column gray 032715

This month marks a year and a month since I entered the world of the CPAP Nation.

If you are considering the CPAP for sleep apnea, I strongly suggest you check out part one, then come back and read part two, as part one is a highly detailed write up of what a CPAP does, why you might need it, and the mountain of data about the benefits of this device as well as a question and answer with Dr. Mari Viola-Saltzman, Expertise: General Neurology, Sleep Medicine, Board Certified, Neurology, Sleep Medicine.  Invest the time you would waste tonight on social media and do something right now and read part one. The CPAP might be the single most important thing you do for your powerlifting outside of the weight room.

With regard to part two, the saying, “I wish I knew then, what I know now,” has never been more appropriate. If I knew years ago, what I now know about the effectiveness of the CPAP, I can tell you I would have run to the nearest sleep study facility and put that weird fighter-pilot looking mask on my face right then and there.

As you have now read part one, you know what got me to the point of having the sleep study, you now know the process involved in the sleep study and which sleep study to have, you know about the stages of sleep, you know the dangers of sleep apnea and sleep deprivation, and you also know the research based data that strongly backs the efficacy of the CPAP.

My purpose for this follow-up is to share with you, powerlifter to powerlifter, my personal experience with the CPAP, the good, the bad and the ugly, and how it has served to benefit my powerlifting

Let’s start with the ugly: Basically, the CPAP looks ridiculous. No, I really mean that. It is this clear, see-through mask that has a hose attached to it, and that hose runs from the mask to the side of a little high-tech box that is about the size of a box of pop tarts…(Mmmmm, pop tarts).

The first time I put the thing on at home, I looked over at my wife and she just laughed because it looks ridiculous. I was thinking, at minimum, they could have at least put a logo on the plastic mask so it would like Bane from Batman, or maybe have a saying written it like, “Don’t wake the sleeping giant,” or “One more rep!” But no dice, it is just fairly silly looking. Having said that, you only wear it when you are going to sleep. Since when did a powerlifter take two seconds thinking about how they look? Honestly, half the time as a male powerlifter, you are walking around with pieces of food hanging off or stuck to your beard, so clearly appearance is not paramount to happiness. This ugly mask is 100% about our sleep and it is that deep stage four sleep that equals true recovery from the training.  As for the ugly part of the good, the bad, and the ugly, cross “ugly” off of the list because it really does not matter.

eric CPAP

The bad:  There are a couple of things that fall into the bad category.

First: The lack of information about the CPAP experience in general from the CPAP folks that you consult with on how to use the CPAP.  You learn all about the benefits and how to use it information, but what you need is the real info to get you through the first psychological barrier with this apparatus. For example, the CPAP at first wear feels like you are putting on an astronaut’s helmet and then trying to sleep with that on. The mask is attached to set of straps that go from one end of the mask, around the back of your head and to the other side of the mask, and the mask, once on your face (over your nose and mouth) feels simply huge.

Second: Another piece of real information is that there is a thing called a CPAP pillow. Pretty much the greatest pillow for your head ever invented, but the “bad” is, this is not a piece of information you are told about, but find out later from other CPAP users after you have tossed around at night trying to get your pillow to work with and not against your CPAP mask.

Third: Another “bad” is that when you initially wear the mask you psychologically have the feeling like you can’t breathe, like you are not getting enough air into the mask from the hose. The reality is, there is actually a far greater amount of air flowing through that mask via the hose than you actually breathe in when not wearing the mask. That little trick the mind plays on you is called ‘perceived oxygen debt.’ This little tidbit would have been nice to know as then you can better mentally prepare for that eventuality. For weeks, I thought my CPAP machine was just not working properly.

The nice thing about all the “bad” is that all of these things are really not bad, and in truth, they all go away after sometime wearing the CPAP for that first few weeks.

PART 1: Is the CPAP the Ultimate Performance Enhancer? 

For example, after about 8-12 weeks, about the time of a long training cycle, the mask no longer feels huge and you actually forget it is on because after a time, this Pavlovian effect starts to occur. That effect is this, you put the mask on and as the mask is now associated with actual deep, restorative sleep, you fall asleep much faster than when you were sleeping without it. The reason for that deep sleep is of course the lack of apneas via the air pressure that you read about in part one.

Personally, I also recommend just looking at yourself in the mirror with this thing on your face when you first get it. That allows for your eyes to give your brain the true perspective of dimension, as seeing the mask as it is, a little piece of see-through plastic that covers your nose and mouth vs how your body perceives it. Seeing it in the mirror gives you enough visual perspective to override the feeling of it being overtly large. Another tip to consider while getting used to the CPAP is to see the CPAP as a means to an end, meaning a tool to enhance your lifting. Think of the CPAP like your own personal sleeping environment or mini-hyperbolic chamber. Half of the psychological battle of getting past the initial oddity of this device, just as it is in lifting, is your mindset. For some, this is not an issue; they put the CPAP on and never look back. For me, it was a bit of a learning curve.

