It’s me and the men. Fat men. Snoring men. Young men. And extremely picky men. That latter is a new one to me in my five (six?) sleep studies. Seriously, does this guy think a hospital is going to purchase his preferred kind of sheets just for him? It’s not like in the pre-bed bug days when you could bring your own special pillow, Teddy bear, towels, even sheets. Now the sleep lab provides everything, and the only thing they want you to bring are your pyjamas and hygiene products. They don’t even want you to put moisturizer on your face. Or gel in your hair. Or mousse. Or hair spray… These last are not because of the bugs but the electrodes.
Then there are the pyjamas. Maybe what’s seen in the sleep lab should stay in the lab, after all I always take my most warm, utilitarian pyjamas in my closet to the lab. Some men, uh, don’t. And most don’t wear anything over theirs, no matter how skimpy. Personally, I like a dressing gown, an extra layer of modesty. Unfortunately, it comes off as soon as one sits down in the control room for the pasting up. More on that later. But first: what am I talking about?!
The sleep study.
The sleep study is inevitable once a sleep specialist comes into your health care picture, whether you’re just an insomniac or having sleep problems as a result of a brain injury. In Ontario, OHIP will pay for a sleep study once every two years. The sleep study records your brain waves (EEG), your heartbeat and heart rate (ECG), your leg movements, your body positions, your breathing during your entire night-time (and sometimes daytime) sleep. It also includes a video and sound recording of you. It gives the specialist an objective picture of exactly how you sleep, notwithstanding the huge distractions in the process. No one ever prepares you for the experience, so I hope this will shed some light.
After checking in at the lab, I discuss my bedtime with the sleep tech. I tell him the time I usually go to bed and usually awaken. Oh no, not enough time to get a proper study, he replies. Not enough time to get proper rest either, I grumble to myself. He talks about using alarms at home inappropriately; I reply I don’t use alarms, and still I awake too early. He doesn’t get it. Someone should tell my brain, see how illogical you are waking me up so early! He tells me I’ll be second to be prepped for bed, and that’ll make lights out for me at 10:30 pm, about an hour before my usual time. The person before me will be lights out at 9:30 pm, or so that’s the theory. This is picky man, and he yaks on the phone instead, pushing mine, and the ones after me, bedtimes back. But I digress. The only other difference to my routine are the electrodes nestled in my hair, glued to my scalp and forehead. I’ll be allowed to wake up naturally. This is new. The thing I never like about these studies is they shock you awake and kick you out while you’re still half-drugged from sleep and the city is just wakening. But I’m ready this time. I’ve prepped my mind. But turns out: I needn’t have. So will I wake up at 5:00 to 6:00 am like I have been for the past week or will this be the day my brain finally decides it wants to sleep to a normal hour?
I ask the tech about snorers. My last study had the worst snorer. He was so loud, I heard him clearly through his door, the intervening control area, their door, the little hallway, and my door. They shut all the doors they could. No good. Guy was married too, I believe. If I’d been his wife I would’ve bought a separate house on the other side of town to sleep in. Luckily, this time it’s all insomniacs like me. They may snore but probably not loudly. The tech offers earplugs. I decline. I have faith in a snore-free night.
After filling in questionnaires and spending seconds checking out one’s designated bedroom, the next step is changing into one’s pyjamas. I must say I don’t like changing in a room with a camera staring down at me even though I know the camera is off (well, it’s supposed to be). I used to be able to stand behind it, but now they have those 360 ones. No hiding. Bathroom is safe though. Oh wait…inspect camera closely…it’s still only unidirectional! It’s aimed right at the bed. And there’s that nice blind spot underneath and to the side of it. I change in the blind spot with the door shut. You’d think shutting the door would be the obvious move. But there’s usually an exhibitionist in the bunch. Picky man is tonight’s and so oblivious to my presence he changes with the door wide open. I avert my gaze. He steps out into full view. Good grief, I really need shades for those pyjamas. Anywhoo…I’m second in line to be gooped up. That’s always my favourite time. Sit still as electrodes are glued on, my hair is totally ruined, and gossip with the lab tech — who’s almost always male; females if there are any are usually walking about doing stuff; but tonight there’s only one tech in this lab.
