Polysomnography: The Sleep Study Part 1

My close friends like to joke about the fact that I sleep a lot. During a normal day, I’ll take a 2-3 hour nap in the afternoon. I go to bed for the “night” between 2:00 AM – 3:00 AM, waking up around 11:00 AM – 12:00 PM. Sometimes I head back to bed as soon as 2 hours after waking up either out of depression, boredom, or a constant feeling of being tired and lethargic. My energy level is minimal during the day. I usually get most of my work done at night after 7:00 PM. I run intro trouble anytime I’m off my schedule traveling or socializing. I’ll either demand that I take a nap or just suck it up and feel miserable for the day.

I talked to my psychiatrist about my sleeping habits. She suggested my abnormal routine might be explained by the fact that I simply function better at night. She said some people are just “hard wired” this way. Her point made sense when I reflected on my own sleeping routine and also when considering other people working the second or third shift. If you head off to work at 12:00 AM, chances are, you’re a “night person” by nature.

I’m constantly at odds with my family over my sleep habits. My parents have done the same routine for well over 30 years now: up at 6:30 AM, work until 9:00 PM at the latest if there are meetings, and go to bed by 11:00 PM. My father, in particular, doesn’t complain about feeling tired and seems to thrive on his routine. My mother, a high school English teacher, works around the “school” clock. She comes home around 4:00 PM or 5:00 PM at the latest and will sometimes “close her eyes” for an hour before dinner. Then, she’ll correct papers or watch TV until bedtime. Both my mother and father can’t understand why I sleep so much or how I can possibly go to bed at 3:00 AM. They believe I need to reestablish a morning oriented routine, since this is the schedule most of the world operates on.

For the most part, I accept my psychiatrist’s theory about my sleep routine. I may indeed work better at night, but that doesn’t explain my constant need for naps and low energy level. I’m 32, not 72, and I should wake up refreshed and ready for a complete day without needing to lie down again later.

So, it boils down to two core issues: 1) Is my BPD/Depression hindering my energy level, causing me to sleep all the time? and 2) Is the quality of my sleep sufficient for a full day of “normal life”, or am I experiencing problems at night that make my sleep unproductive?

For the record, I have snored since I was a child. My family has even complained about it. Sometimes I’ll awaken suddenly at night finding myself moving around in my bed, as if I was acting out my dreams in real time. I’ve hit my head on the wall, had “sex” with my bed, and even caught myself attempting to run while in my sleep. If I’m sleeping somewhere other than my own bed, I suffer occasional Night Terrors, where I have a horrific nightmare and wake up screaming out loud in a panic. This happened twice while I was in Panama staying at a friend’s apartment 3 weeks ago. It scared everyone in the apartment: They thought I was either possessed or getting murdered 🙂 .

All of this strife over sleep finally led me to see a doctor specializing in sleep analysis. His immediate suggestion was that I should go to bed earlier than 2:00 AM or 3:00 AM, although when considering my mental illness and medications (particularly Clonezapam before sleeping) my odd routine was understandable. My chief concern was my low energy level. I expressed worries that I was not able to have a full day – regardless of my bedtime – because I was sleepy and depressed. I told him I wanted to start exercising again, but how could I even fathom lifting weights and/or running when I can barely get myself out of bed?

As a result, he prescribed a Polysomnogram, or Sleep Study, to analyze what happens throughout my body while I’m asleep. For those that have not heard of this, a sleep study is a relatively simple procedure.

Polysomnography: The basic procedure and preparation

First, you report to the study clinic an hour or two before your regular bedtime. In my case I went to the clinic at 9:30 PM because they could not accommodate me going to bed at 3:00 AM. They wanted me to attempt going to bed earlier. General preparation instructions included NOT taking a nap, avoiding caffeine and any other non-prescribed stimulants, and eating light. Pack your normal bedtime clothes and bring a pillow if you want. While at the Clinic I was told to follow my normal nighttime routine, including watching TV for a couple hours before brushing my teeth and heading to bed. The Doctor also wanted me to take all my medications as normal, including the Clonezapam.

About 30 minutes before bedtime, the lab technician will escort you to your bed at the clinic and start preparing you for the study. It’s a good idea to go to the bathroom before this begins. I was a little nervous so I made sure to empty my bladder, going twice before prep began. Then, the technician will start placing electrodes at various locations on your body, including your head, legs, and chest. My technician also attached a band around my chest to measure breathing, plus a nose piece (like what someone on oxygen might wear) to measure my nasal respiration. The preparation took about 40 minutes in total.

Once everything was set to go, everything else was straightforward: position yourself in bed as normal and sleep. If you can’t sleep, feel free to move around and find a more comfortable position. The various wires and straps attached to my body didn’t really bother me: the technician attached them with small pieces of tape and they were very unobtrusive. If you need to go to the bathroom, unplug yourself from the hardware and go, making sure to hook yourself back up when you return to bed. I had to go to the toilet twice that night: once about 45 minutes after lying down, and another time around 7:00 AM the following morning when I woke up early. I went back to sleep briefly and the technician got me out of bed at 10:00 AM.

Overall, I would say the experience of having a sleep study is pleasant and nothing to worry about. My only regrets were that I suffered insomnia for the first 1.5 hours or so. Additionally, when I finally drifted off to sleep, I slept lightly and did not sleep as soundly as usual. Hopefully these anomalies will not affect the test results.

For Part 2, I’ll talk about my results and the Doctor’s analysis of my sleeping routine…