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Sleep Blog:  In Search of a Good Night's Rest

By:  Susan Laine

 

This is a blog of my experience in the Suburban Hospital Sleep Disorders Center.  I was admitted for one night in February 2011 to have a basic sleep study called a polysomnogram (PSG).  In Part 2 – The Sleepquel, below, I write about my diagnosis and tips from the doctor for more restful sleep.

My Sleep Study

February 11, 2011

8:30pm – I arrive at the hospital and register for my sleep study. Since I work at the hospital, it feels odd registering as a patient.  

 

9pm – Sleep Technician Miriam Takawira meets me in the lobby to escort me to the 2nd floor of the hospital where the Sleep Disorders Center is located.  She tells me she will be there all night monitoring my sleep. 

 

9:10pm - Miriam explains what will happen – she will give me time to get comfortable and change into whatever I am going to wear to sleep.  Then she will return to wire my body for the study. 

 

I ask Miriam if this kind of work causes her to have some sleep issues of her own.  She laughs.  I wonder if its not such a good question to ask a sleep tech right before she is about to hook me up with a lot of electrical wiring and then stay up all night to watch me sleep.  Miriam is a registered polysomnographer (RPSTG) with 10 years of experience.  That’s good.

 

The room is like a bedroom.  There is a sink in the room, but no bathroom – that’s across the hall.  There’s a television and lamp and the bed has a comfy-looking bedspread. 

 

I fill out some more paperwork, change into my night clothes and wait for Miriam to return.

 

9:30pm - Miriam is back and prepares to attach the leads that will measure things like breathing, muscle movement, snoring, nasal flow, pulse ox and more.  

 

10:15pm - I was falling asleep while she was putting on the leads. It was like getting a mini massage.  She swabbed the area with cool alcohol and then attached one of more than 14 leads on my head, face and neck and legs.

 

Good thing I bought the sleep shirt in the hospital gift shop and not the two-piece pajama set. It was easier for Miriam to put the leads on me and more comfortable for me that there were not wires pressing against my skin around my waist.

 

It took Miriam 40 minutes to finish attaching the leads.  She said some techs can do it faster – but she takes her time.  It was fine.  While she worked, I watched a video that explained various aspects of the sleep study, symptoms and consequences of sleep disorders and treatment. 

 

All of the multi color wires are going from the leads on my body to a box-like mechanism that rests on a table beside the bed.

 

Miriam explains that if I need to get up in the night to call her, she will have to un-tether me.  Then she shows me my “purse” that I will have to carry with me.  The box-like mechanism I described earlier with all of the wires connected to it from me,   has a strap with a loop that will go around my wrist. I basically have to take the entire operation with me! I decide to make the trip across the hall now and hope that once I am plugged back in, I stay that way. 

 

10:20pm - When I looked at myself in the mirror, I was glad I decided not to do a video blog. It would be like watching Hannibal Lecter telling you a bedtime story.  Words will have to suffice in describing my experience!

 

10:30pm -  I’m settling in and I hear Miriam’s voice say, “Susan, we’re going to do a few exercises.  She communicates with me via an intercom system from the “control room” where she sits.  She says, “Just follow my instructions.”  She takes me through exercises that include head turning, breathing and leg movements.  She even asks me to make snoring noises.  This is called bio calibration – and she uses the measurements from these movements and sounds as a baseline for the study.  It will be repeated at the end of the study, too.

 

11:11pm -  I am feeling very tired, wondering if I’ll be able to sleep with all of these foreign objects coming out of my body.  Miriam assured me that I could toss and turn and that if something comes undone, she will know and come in to reattach. 

 

There is a camera trained on me in bed.   The idea that someone is watching me sleep… or watching me on a monitor from another room is unnerving.  But they must watch and monitor – that’s the purpose.  Miriam is trained to observe signs of sleep disorders. She will be looking for snoring, teeth grinding, irregular breathing and leg movements.  This video will never make it to YouTube. 

 

11:20pm - Miriam said she’d like me to try to go to sleep by 11:30pm.  I am feeling very sleepy, so I will try.   I was anticipating tonight’s study – and not in a good way.  But now that I’m about to go to sleep, it seems to be going pretty well and pretty fast.  I realize that I’m very close to learning why a good night’s sleep is so elusive for me. 

 

11:30pm -  I’m trying to get comfortable, and planning to make this my last entry when I feel something pop off my leg.  Before I call Miriam, she’s gently tapping on the door.  She knows exactly what happened because she wasn’t getting a signal for leg movement from my left side.  She plugs me in again and says good night. 

 

And I’ll say good night too.

