and short of it is, Chinese medicine either treats sleep apnea as a phlegm problem, or as a symptom of a larger systemic problem. Some Chinese doctors will want to know exactly when you are waking up during the night because that tells them what part of your body is in distress. Whether that's what it is in reality or not doesn't matter. The initial visit plus follow-ups and medicine can run you anywhere between $150 and $400.
• Surgery: I did a lot of reading about this on the Web. The general consensus among people who have had the surgery is that it doesn't usually work as intended. Some people are cured, but most seem to have continued sleep apnea problems. Some had some unexpected side-effects or complications. It's also very expensive. Chinese doctors will tell you to never have this kind of surgery. Personally, I'm not going to have any part of my body removed unless it's a life-threatening situation.
• Get a mouth guard: Do you grind or clench your teeth while you sleep? If you don't know the answer to this question, I'm sure your dentist does. Get a good mouth guard designed for this purpose (the cheaper sports ones will work too, but I've found the kind made for nighttime use to be much more comfortable). It's possible the teeth grinding is part of what's waking you up and contributing to your apnea.

Diagnosis

From what I understand there are actually two types of sleep apnea. The most common one is a physical problem in your throat, which is what I'm talking about in this article. The less common one is a brain malfunction that causes you to temporarily stop breathing while you sleep. As far as I know, only obstructive sleep apnea is reliably treatable.

The only way western medicine will diagnose sleep apnea is with a sleep study. This is where you go into a clinic or hospital, a technician glues a bunch of probes to your head, and then you're watched via cameras while you sleep. I went in for a sleep study and it was miserable. I don't remember sleeping at all, but apparently I must have, because the technicians recorded a dozen or so sleep apnea incidents during the night. Other people I know who have done sleep studies were offered a CPAP machine after the apnea becomes apparent to the technicians. I wasn't, and I don't know if that is normal or not.

I think sleep apnea is at the core of a lot of related health troubles. When my apnea was at its worst, I suffered from a number of unusual health problems -- mostly digestive. I became suddenly and inexplicably lactose intolerant for a week or so on two separate occasions. I've gained as much as 30 pounds without any change in my diet and exercise regimen. I've become sporadically gluten intolerant when the apnea is particularly bad. The worst, though, was back in high school when I was diagnosed with depression. I'm not sure that there was a chemical problem with my brain -- I don't think I was really suffering from clinical depression in the traditional sense, because all of the anti-depressants the doctors prescribed (three or four different ones in increasing doses) never had any noticeable effect on the way I felt or behaved. One thing I do remember about that period of my life was that I was horribly tired at all times. I'd get home from school and I'd feel so wiped out that I could hardly walk, then take a 2 hour nap before dinner, wake up more tired than I was when I went to sleep, spend another hour recovering from the nap, and then finally start to come back to life while feeling like I'd just gotten done crying profusely. Several doctors told me that this was a symptom of depression, but I am now convinced that it is the other way around -- sleep apnea and insomnia led to health problems and depression.

The sudden and dire urge to take an afternoon nap still hits me sometimes. I'm still not sure exactly what causes this to happen, but my analysis suggests one of two possibilities: A high carbohydrate or caffeine intake during the day, or a side-effect of sleep apnea the night before. Or both. Or maybe eating too much sugar and gluten and caffeine causes sleep apnea. I haven't figured it out exactly.

I know that my father has had sleep apnea for a long time because he snores loudly when he sleeps, and I could frequently hear him stop breathing while he snored. He'd seem to wake up a little, then go back to snoring. I believe he now uses Breathe Right strips to cure his snoring and his sleep apnea.

Conclusions

So that's everything I know about sleep apnea thus far. If you have more information -- especially if you know of any cures or treatments that I did not list here -- post a comment.

Sources

I don't have my original list of sources, but a lot of my information came from reading posts on The sleep apnea support forum. You can also use a variety of different terms in Google to look for specific research, studies, and personal experiences related to the treatments you are interested in learning about.

What worked for me?

Ultimately I took a number of approaches to cure my sleep apnea, most of which are listed above. The basics are that I don't drink caffeine after noon; if my nose feels a little constricted before I go to bed (if I can't take a deep breath through my nose comfortably), I'll use a Breathe Right strip; and I spend at least five 30-60 minute cardiovascular workout sessions in the gym or playing sports each week. I'm convinced that getting good exercise and keeping my heart and lungs in good shape is a major factor in curing sleep apnea. I am also trying to keep my weight down, but that is always a challenge. I sleep much better at 175 than I do at 190, but it is very hard for me to maintain that weight. I have an intolerance to wheat gluten, and I've found that if I eat too much wheat (not very much at all, really), I can have trouble sleeping.

The Chinese medicine did work while I was at my worst with sleep apnea. I didn't do acupuncture; I was presscribed various blends of really terrible-tasting herbal teas that had to be brewed manually from bags of herbs every three days. While this may work, it is also expensive, and the Chinese doctor is a good 45 minutes away from my house, so it's not a solution I'm all that comfortable with if there are good alternatives.

I know I've gotten a good night's rest without apnea if I have vivid, uninterrupted dreams, and wake up feeling good. If I wake up feeling more tired than when I went to bed, then I know it's been a bad night, and I take extra measures to make sure the next night's sleep is apnea-free. Like my weight, this will probably be a lifelong battle for me, but everyone's got health problems to deal with, really.