Thursday, December 13, 2007

The Study of Sleep



Just a few hours ago, I returned home from an overnight sleep study. I always enjoy these diagnostic tests and studies since they afford me the opportunity to experience what my patients must endure. Just like my MRI, I treated the evening not only as a diagnostic test to ascertain the etiology of my own disordered sleep, but also as a study of the diagnostic study itself, and an evaluation of what these types of experiences are like for the average patient.

As I have consistently discovered, aside from the functionality of equipment involved, the personality and approach of the technician administering a diagnostic evaluation is likely the most important aspect of the test's administration (not to overlook the cooperation and open-mindedness of the test subject him- or herself).
Luckily for me, the technician who administered my sleep study was personable, affable, funny, competent, kind, compassionate, and apparently wholly interested in my need to have a positive experience, in spite of his own challenge of being a circadian-challenged worker. While he spent thirty minutes attaching numerous wires, tubes and electrodes to various parts of my body, our exchanges included an examination of his occupational challenges, the absurdity of the situation in an existential type of way, and the odd nature of sleep disorders. It is truly a gift when a skilled professional can transform a relatively uncomfortable experience simply through the power of their personality and approach to the task at hand. And at this, my technician was richly skilled.

Apart from the interpersonal aspects of the situation, I was mostly affected by the inherent irony of attempting to sleep "normally" under what are undoubtedly abnormal conditions. The room, while homey like a nice hotel, still had a somewhat clinical feeling, especially due to the necessary presence of the equipment, wires, infrared video camera, and tubes which give the room its clinical functionality.
Since this was a study to determine my sleep patterns, I was instructed to eschew my usual medication which keeps my Restless Legs Syndrome at bay for one to two days prior to the study. Consequently, I was thoroughly exhausted from two nights of poor sleep, as well as somewhat intimidated by the need to sleep on command. Exhausted, overtired, unmedicated and uncomfortable, the challenge was a steep one.

The picture: two cannulas in my nose (one for the measurement of oxygen flow and one for heat); six electrodes glued to my scalp to monitor brain waves; four sensors taped to my face to monitor eye movement; one on my throat to record snoring vibrations; four electrodes to the chest for an ECG; and two tight straps around my chest and abdomen to measure breathing patterns and depth---all attached to one "motherboard" which slept silently beside my pillow.


The initial result: two hours of tossing and turning, five hours of relatively solid sleep interrupted by interesting trips to the bathroom with the said wires and tubes along for the ride, and a grateful arrival home to my peaceful and welcoming abode following 20 laps at the pool to wash off the night's travails.

So, if I am again meant to sleep and perchance to dream, may the results of this most interesting and amusing study be edifying and useful to both myself and my trusted diagnosticians. If not, then it's back to the drawing board, and the overall elusive nature of healthy, restful sleep.
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