[re-post] Week #1: Sleep studies in a city that never sleeps?

I originally posted this a a comment before I had access to the blog and before I knew what I was doing. So here it is ... 

During my first week, I had multiple meetings with my mentor: Sleep Medicine specialist, Dr. Ebben, who has a background in Psychology and a Ph.D. in Neurology. How does one develop a sleep disorder in the city that never sleeps? I spent all day Thursday pondering that question by shadowing Dr. Ebben and meeting with a slew of patients throughout the day. Apparently, there is a multitude of ways that the mysterious thing we do called 'sleep' can go wrong. Dr. Ebben's interview process (for new patients) gets right to the bottom of the problem and always starts with: "How can I help you?" It was both fascinating and slightly awkward to be in the room during the interview because I really got to know these people quickly. Sleep habits are very personal and often correlate with stress/anxiety, emotional health, lifestyle, romantic life, etc. However, most patients were unfazed by my presence and were simply focused on fixing their problem.  

I met patients with everything from REM-behavior disorder (where the patient acts out dreams) to common sleep apnea. One of the REM-behavior disorder patients reported punching his partner in the face during an episode. In the past, others reported him diving off of his bed face-first (this one required extensive surgery) and boxing an invisible opponent while standing on his bed. Sleep disorders are not only intriguing to study, but they are necessary to treat in order to preserve the safety of patients and their loved ones.

Dr. Ebben specializes in sleep apnea of which there are two types: obstructive (blocked airway due to obesity or anatomical obstruction) and central (more neurological and complicated). Basically, to have sleep apnea you have to stop breathing (for more than 10 seconds), multiple times throughout the night. This can go undiagnosed for years, putting serious strain on the heart and causing seriously-fatigued people! While there is no sure-shot cure, treatment methods exist such as CPAP: continuous positive airway pressure therapy and BiPAP: bilevel positive airway pressure therapy, which can reduce apnea episodes from over 100 times per hour down to below 5. My project for the summer will be to create a novel actigraph device to measure sleep/wake in sleep apnea patients. This week I began putting a parts list together and designing the wearable device.

Other random fun facts I learned:

v Lots of sunlight exposure in the morning will cause someone to go to be earlier. 10,000 lux of light is optimal and the light/dark cycles are most sensitive to light in the blue range of the spectrum. 

v Melatonin is like the anti-sunlight. 

v Slow phase sleep is therapeutically extended by beta hydroxyl butyric acid (aka the date rape drug). Body builders will slip this in with their protein shakes because it jacks up HGH levels. 

I look forward to getting into the OR next week. Somebody hook me up!