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.
I Meet the Sleep Doc (cont'd)
Three Sleep Problems"I think you have three problems," he said. "First, from what you told me about your sleep habits, you have a slightly delayed sleep cycle — your body wants to stay up late and wake up late. We can give you tips on how to deal with that.
"Second, as we discussed, you have lost your confidence in your ability to sleep. We can help with that, too."
"But I also think you may have a slight sleep apnea, and this is the first thing we need to deal with."
I was surprised. Sleep apnea, the most common of all sleep disorders, is a condition in which the tissue of the throat collapses, causing a partial or complete blockage of breathing. The block lasts only a few seconds, but as it recurs during the night, it shatters sleep into shallow and unrefreshing fragments.
"You never reach the deeper levels of sleep," said Dr. Clerk, "so you awake feeling unrested."
Sounded familiar. "What tipped you off?" I asked.
"You said you wake with a dry mouth," he said, "which is a sign that you are breathing through your mouth. And you mentioned sleep paralysis, which is an indication that your sleep is fragmented; that you just aren't sleeping deeply enough."
My Romantic Illusions ShatteredThere was nothing I could say. For years, I'd seen my sleep woes in terms of epic suffering — you know, I was dark, complex, tormented, a regular old Job of the Sack. But as it turns out, it all comes down to some excessive fleshy matter flapping around in my windpipe.
"But we won't know anything for sure," said Clerk, "until we do the sleep study."
Which will begin in a matter of moments and continue until dawn. When it's finished, I'll have a 6-inch-thick readout of 12 basic sleep functions, which experts here can read like a book. They'll be searching for any breathing problems that might keep me from sleeping deeply. They're coming to wire me up now. Read on for the preliminary results.
By the way, remember the plastic tube I told you about earlier? The one they jam down your throat? Well, they don't do that. Instead, they thread a thin catheter up through the nasal passages, then down the throat and into the esophagus. I'm supposed to sleep that way — the guy who can't sleep if the cat's breathing too loud.