I Meet the Sleep Doc

At 2:30 this afternoon, I sat down with Dr. Alex Clerk, director of the renowned Stanford Sleep Disorders Clinic, and told him no, I do not snore.

"No one has ever complained about it?" he asked.



"Nope," I said.

"Not even when you were younger?"

"Negative," I answered, "and my wife never complains."

"Never?" he persisted.

"Well, not much," I allowed.

Clerk nodded and jotted a note. For half an hour I'd struggled to convey the baffling mysteries of my slumber- related woes — the restless late nights and bleary-eyed early mornings, and the middle-of-the-night awakenings. I told him about my bizarre sleep paralysis, and the way I toss and turn for hours. I brought up everything I could think of. It was murky and enigmatic, I know, but I wanted him to understand. After all, I was about to undergo an exhaustive sleep study to uncover the reasons I sleep so poorly. I wanted him to have all the information I could provide.

The Riddle of Sleep

Clerk, a quiet, patient guy, listened politely to everything I offered, but he really seemed interested in the snoring stuff, which, I thought was a complete dead end. So I tried to steer him toward what I thought was the crucial matter.

"The worst thing," I said, "is that sleep is so hard to conjure, as if it's a trick I have to perform, or a riddle I have to solve. I just have no faith that sleep will come my way." I spread my arms in a gesture of frustration, as if I held in my arms this enigmatic misery that had no name.

Then Clerk nodded calmly and named it. "Psycho-physiological insomnia," he said. "It means you have lost your confidence in your ability to sleep. You worry about sleeping, and so it is harder for you to sleep. It becomes a self-fulfilling prophecy. But that's a secondary problem. First, I want to get a look at your throat."

The Verdict: A Snore

Moments later, Clerk was probing my mouth with a penlight and a tongue depressor.

"Your uvula is longer than normal," he said, "you still have your tonsils, and the tissue of your soft palate is thicker than usual." He nodded as he slipped the penlight into his chest pocket. "I thought so," he said. "You snore."

"You can tell from just looking?"

"The excessive tissue in your throat reduces the size of the airway," he said. "That forces the air to rush through. The rushing air forces the tissue to vibrate, and the result is snoring, a sign that the airway is compromised."

Clerk then carried on a complete physical exam, and when he finished he gave me his clinical assessment.