The sophisticated sleep lab I walked into when I first arrived on the Sleep Clinic floor has women behind the controls and ushering the guests to their rooms, handing them their questionnaires to fill in immediately. The control room looks like something out of a television show with its modern monitors and dark-tinted glass windows. How come I can’t be there? That’s where I was first going to go until my new sleep specialist amended the sleep study requisition form after he enrolled me in the research sleep study. So I get to be in the side wing with its pokey control room and in the bedroom with a picture of a foot in it and pasted-up warnings about bed bugs. Who thought that would be restful, the foot splashing on a pond with reaching tree branches? Or the warning?
My first sleep study experience was quite different. A beeping O2 sat monitor disturbed my sleep in my first study until the tech removed it. That was in the old sleep lab at the Western in the hospital proper. It was sound proofed like a sound studio. You walked in, and it sucked the sound out of your ears. It was grey too and separated completely from the rest of the floor. The EEG readings were recorded with flailing needles on paper unfurling across a wall. In contrast, the last two sleep labs had windows. The street sounds through their windows and, at one, streetcars clanging by, were rather disturbing. But nothing competes with the snorer. There’s always one. But back to the labs. These labs, main and side, are on their own floor tucked in a rabbit warren of rooms and halls. No windows to let in street sounds. Thank you Lord. Computers record the EEG and heart readings. The rooms are hushed, but sound carries in the air like normal, which makes it easy to eavesdrop on the convo between the tech and picky man while he’s being strapped and gooped up. Hey, a gal’s gotta do something when she didn’t think to bring anything to read because in the last few studies there was no time to read.
It’s my goop-up, I mean, paste-up time. First the tech measures my height and weight and neck circumference. Then blood pressure. Luckily one doesn’t need to take one’s sleeve off (which would mean removing the pyjama top; normally the BP cuff goes round bare skin). And then the fun begins.
The tech asks me to hold out my arms; he wraps and clicks into place a soft black strap round my chest and tightens it. This one is more comfortable and sturdy than ones I’ve had in the past. He then wraps a matching strap round my waist. They will measure my chest and abdominal movements. Now the worst part: he places on my face a double form of that oxygen tubing lung patients wear, hooks it round my ears, and tightens it under my chin. One breathing monitor measures pressure as I breathe in and out; its prongs reach into my nose (oh, yuck and ticklish). The other is a nose-wide bent red rectangle, which measures temperature and temperature changes; it sits under my nose. He tapes the tubing to my cheeks so it won’t slide away from underneath the nose during sleep. But the prongs still move every time I flip over. Talk about a sleep disturbance. The electrodes are innocuous compared to that!
The tech has a cart with everything ready to paste on. He asks me to sit down next to it. I see about nineteen squares of gauze with a blob of paste centred on each lying ready for me. He places one on the middle of my forehead, pressing it into place with the palm of his gloved hand. He presses one each on my temples beside my eyes, one on each side of my jaw, midway between the jaw angle and chin, several on my head, parting my hair to get contact with my scalp, one on each side of my neck at the back base, and two more below and to the side on my deltoids (my upper back). These last four are how they measure heart rate and beat in women. No ECG electrodes on the chest for women. Good thing as almost all the techs who’ve pasted me up are men, and modesty is already in short supply when sitting there in one’s pyjamas.
He lifts up a tangle of very thin, coloured wires. At one end of each wire are yellowish plugs that look like laces that have been fused closed with a lighter; at the other are tiny metal circles: the electrodes. He attaches all but four of the electrodes to the paste on the gauze squares on my head and neck. He hands me the last four wires, two at a time, asking me to thread two down my right and two down my left pyjama legs. He plugs all the fused-ends of the wires into a purplish rectangle box, except for the leg wires, clips a strap to the box, slips the strap round my neck so the box dangles down my chest, and hooks the leg wires and tubing though my chest strap. Time for bathroom and bed.