February 12, 2011

5:45am  - I hear Miriam over the intercom say, “Good morning Susan, the study is complete.”

 

Miriam observed that I woke up on my own.    Otherwise, I think she would have let me sleep a bit longer. She says she will give me a few minutes and then we’ll do the exercises again.

 

6am - We finish the exercises and Miriam comes in to unhook me.  I ask her if the camera is off, so I can get dressed!  She assures me it is off. 

 

After I get dressed, I do something that normally would not happen.  Because I am writing this blog, Miriam invites me into the control room to show me how my study looked through the night.   

 

She shows me a monitor full of squiggly lines.  Each line represents measurement for each of the leads I was hooked up to – mouth breathing, nose breathing, sleep stages, (including when I was dreaming), leg movement, etc.  She shows me what it looked like when I was snoring (charming), and when I was in deep sleep.  Very interesting.  But that’s as far as she would go.  A doctor interprets the study and within a week, I will know the results.  I’ll share all in the summer issue of New Directions!  Stay tuned.

 

In the meantime, I am planning to read up on what the possibilities could be.  Some good sources for information are the following:

 

 Email Susan if you have questions about her experience:  slaine@suburbanhospital.org

 

In Search of a Good Night’s Rest:  The Sleepquel

June 13, 2011

 

Basically, the result of my sleep study showed “no evidence of sleep disordered breathing.”  While this was a surprise to me, I was relieved.  Here is what it did show:

 

During the study period, I was asleep for 336 minutes – roughly 5.5 hours.  My sleep architecture showed that I cycled through all of the stages of sleep, reaching restorative sleep or stage lll/lV sleep 48.8 percent of the total sleep time.  Sounds pretty good, except the normal range for Stage lll/lV sleep is 3-21% of total sleep time.  I basically skipped Stage ll, which ought to be 46-67 percent of total sleep time.  For me it was 15.3 percent!  Finally my REM sleep was just higher at 29.8 than the high end of the norm of 29 percent.  Basically, I fell into a nice deep sleep much sooner and for longer than I should have. 

 

Dr. Carolyn Wang, Medical Director of the Suburban Hospital Sleep Disorders Center, says these numbers suggest some level of sleep deprivation. 

 

For optimal daytime functioning, an adult requires 7.5-8 hours /night (children require 8-10 hours).  Millions of Americans exist on much less sleep than is optimal. Lost hours of sleep stack up and by the end of the week, we can accumulate quite a sleep debt. For example, if I’m only getting 5.5 hours/night Monday thru Friday and I should sleep 7.5 hours/night, my sleep debt by Saturday is 10 hours.  Add that to the debt I accumulate week after week and it is difficult to catch up.  The result is that our brains don’t function optimally; we may drive when we are too tired; and lack of restful sleep can weaken the immune system and make us sick. 

 

Dr. Wang’s advice to me for achieving more restful sleep is very reasonable and practical:

 

  • Set time for sleep to number of hours of sleep needed for adequate daytime functioning (7.5 -8 hours/night).
  • Choose regular bedtimes and wake times, including weekends.
  • Total sleep time should not be more than one hour longer than usual, and bedtime and wake time should not be more than one hour earlier or later than usual.  DO NOT ATTEMPT TO MAKE UP LOST SLEEP BY EXTENDING SLEEP PERIODS.
  • Don’t take your office to bed – engage only in relaxing activities 1-2 hours before bedtime, such as a warm shower and/or gentle stretching.
  • Avoid naps; but if you take them – nap no longer than 30 minutes or later than mid-afternoon.
  • Do not drink caffeinated beverages after 6pm or within 4 hours of bedtime.
  • Do not eat a meal or large snacks within 3 hours of bedtime.

 

As for my snoring… Apparently it is not as bad as my daughter Shana likes to tell people it is!  My test showed that I did snore, but it was in the mild range with an occasional severe episode.  Some people with severe snoring might choose to consult with an Ears, Nose and Throat (ENT) specialist.  They can look for the root causes of snoring. 

 

Dr. Wang says that if I cannot achieve more restful sleep following these recommendations, I could dig deeper with further sleep testing at the center.  So far, this advice is working for me.  I found that something as simple as not having my smart phone within reach makes a big difference.  Spending the night in the Suburban Hospital Sleep Disorders Center was a very valuable experience.   It was a real wake up call.  Pun intended!

 

Sleep disorders or sleep problems should not be taken lightly.   It is my responsibility as a professional, a mother and a good citizen, to get a good night’s rest, so that I am thinking clearly, driving while alert, and maintaining good health. 

 

See resource links above to learn more about sleep deprivation and other sleep related disorders.