It has been emphatically reported to me that there are times at which I snore loudly enough to frighten children and small animals several counties away. Although I’m usually not that bad a snorer, it’s enough of a problem that I was eventually convinced that I should get it checked out. My internist recommended an ear, nose and throat doctor, and my ENT suggested a sleep study.
Last night I had the sleep study done at the N.Y.U Sleep Center. For reasons inexplicable, the N.Y.U. Sleep Lab is located in Bellevue Hospital, two doors down from the N.Y.U. Medical Center (separated by the City Morgue). I got to Bellevue at 9:00, went up to the seventh floor, and buzzed the door of the sleep center.
I was met by Julian. He and his colleague Samantha were the two sleep technicians who would be keeping track of my slumbers. He ushered me in, and showed me to my bed-chamber for the evening, a small room with a bed, a night table, a chair and little else. It was one of four such rooms off a central area with a bunch of computers, video recorders and other electronic equipment.
Once I filled out a bit of paperwork, Julian suggested that I get into my nightclothes. After I put the set of blue pajamas that I wear on such occasions, he asked me to sit in a chair in the central area so he could measure my head. He took a paper tape measure, and began to quarter and re-quarter my head, drawing little crosses in the various quadrants of my hair with what I sincerely hoped was a washable marker.
Once he was done, he explained that he would be attaching the electrodes that would measure my brain function, muscle tone, and heart rhythms. It turns out that he had to attach 19 electrodes to my head, two to my chest and four to my legs. They were each small metal disks attached to long, thin electric wires. Julian swabbed each attachment area with an alcohol wipe, covered the electrode with a conductive gel, and stuck them to the appropriate body part with medical tape and some sort of water-soluble glue.
Julian gathered the wires coming off my head and body into a big, multi-colored ponytail, and plugged each of the electrodes into a small box with lots of cryptically labeled connectors on the front and a big multi-pin plug on the bottom. He then took two elastic bands and put one around my chest and the other around my stomach, and plugged the wires coming off them into the box to measure respiration. When he was done, he hung the box on a strap around my neck so I could move around until I was ready to go to sleep.
A major issue they look for in a sleep study is sleep apnea, a condition in which you stop breathing for short periods while asleep. One treatment for this is to sleep with a machine that blows somewhat pressurized air through a mask into your sinus passages to keep your airway open. He proceeded to show me some options for masks that might be tried early in the study if they found I had serious apnea. Two of them were rather straightforward masks that were attached by elastic straps to cover the mouth and nose or nose alone. The third, however, made me think of the outfitting in a really bad sci-fi flick. It was a curved, mostly-rigid tube that ended in a hook-like plug with two gaskets that fit in your nostrils. You’d put the end up your nose, and the tube would go up and over your brow and around your head to keep itself in place through pressure on the back of your head. Though it was an intriguing option, I decided that Julian should try one of the other masks if it proved necessary during the study.
It was now about 10:00, and I wasn’t ready for bed, so I went into my room while Julian and Samantha finished wiring up the two other sleep study subjects that were there that night. I bit after 11:00 I’d read enough, and headed for a last trip to the bathroom. There I learned that it is rather a challenge to wash up and brush your teeth in an elongated, handicapped-accessible sink while avoiding dunking the electrical box and wiring looped around your neck into the water.
After all of the sensors that had already been attached to me, I didn’t think that there could be much more, but there was. I got myself into bed, sinking into the too-soft mattress, and Julian came in to complete the hooking-up process. The box was hung on to a hook above the headboard, and a thick connector was attached to the plug on the bottom. Another sensor was attached to the elastic band around my chest to measure my sleep position. Then Julian pulled a thin clear tube out of the night table and said this is a cannula. It had a small fitting with some more sensors that went up my nostrils and the tubes went over my ears and around the back of my head to attach to some other machine. Eventually he pulled out a small, rectangular device and said it was the last of the sensors. It was a pulse monitor that fit over one of my fingers, with yet another wire running off it to be taped to the back of my hand.
Once I was fully hooked up, the sensors had to be tested and calibrated. As I lay in bed, Julian gave me instructions through the intercom: Close your eyes . . . open your eyes . . . blink five times . . . look up . . . look down . . . look left . . . look right . . . grind your jaw . . . pull on the chest band . . . pull on the stomach band . . . point your left foot . . . point your right foot. When this was done, Julian came in and I asked how I was supposed to sleep in this spider-web of wires, particularly as I tended to toss and turn. He said that the set-up was pretty well able to deal with any sleeping position, but just try not to do any 360’s.
When he left and turned out the light, I tried to settle in to sleep, but sleep didn’t come easily. I started on my back, shifted to my left side, and then rolled onto my front. I was going to continue rolling toward my right, but remembered Julian’s admonition about 360’s, so I shifted to sleeping on my right the long way round, trying no to tangle any wires. At one point Samantha came rushing in to reattach a sensor, but other than that everything pretty much stayed in place.
I stayed awake for a good long while (I’m sure exactly how long has been faithfully recorded) but eventually sleep overtook me. Several times I recall waking up briefly, and one of those times Julian came in for some reason. While he was there I asked him to detach me so I could get some water and use the bathroom, which he obligingly did. After I got reconnected I settled in, and the next thing I knew Julian was turning on the light and saying that it he had seen from the monitors that I was awake (probably even before I really realized it myself), it was 7:15 a.m. and the study was done. He had to do another calibration of the sensors before he could unplug me, so we went through another round of my moving my eyes, jaw, feet and whatever else he told me to. Then he came back into the room and detached my tethers. I went out to the chair in the central area, where he removed all of the electrodes from my head and body.
After a short wait for one of my fellow study subjects to be done, I went into the bathroom to take a shower, confident that my adventures were at their end. While I was showering, however, the rod holding the shower curtain up suddenly crashed to the floor. I tried to reset it, but it wouldn’t stay up, so I took the remainder of my shower with one hand holding the shower rod and curtain in the air while trying to make sure that I got all of the glue and gunk off of my hair and body. Eventually I concluded that I must be clean and got out.
When I was out and dressed, I saw that Samantha was ready to leave. I thanked her for all she had done, and utterly innocently and unthinkingly said, “it was a pleasure sleeping with you.” A moment later, realizing what I said, I added, “such as it was.”
By time I had gotten my stuff together, the fellow who analyzed the data had come in, and he and Julian were able to show me some of what had been recorded on the computer terminal that all of my sensors were hooked into. By my brain wave patterns they could see when I was sleeping and the sleep stage I was in. The sensor in the cannula in my nose showed that yes, in fact, I did snore, and that it was heaviest when I was on my back. It also appeared that when I was snoring I sometimes woke myself up for short periods. Fortunately, it did not appear that I suffered from sleep apnea, though all of the data would have to be gone through in detail. I’ve got an appointment for a consultation in a few weeks, at which point I’ll learn the full results and potential treatment options.
When I was done, I thanked Julian, wished him happy holidays and, to be fair, said it was a pleasure sleeping with him, too.