Lie down on your back on the bed with its two soft pillows (two! Luxury! Last time I got one small pillow), not-tucked in sheets, and light coverlet; have a man loom over you as he takes the box off you, plugs it and the tubing into the equipment next to the bed, and places it on the bed near the edge; sacrifice your left forefinger to an O2 sat monitor that is clipped and tightly taped on; thank the techie stars that the O2 sat monitor is much smaller than the behemoth used twenty years ago; wait patiently as the leg electrodes are pasted and taped to one’s calves then plugged into the box; wait for the sleep tech to return to the control room then obey the spoken commands coming through the intercom for the calibration session; watch as the tech searches for the problematic connections, tapes them, and pulls the stomach strap down so that it is over the belly properly; finish calibration; watch as the tech turns off the light; get blinded by the red spotlight of the O2 sat monitor as move hand into field of view; lie on side, feel nasal prongs move in nose, get blinded again by that red spotlight, tuck offending hand under pillow, be very aware one is being watched and listened to, and wonder:
How the hell is one supposed to sleep?
For a very dark room (no windows), there was an awful lot of light once my eyes had adjusted to the blackness. There was the thin space between door and jamb through which light seeped, and there were two inexplicable rectangles of faint light on the ceiling above my head. There was also that damn red spotlight that shot into my eyes like an alien probe every time I shifted position and moved my left hand in the process, always accompanied by the prongs moving against the inside sides of my nose.
I didn’t sleep.
Well, I’m sure I did because I awoke with a final snap at about 6:10 am, after several awakenings, to hear the gently happy snoring coming through the wall from the next bedroom and because the tech commented on how long it took me to fall asleep and asked me if it always took me that long.
And that’s when I realized how effective my AVE unit is for getting me to go to sleep and stay asleep. Even though the nasal monitors interfered greatly, the lack of sleep and time to fall asleep wasn’t that different from how it used to be before I began using my home AVE unit. It was my sleep in the raw sans aids. God, how did I survive without my unit all those years?!
Anyway, he asked me to stay in bed on my back. The others in previous sleep studies removed all the stuff in the control area or room, but he did it while I remained in bed. After unplugging the box, thankfully the first thing he ripped off was the nasal monitors. He threw a 3-pointer side- and backwards into the garbage bin. Good to know for hygiene reasons the nasal monitors and tubings are disposable. My chest strap had slipped down but everything else had remained in place. They were all soon off. Last time, the tech used alcohol to remove some of the paste in my hair. Most don’t. This tech didn’t. He then handed me another clipboard of questionnaires. I ticked through them quickly, eager to get out of there.
The penultimate step in the sleep study process is the shower.
They provide a shower. But I prefer to use my own. It means looking rather like Frankenstein out in public. A hat that comes down to the forehead and is washable is a must. The provided washcloth and their tepid water can remove the paste on the forehead and any tape remnants but not from the hair.
At home, ensure your hot water tank is full and ready. You’ll probably drain it. You’ll need hot water to melt the paste, otherwise it’ll take much longer to remove. If you’re bald or have a buzz cut, this process will take five minutes or less. But for everyone else… I’ve tried many methods. The alcohol certainly helped but didn’t do even half the job. I first massage in a large blob of shampoo in. Don’t bother. Instead, take a big bar of soap, and while standing underneath the hot, running water, push the bar against the paste, like one pushes air bubbles out of wall paper or out of an iPad screen protector. After one blob of paste comes out, move to the next. Or, if you’re like me and get bored with one blob, move on then come back. The paste at the back will be harder to remove because it’ll be buried in more hair, especially if you have long hair. Once you think all the paste is out (it won’t be), massage in a large amount of shampoo then comb it through. Rinse with hot water. Repeat with conditioner. Comb that through too, this time with the fine teeth. Rinse with hot water. Using this method, for the first time, I didn’t discover bits of paste in my hair once it had dried, and I didn’t need a second shampoo. Now commence with your usual shower routine and soothe your scalp with cool water.
The only other addition to the process is cleaning every fabric thing you took to the sleep lab. Given that bed bugs are rising up again and you don’t know who you’re sharing the lab with, it’s only prudent. Toss them all in the washing machine, including your clothes, as soon as you walk in the door, before showering.
Last step: flake out.