Jun 22, 2005

watching the watchers

My good friend DocrPm (I can never remember which letters are capitalized) brought a smile to my face this morning with a post up about his experiences with a sleep clinic. There are a number of character traits that he and I share. I can now add sleep issues to that list. I should have seen it coming.

My experience with sleep clinics occurred a year or so ago. I too was being tested for sleep apnea. I suspect that like me, his fiance was the one to prod him along. After all...how do you know you have a problem when you are asleep? Something tells me it is quite frightening to be laying next to someone in bed when all of a sudden they stop breathing. And then after a minute (that's a long time if you are aware of the passing seconds) or so there is a huge gasp for air. Creepy. At least that's how my wife describes it.

In addition to this I snore, grind teeth (not so much anymore), get 'restless legs' once in a while, and most importantly don't fall asleep well. I don't have insomnia per se but I rarely can get into bed and fall asleep. My wife on the other hand is a maddening example of someone with perfect sleep habits. She has fallen asleep within 1 minute of getting into bed every single night I have been with her. She never stirs in the middle of the night. And she awakens after 7 hours feeling refreshed.

My habits are a little more lottery like. Sometime I win big and sometimes I lose big. My younger years were painful. More recently I've perfected a series of activities that has rendered most of my conscious sleeping problems inconsequential. Most importantly this involves 1 hour of reading every night which totally works for me. I've heard that this is the sleeping equivalent of swimming right after a big meal. Maybe it is. But it works for me. It looks like dOCRPm also uses this technique.

My other issues are unconscious and therefore harder to address - snoring and stoppage of breathing. These don't seem to affect me and surprisingly my wife doesn't seem to mind either. But if they are indications of apnea you have an increased risk of heart diseases down the line. Not surprisingly they are related issues. Both concerned my wife enough to set up an appointment at a sleep clinic. DoCrPm lays out the experience well. I imagine insects caught by spiders feel like a person trying to sleep in these clinics. You are cocooned in cables and patches and someone is always watching you. Check out the picture below for a good idea of what I'm talking about. The look on that guy's face is about right. It can easily come off as a Big Brother gone bad experience. The best metaphor I can think of is Sauron's fiery eye bearing down on you. They know when you move a muscle, they have infrared monitors so you can see you in the dark, sound monitors transmit your snores, your breathing is monitored, blood pressure, heart rate, brain waves, ...

It's disconcerting to be in a pitch black room with no sound and yet know that there is someone outside the door that knows more about what is going on with you than you do. Except of course for your thoughts. But given the patches hooked up to your head you are not even sure about that. Come morning you are convinced - absolutely convinced - you didn't sleep a lick.

My experience differed in one significant way however from doCRPM's. A scientist by training, I actually found it interesting to be on the other side of the experiment. Maybe I did this to relax myself. But I spent my time observing and interrogating the clinicians. What were they doing? Why were that doing it? How were their lives made different by working a night shift?What kinds of things had they seen people do in their sleep? How did they handle it? Do you spend all night staring at data?

Here's what I learned. Contrary to the list of things you might be worried about doing in your sleep (screaming, farting, etc.) they have seen worse. Much worse. And contrary to the 'evil-eye-bearing-down-on-you' aspect to the night, they don't spend much time watching you. They really just check the number of times you stop breathing and for how long. That's all that matters. And even that is kind of automated. In the morning they check your brain waves to see if you are up. If you are they come in and say, like they did with docRPM, "I saw you were awake so I thought I'd come in." And finally they state emphatically that even if you don't think you slept a wink - you did. At least enough for them to figure out if you've got problems.

The results for me came back negative for sleep apnea. I stopped breathing 10 times in the night. This sounded bad to me but apparently this doesn't even register as a small problem on the level of stoppages associated with apnea. The clinician said some of the worst cases involve stoppages every 5 minutes.


Anonymous said...

another nice post. glad you enjoyed mine.

interesting indeed to hear that we have the same problems. the commonality extends to grinding of the teeth (although i'm actually a clencher and have to wear a night guard — i've cracked three teeth from clenching). i also occasionally get the restless leg syndrome as well, which it turns out they treat with a parkinson's medication if you've got it really bad.

the scientist in me wanted to know about the clinician as well, and i interrogated him along similar lines. the first thing that occurred to me was how unique his life is; everyone sleeps, but few people watch people sleep.

he had a pretty easygoing attitude about the whole thing, although he did seem to have an interesting stable of stories. he said the freakiest one for him is the people who scream in their sleep — not fun. he also told me a story about going in once to try to fix the electrodes on a guy, and the guy woke up with the tech above him, freaked out, grabbed the tech and started beating him up (he said the guy was probably ex–military and was going on instinct).

it's good to hear that your sleep issues don't extend into your waking life. i wish mine didn't, but then again, maybe i just need to sleep more regularly. my night–owl tendencies are in conflict with working life.

— docrpm (no intercaps, rPm in email)

ps: oh yeah...one more thing. not only are *our* sleep patterns similar, but so are those of our partners. my fiancee is asleep with about 12 seconds of hitting the pillow, sleeps the whole night through, and wakes up with a smile. the only thing that ever keeps her from sleeping is my snoring.

Chookster said...

I should have guessed we'd have the same problems. Most have abated from my college years when their occurence peaked. Probably because I let go of that college angst many suffer from :).

I think the grinding has largely stopped. Wifey doesn't seem to comment on it anymore.

I only get 'insomnia' now when my wife is away (this week unfortunately). Here easy going sleep seems to help me. But if I crank out 1 hour of reading each night and stay on a schedule then I really don't have many problems. A steady office job tend to force you into a schedule.

Your stories about the clinician are IDENTICAL to mine. Screaming and attacking them being the worst as you point out.

And that's funny about our partners being the same. My snoring is horrendous but wifey doesn't seem to be bothered by it at all. That was one sign she was the one. ")