Sleep - parasomnias and other things

I attended the British Sleep Society's Spring meeting in Eastbourne a few days ago with my fellow Sleep Technicians.

We were referred to as ‘scientists’ and sat through a workshop on the logical steps needed to publish scientific research. Um...haha...not likely! But on reflection, I wondered...

‘Sleep medicine’ is still in its infancy. Those involved in sleep are researchers. Together with our incredibly patient patients (lets face it - we don't know everything and wouldn't if it were not for our patients!), our combined experiences/knowledge add to the overall picture of sleep. So I suppose, in effect, the workshop of scientific writing was not really that far out...but still can't imagine myself doing it.

So little known about sleep and the reason we need it. There is a great deal of speculation but everyone sort of seems to agree that "sleep is of the brain, by the brain and for the brain." I have my own theories, not based on hard core scientific logic, but on intuition.

I hear repeatedly that the most frightening thing for all patients, is the lack control and/or awareness of what they do when they sleep. Of course, there are those who don't believe it...until they see the video recording.

There are times when I wonder what on earth I am doing working in a sleep centre. 9 years ago my life took a 90 degree right turn and I landed up here. I could never have, in my wildest dreams, ever have come up with a career like this - didn't even know it existed!! After having worked for 20 years in law, I found the overwhelming compassion of everyone involved in sleep refreshing. It brought out my warm nurturing side. 

I used to be the secretary taking dictation and typing it up for lawyers...nowadays I dictate letters to referring doctors and a secretary types it up for me...how weird does that feel?!

I always thought I'd be teaching metaphysics, meditation or something along those lines (which I may of course in the very distant future)..but every time I think it is time to move on, something pulls me back. Reckon my destiny is tied up for sometime with sleep.

Sleep consultants and technicians are thin on the ground. We can't keep up with the referral demand as the awareness of GPs and their patients grows and being part of the NHS where the service is free, we are seeing babies right through to 80 year olds coming through our doors. Therefore we have a cross-section of patients and have to adapt how we deal with each individual.

One of the many things I love about this country - no-one is turned away no matter who they are. It does not matter how much money you do or don't have, everyone gets the same treatment. We do our best to either help them or point them in the right direction.

Some of my colleagues and I at the BSS

It's not all hunky dorey. 

I get really irritated by those that act like victims making no effort to help themselves, those that demand, believing it is their 'right'.

The downside of having free medical care on tap is that abuse of the system occurs and many patients do not care about or respect the equipment they receive. I reckon that we should be charging - even if it is only the price of a prescription of £8.05!



And then there is the really 'wonderful' phenomenon of walking into a closed bedroom in the morning to be overwhelmed by bad morning breath, all night farting fests, or the unwashed smell of those too obese to bathe themselves...and having to breath that in while smiling and chatting to the patient about their night...when all you wanna do is run away and vomit into the toilet!!

One of the talks was given by a speech and language therapist from the British Lung Foundation. Patients have difficulty absorbing what sounds like gobbledygook them and quite regularly when they come back to the technician respiratory clinic, I hear them say that they couldn't remember what they were told in the morning after their night with us.

Not only do we troubleshoot, we educate - which is the part that I love the most.

The BLF use a formula to make their leaflets and website more readable. Here is a link if you would like to know more on the SMOG readability formula.

I don't know about you, but I find that any articles that are too high falluting and full of long words, instantly sends my brain into a fog and my mind starts wandering. 

My hubby always says Keep It Short and Simple - KISS. 

Hmm...simple I can do...but short - never!?

Another interesting talk was about sexsomnia - the act of initiating sex with a sleeping partner or masturbating themselves so much that it creates friction burns - all occurring when the patient is fast asleep. Again, a little known phenomenon. Interesting to us, but extremely traumatic for the patient and their partner. Some of them are so distraught and desperate they resort to all kinds of things to put a stop to what they do in their sleep, such as wearing layers and layers of underwear so tight it restricts the blood flow or tying hands to the headboard so tightly that in a frantic bid to escape while asleep, fingers are broken.

For these patients (and other parasomnias), we do a full PSG wire up of the head and this will give us EEG data so we can see what is happening with the brain during an episode. It is not ideal doing this in a laboratory/hospital setting, but at the present moment that is all we have to work with until the technology moves on.

And then there are parasomnias such as night terrors, sleep walking, sleep eating, sleep violence...and the respiratory side - cessation of breathing, those with lung diseases and so on...

This job is so varied...there's ne'er a dull moment whether a day or night shift!

On a more serious note - the medical profession owes a debt of gratitude to its patients for the enormous contribution they've made to science over the millennia.

Therefore I'd like to say - THANK YOU.