Clint CPAP

Clint Darden

This brings me to a digression I will call, CPAP Tip #1.

REMZzzs. This is a product (google it) that if you have facial hair, and you wear a CPAP will make your sleep inordinately better. The CPAP mask won’t properly seal to your skin if you have facial hair (which a good majority of male powerlifters have) and the lack of that seal causes air leaks that can minimize the air pressure and also cause noise, like air escaping from a tire. Both of these things caused by the leaks interfere with your quality of sleep. The REMzzzs, is a thin soft cloth-type material that goes between the mask and your facial hair thus creating a seal and negating all the sound and pressure loss issues.

Moving onto the CPAP pillow. The CPAP pillow is a must for a few reasons. First, it is unbelievable comfortable, and two, the shape of the pillow keeps your head still and very comfortable when sleeping on your back so that you don’t accidentally knock the mask off your face when rolling over. This is where you say, “Yeah, but I can’t sleep on my back.” That is true, as sleeping on your back when you have apnea, only makes the apnea worse, which is part of the magic of the CPAP. With the CPAP you can sleep on your back, and that position alone will do amazing restorative things for many hip and back issues.

On to the oxygen debt feeling. The cure for that is initially just wearing and turning on your CPAP during a weekend afternoon, while you are merely sitting up watching something on TV or reading a book or checking your Instatweetfacepinterestumblergram pages. There is something less threatening/mysterious/unsettling about wearing something foreign on your face with a hose attached to it during the day then trying this at night when everything is quiet and all you can do is think about how weird the whole CPAP device and experience is.

So, like the “ugly,” the “bad” is not really bad as the things you didn’t know about the CPAP going into it, you will easily plow through and none of them are really much more than a learning curve as well as minor inconveniences.

Lastly, but of the most importance, the “good.” You can read the volumes of research on the CPAP and see the benefits, so I will just share with you what I experienced. For me, it took about 12 weeks before I really felt comfortable in my CPAP as I had to discover all the little tricks and such I detailed for you in the “bad” section. You are going into this CPAP experience now armed with these tricks on the front side, so they will be of value to you and this information will serve as a catalyst toward you reaching the deep stages of sleep at a much accelerated progression.

kirschen CPAP

Dave Kirschen 

Once I began sleeping fully at night, there were a number of very significant things that happened and over time those occurrences became more and more pronounced. The first thing you will notice is that you will actually sleep through the entire night.

Full night of sleep: Prior to getting the CPAP, you are suffering from sleep apnea and because you never really reach a deep stage of sleep, your kidneys/bladder don’t get the signal from your brain that you are in deep sleep, because with sleep apnea, you don’t reach a deep healing sleep, thus the body thinks you are still awake and it will continue to produce waste products at the rate it would during your actual awake time. Thus, most powerlifters with sleep apnea have to get up a number of times at night to use the rest room. I know through countless conversations with powerlifters who have a CPAP, that without exception, none of them were sleeping through an entire night due to this issue and after the CPAP they are able to reach a deep sleep, thus they would finally experience a complete night’s sleep without interruption.

Nodding off: Prior to the CPAP, and one of the reasons for getting the CPAP was that in my experience, I was plain old falling asleep during the day. I would get up in the morning, feel tired, drive to work sleepy, as well as finding myself having to take a quick 10 minute cat-nap in my car when I got to the gym. What surprised me to no end was with one single full night’s rest with no apneas, literally the next morning upon waking I was not tired. I remember driving to work and feeling awake and aware and feeling that way throughout the day and throughout the workout after work. About 12 weeks into the CPAP I took my last nap as I simply do not need one now, and that was completely unexpected. The reason for nodding off, if you have this issue, is also explained in part one, and that is key for you to know.

Hypertrophy: As the time progressed, around the three to five month period, I found my energy at the gym was higher as was my stamina.. I began to add some reps to my working sets, then I found myself adding additional sets, and ultimately adding completely addition exercises to my training as I had to energy to do so. The downside is muscle hypertrophy, as I put on 22 pounds in 13 months. This was the largest gain in skeletal muscle in one year that I have experienced since my first year of powerlifting way back in the late 80’s. As I monitored this increase in skeletal muscle, I also monitored my waist and body fat, which simultaneously diminished. That all being said, I suppose that hypertrophy could be looked at as a downside as you will be in a bigger weight class and your gear will need to be adjusted if you train and compete in gear. The point being, it is the sleep that allows for the recovery and that becomes exponential over the year. It also means you can train much longer and with greater weight as your body is actually recovering each and every night.

