Texas Rangers First Baseman Speaks About His Struggle with Sleep Apnea

Mike Napoli started his professional baseball career back in 2001, but it was not until 2006 that he debuted in the Major League Baseball, which was a milestone for him as he hit a homerun in his first match. His career continued to soar in the following years. However, in 2014, he suffered from few minor injuries and sleep apnea. The latter gave him difficulty functioning in matches and practices. He would miss or fall asleep during batting practices. He also would feels dizzy during the actual game as he was sleep-deprived. Because of this, he has considered retiring.

His Sleep Apnea through the Years

Napoli had this condition for eight years. According to him, he got away with it in his younger years by just taking a hold of himself, enough for him to function and get through the day. However, as time passed, his schedules became harder to manage and the stress that came with it made his sleep apnea worse. He became fully aware of his condition during the 2007 Playoffs. His mother stayed with him in his hotel as his sleeping patterns alarmed her. In an attempt to find a way to minimize, if not get rid, of his sleep apnea, Napoli tried the different treatments below:

• C-PAP: C-PAP is a breathing device, commonly used for adults with moderate to severe sleep apnea. This machine uses a mask that either fits over the nose or over the mouth and the nose. It blows air gently into the throat with the air pressure keeping the airways open while sleeping. According to the American Sleep Apnea Association, or the ASAA, there are 10 million Americans using this machine, and this number is increasing by 8 percent annually. Napoli has used the machine when he was younger, but like many other C-PAP users, the device is very uncomfortable to wear.  He had to wear it every night but would take it off when it started getting constrictive or itchy. Another reason C-PAP users stop using the machine is because it's a temporary solution. As it is not addressing the real cause of the problem, a person with sleep apnea has to always wear this machine.

• Dental Mouthpiece: Commonly called an oral appliance, a dental mouthpiece assists people with mild sleep apnea. This is a custom-fit plastic mouthpiece either made by a dentist or an orthodontist. During sleep, the mouthpiece will adjust the lower jaw and the tongue to keep the airways open. Like the C-PAP, this method does not give any long-term treatment as well. For patients with severe sleep apnea, it does not provide any relief. As expected, this did little to no comfort to ease his problem.

• Medication: As with most sleep apnea sufferers, Napoli tried different medications to cure his condition, but with time he felt worn out from taking all the pills. At one point he even used the C-PAP, mouthpiece, and medications altogether. Even after this, he would still wake up a few hours later.

Breathing Pauses Up To a Hundred Times a Night

ASAA estimated that sleep apnea affects 22 million Americans. Another study, which came from the American Academy of Sleep Medicine or AASM, shows that individuals with this condition are 2.5 times more likely to be driving, causing 6,400 fatal crashes caused by drowsiness every year in the US alone. Sleep apnea causes irregular breathing and snoring. This makes the individual momentarily stop breathing, which can cause severe exhaustion. Some breathing pauses can last more than 30 seconds. These breathing pauses may occur 30 times or more within an hour. It can also cause diabetes due to insulin resistance, metabolic syndrome, and liver problems if left untreated. After undergoing a sleep study, Napoli found out he was having breathing pauses for 40 to 100 times a night.

Making the Big Decision

In the late 2014 Season with Napoli running out of choices and his condition getting worse, he was left with either retirement or getting a major surgery. Finally, he made the decision of getting the surgery. This sleep surgery is called bimaxillary advancement surgery or most commonly known as maxillomandibular advancement (MMA). Originally, this procedure was used to correct jaw deformities. In this procedure, the upper jaw (maxilla) and the lower jaw (mandible) forward are cut and moved forward, thus enlarging the entire airway. This is the most effective treatment for moderate to severe obstructive sleep apnea. Small titanium plates, screws, braces, and rubber bands have to be attached accordingly to keep the integrity of the bite. The swallowing and the speech ability are not affected, but this does not mean that no pain, swelling, and numbness of the lower lip and chin temporarily are felt as side effects.

The surgery took eight hours to complete; after which, Napoli spent two days in the ICU. For six weeks, he was on an all-liquid diet and eventually lost 15 pounds. Currently, he still has two screws inside his skull, located in his sinus area. Understandably, these screws bothered a lot of patients, but according to Napoli, he would leave them there.

The Longest Three Months

For three months, he couldn’t do anything due to body weakness caused by a very restricted diet. His diet only consisted of shakes, smoothies, and pureed soups because even clenching his teeth was an impossible task. He hired a chef to prepare all his liquid-based meals and made sure to get proper nutrients, especially protein. His surgeons told him that he would feel his lower lip, front teeth, and the roof of his mouth again within a year, though there was a chance that the sensation wouldn’t come back. This didn't bother him at all. He continued doing his best to regain his health and eventually had his first real meal three months after the surgery from Ruth’s Chris Steak House. Concerned how he would look like chewing with his “newly constructed” jaw, he chose to enjoy his solid meal at home.

Dreaming Again

Napoli said that the best part of the procedure is having the ability to dream again. People with severe sleep apnea have difficulty dreaming. This is because dreams happen during the Rapid Eye Movement (REM) stage of sleep. Individuals with sleep apnea always wake up before entering this stage. This lack of REM sleep can cause problems in long-term memories, cognitive impairment, and depression. Napoli said that his dreams were so vivid that he has this strong urge to share his dreams with anybody. He would remember places and people he met in his dreams.

A New Chapter in His Life

Not only is he dreaming again, according to him, but he also feels more energetic than before. He became more active than the other players. His current physical and mental state is a far cry from his condition before. He looks forward to waking up in the morning and working out, an activity he once dreaded. Clay Buchholz, Red Sox Pitcher, said that before the surgery, Napoli always looked like a zombie that he was always worried on how Napoli would hit the ball. Now, even after the practice, Napoli’s energy is still up to the roof as he would run around picking up the balls.

People have asked him about the procedure, and he would openly talk about it. In fact, he highly recommends it to fellow sleep apnea patients. The recovery process is long and hard as it can take three months or more. Of course, the limited mouth movement affects the patient’s diet, which sometimes takes a toll on the person’s overall physical health. However, after experiencing life minus the sleep apnea, Napoli said it’s totally worth it.