Sleep: Getting too much or too little?

Insomnia is a nighttime inability to get to sleep and/or to stay asleep.

Hypersomnia or “excessive daytime sleepiness” is usually explained by: fragmented or poor quality sleeps the night before (due to many reasons including stress, work or family relationships) or an abnormal need for sleep (such as narcolepsy or depression). When doctors can’t find the root of excessive sleeping, they’ll brand it as idiopathic hypersomnia).

Excessive sleepiness can also occur in a variety of neurological conditions.

If you’ve experienced problems over say two months getting to sleep or staying asleep; not feeling rested when you awake; being told you snore loudly or taking short naps most afternoons, then complaining to your general practitioner may result in a referral to a sleep specialist who will inquire into your sleep history, medical history and could recommend an overnight sleep study (which is not painful, just uncomfortable if my experience is anything to go by).

There are two tests, night and day. The night test is universal and the latter is performed only if you suffer daytime sleepiness.

The night time test involves an overnight stay in a sleep clinic, which may be a hospital room, where countless electrodes are attached with glue to the scalp (to track brain waves); under the chin (to measure variances in muscle tension); near the eyes to determine eye movements; inside the nostrils to gauge air flow; on the legs to confirm restless leg syndrome. Hooking you up involves you getting into your pyjamas and sitting on a chair head bowed motionless for 45 minutes while a sleep technician attaches countless electrodes to facilitate monitoring.

If the technician fails to draw the blinds in your room, feel free to do it yourself. Afterall the entire objective is as sound a sleep as possible. Once you’re tucked in bed, by about 9:30 pm, the technician will turn on the CCTV. So remember to smile! I kid you not, the infrared camera is quite a distance from the bed but the nurse could clearly see when I countermanded her instructions and grimaced when asked to smile.

Trying to sleep under these conditions with the best of intentions is, to be fair, very, very difficult. But not painful at all. I suppose it’s a lot like after pitching tent, trying to get 40 winks, on a hard surface, on a wet night, in a sleeping bag when you’re middle aged. Using the same bag you used in high school, that is.

Before the technician switches off your room’s lights from her workstation at 10:00 pm sharp, over the intercom you’re told that a nurse will arouse you at 6:30 am. Trust me, your sleep will be more fragmented than usual, on account of the strange place you’re at as well as the many electrodes attached to you, that you’ll be up well before your 6:30 visitor.

Oh and at 6:30 you’ll be dragged out of bed. No ‘five more minutes please, I am so tired’.

Dressed, having eaten breakfast, some three hours later you’ll begin the Multiple Sleep Latency Test, which is a series of 4 or 5 twenty minute naps taken at 2 hour intervals, starting anywhere from 9:30 am to 10:00 am. You’ll be told to get in or on to the bed. The lights will go out and your job will be to fall asleep. Some 20 minutes later you’ll be roused and told to move out of the bed and into the chair.

The purpose of the MSLT is to determine how long it takes a person to fall asleep and the depth of that sleep. Does the person enter the REM zone? That is, does dreaming take place?