david allen CPAP

David Allen

Glasses: I wear bifocals and six months or so into the CPAP, I went to the eye doctor because I felt my eye sight was really getting bad. Everything up close with the bifocal was fine, but my vision with regard to things far away was getting progressively more blurry. After my eye exam, the eye doctor said my prescription for my glasses was “too strong,” thus the blurry vision. I asked if the CPAP could have anything to do with the fact that I now needed less of a prescription and it turns out that improved eye sight is very common with the CPAP. One reason is that at night the blood oxygen level is increased (I detail this in part one) and that helps your eyesight as well as the fact that the tiny filters in your retinas also work better as the filtering occurs the most during a deep sleep. Lastly, as it relates to your eyesight, the increase in blood oxygen also lowers your blood pressure, thus the combination of all three of these things caused me to get glasses with a milder prescription. As far as your eyesight for the up-close reading portion of glasses, that unfortunately is about age and the CPAP can only help with the far away aspect of eye sight. Sorry, master lifters.

Mood: Nothing can make you more cranky than getting up for work and just being exhausted, day after day, month after month, year after year. Not that any powerlifter is a joy to be around in the morning, but again, after that sort of magical three to six month period there was a huge differentiation in affect when comparing sleep deprived vs with restorative sleep via the CPAP.

Although eyesight and body weight are measurable, some of the most telling data came in the form of my yearly blood work and physical.

For my work, I have a physical and blood work done in August. For the most part, my numbers are the same year after year, but this year, the year after the CPAP, the numbers in the area that relates to powerlifting were drastically better.

Blood pressure:  Virtually every day my BP now vacillates just under that magical 120/80 (today was 112/80). This is due (again, see part one for the details) to the extra O2 your body is getting without sleep apnea. When your body is not getting the full complement of O2 due to sleep deprivation, the adaptation is the rise in one’s blood pressure as that serves to move more oxygen. Simply put, now that you are getting the full complement of oxygen during sleep, your body does not need to compensate by raising your blood pressure.

IGF 1: This is, in laymen’s terms, a way to measure your body’s production of natural growth hormone. This is something most master lifters monitor and the difference after the year of real sleep was so pronounced that I had that test run a second time to make sure the test was not somehow incorrect.

steve CPAP

Steve Goggins

Although not something I have had to personally deal with, the positive effects on blood glucose levels with those who struggle with this issue is another area that is positively impacted by the CPAP benefits. In fact, there are studies showing even one night of sleep deprivation can significantly impact these numbers, so one can easily speculate the damage caused in this area by nights, months, or years of sleep deprivation on blood glucose and one’s health.

If you have taken the time to read this far into this article, you most likely have concerns about sleep apnea and are considering the CPAP but for whatever reason you have not gone through the sleep study. The point I am trying to drive home to you is this: sleep apnea, thus sleep deprivation is the number one thing destroying your powerlifting, more than bad nutrition, more than a poorly constructed training program, even more than skipped training sessions. More than anything ,your body requires a restorative night’s sleep and it requires this each night, every night, day after day, month after month, year after year, decades after decades. When the body is not getting the proper repair, this will result in the lifter never reaching their true strength potential and ultimately will result in injuries that will mount up, one after another, after another. Those compounded injuries and the effect on your general health will also only exponentially increase the detrimental effects on your lifting. The CPAP, as goofy as it looks and as weird as it initially feels, is the only way and the 100% way to destroy the negative force on your powerlifting goals.

A true aside: I was emailing back and forth with Mark Watts of elitefts as I was getting ready to travel out to the elitefts compound in London, Ohio this summer for The elitefts Powerlifting Experience II. I was telling Mark that I was a little concerned who my elitefts roommate for the hotel was going to be during the trip, because I didn’t want to ‘weird someone out’ when I put this Darth Vader looking thing on at night. Mark just laughed as the joke was on me because — he told me that a large number of the guys on team elitefts have a CPAP. This information was just one more additional affirmation for me, because team elitefts is pretty much a who’s who in powerlifting, and clearly they place a great deal of value in restorative sleep as part of their overall powerlifting big picture.

Let me put it bluntly, when guys like Vincent Dizenzo and the legendary Steve Goggins travel with their CPAP and use it each night, and they swear by it's life-enhancing worth, you really don’t need much more of an endorsement than that.

So, keep in mind what I said in part one. if you are a male and have a neck that is 17+ inches (if you have been powerlifting for a while, this is likely the case) and you always, and I mean every day, feel tired, you should consider having a sleep study done. Once you have that information from the study, if sleep apnea is what is causing those tired feelings, do the single most important thing you can do for your training and powerlifting: get the CPAP and use the CPAP. It simply does not make sense to train as hard as you do, watch your nutrition like you do, put together and follow a meticulous plotted out training program, spend your hard earned money on supplements, and then negate all that by being sleep deprived each and every single night of your life.

Header image courtesy of Grant Pullin, Dave Kirschen, and Clint Darden

Eric Maroscher's Coaching Log