At bedtime last night, I just wasn't in the mood for the traditional warm bath and hot mug of cocoa, so I decided instead to have tiny metal electrodes glued to my skull. Then I allowed a nice young man named Jonathan to thread a wiggly plastic tube up my nostril. The tube snaked through my sinuses and dangled down my windpipe where it felt like some monstrous gnat struggling between my tonsils. Oh, how I hated the tube, but today I praise it, for without that linguini-like length of plastic, the riddle of my lifelong slumber woes might never have been solved.
Wired Like a Christmas Tree
I'm talking about my sleep study, of course, which concluded at 7 a.m. PDT this morning, in the Stanford Sleep Disorders Clinic. The tube I speak of is actually a sensing device that accurately measures breathing resistance in the esophagus, a bit of data that in my case was crucial to solving the mystery. But I'm getting ahead of myself, so let's slow down and start at the beginning. The sleep study fun kicked off last night when a clinic technician — Jonathan — wired me up like a Christmas tree, then squirted a glob of lubricant up my nose, and slid the esophageal tube home. When I gagged and doubled over, Jonathan looked concerned. But he assured me I'd get used to the discomfort.
At 11:15 p.m. they turned out the lights, left me alone, and my long night voyage had begun. Incredibly, I did get used to the esophageal tube. Even more incredibly, I soon began to doze. But it didn't last. I rose up out of that shallow slumber like a stone skipping off a pond. And when I awoke, I was more awake than I'd been before. Wide-eyed, I counted the ceiling tiles, I felt the hours pass. I felt such an urgency to sleep. It become an obsession. A duty. I tried mightily to relax. Instead, I grew sullen and irritable. The wires were tangling my fingers. The room was too damn cold. And the esophageal tube began to bother me again terribly, like a fishbone caught in my throat. For hours, I thrashed, sighed and prayed for dawn. There was talk of pulling the tube. Someone suggested medications. The night was an endless black hole. And it all felt so damn familiar.
Secrets of Slumber in Jagged Lines
Then, astoundingly, I slept. Sleep hit me sometime after 2 a.m., and I stayed under until 7 a.m. on the dot when a tech named Alec came in to cut me loose from my electronic bondage. After a shower and a quick cup of java, I met with Dr. Clerk, who was ready to spell things out. He had with him the massive polysomnogram, the overnight compilation of all the data fed by the monitors and sensors attached to me while I slept. Within that fanfold tome, all the secrets of my slumber were written out in continuous jagged lines.
Clerk tossed the document on a table and flipped the pages. Finally, he paused and pointed at the top line on the graph. "This measures EEG," he said. "These high-amplitude waves are delta waves, which indicate you're sleeping deeply. But watch ..." He flipped several pages and pointed to a flat line near the middle of the page, which recorded input from a tiny microphone taped to my neck. "This is snoring," he said.
Then his finger slid down to the line representing the esophageal tube. Big dips here showed signs of trouble. "Your breathing is difficult here," said Clerk, "and look what happens to your sleep." He pointed at the EEG line again, where the big, restful delta waves had been replaced by tinier, tighter waves indicating lighter levels of slumber. "You are being aroused for just a few seconds," he said, "Too briefly to notice. But it is keeping you from the deeper levels of sleep."
Clerk flipped to other pages, showed me one brief arousal after another, all night long. It wasn't full-blown apnea, but it was enough to make my sleep thin and unrefreshing. "It's a very subtle breathing problem," Clerk said, "Without the esophageal tube, we wouldn't have seen it. Still, it's disruptive enough to give you the feeling that you don't sleep deeply." He politely pointed out that a little weight loss would ease the situation by lightening the load on my throat when I recline. If that doesn't do it, he said, surgical interventions could widen the airway.
"But we also must treat you as an insomniac," he added, "to help you with the great difficulty you have in falling asleep." Clerk offered me some surefire sleep tips concerning sleep routines, sleep environment, relaxation methods and so on, but I'll deal with that later. Right now I want to savor the satisfaction of having flushed out my hidden enemy. Finally, it has a face. It has a name. And now, it has me on a diet.