We spend about a third of our entire lives sleeping -- or trying to. “The most common sleep disorder in America is people not getting enough sleep for lifestyle reasons. Insufficient sleep,” said Rafael Pelayo, a doctor with the Stanford Sleep Medicine Center in Redwood City. People with sleep issues go there to learn more about the quality and quantity of sleep they get.
I spent a night at the Clinic -- hooked up to electrodes -- to see what it was like. I got there around 5 in the evening. It began like any doctor's visit. The staff measured my blood pressure and asked me questions. I was game to do the assessment, but sleeping is not one of the things I do best -- as Dr. Pelayo would soon learn.
He asked me, “So, let’s start from the beginning. If you were really a patient here, you would have come in, got your vital signs, and I would ask you why you are here.” I told him that, like anybody, I have sleep issues. I feel like I don’t sleep soundly. Pelayo wanted to know how long I have felt this way. I told him, “As long as I can remember.” This surprised Pelayo, “You have no memories of sleeping well?” I told him that I didn’t.
Shhh, people are sleeping -- at the Stanford Sleep Lab.
Dr. Pelayo asked when I went to bed as a kid. I hadn't thought about that in years. I told him that as the youngest of three, I always went to bed first. He suggested that maybe I kind of resented that early bedtime -- creating anxiety. “So, you had an inappropriate bedtime, so going to bed is a drag, is a hassle, right? -- [you] wanted to be up watching TV. Right? And it’s not fair that your older sibling gets to stay up later than you,” he summarized. One thing I quickly began to realize: Sleep and psychology are very much inter-twined.
We talked about what I do in the evening. When I go to bed. How many times a night I think I wake up, and how I feel in the morning. My answer? Tired.
Pelayo told me, “You could have a little bit of two things going on, a little bit of a light sleeper with mild sleep apnea can overall give you un-refreshing sleep. The thing to do is to tease it out and break that down into the different parts of it. So, tonight we’ll measure how you’re sleeping, and in the morning we’ll go over the results with you.”
It was time to get ready for bed, no small thing at the Sleep Medicine Center. I went to my room -- called simply Sleep 18. Technician Robert Tognoli hooked me up with 28 wires in all -- attached to my legs, my head, my abdomen - all of it designed to sense and measure my breathing, eye motions, blood oxygen, snoring, leg and chest movements.
Tognoli told me the wires would monitor the phases of my sleep, when I dreamed and if there were any “interruptions to my sleep architecture,” as shown by my brain waves. Then he stuck all the wires into a box that he hung around my neck. Next, he turned on a machine that blew air to dry the glue holding the wires attached to my head. Finally, I was ready to hit the sack. How did I sleep, and what story did all those wires tell?
I woke up at about 7 a.m. the following morning. The overnight sleep technician came in and disconnected all the electrodes. I showered to get the glue off me and then sat down with Dr. Rafael Pelayo to go over the results of my night of sleep. “We look at every single second of your sleep. So you were in bed maybe eight or nine, 10 hours. We're going to look at it page by page through the night,” Pelayo told me.
Name that pattern, or Scott Shafer's sleep?
The computer screen showed more than a dozen lines -- squiggles of green, red, blue, purple and black. I wanted to know what Pelayo was looking for. “Actually, you learn to look at the whole thing. But I’m looking at brain waves, I'm looking for arrhythmias, like a weird heartbeat. Little drops in oxygen. Irregular breathing for the most part,” Pelayo said.
Irregular breathing can signal the most common and potentially dangerous sleep problem: sleep apnea. Pelayo scrolled through the screen shots -- each one represented 30 seconds of sleep -- there were hundreds of them for the night.
“By the way your EKG heartbeat is nice and slow. You’re an athlete, you’re a swimmer. Your heart rate is 53. You’d probably be happy with that huh?” Yup.
Now, if you asked how long I thought it took for me to fall asleep last night, I'd swear it was one or two hours. The reality? Not even close. Pelayo explained, “And look at these brain waves. This is what they call K complex. See, it's this different wave. That means you’re in stage 2 sleep. You’re snoring. Your breaths are kind of shallow now. You’re out. You’re gone. And that’s 20 minutes after they turn off the lights.”
Pelayo talked about the three phases of sleep. Then he skipped ahead a few hours -- to where the graphs got more animated, to rapid eye movement or REM sleep.
“Dreaming, which is probably the sexy, interesting part of sleep, that’s only 20 percent of the night. And if that’s all we needed, we’re wasting 80 percent of the night. In fact we think the entire sleep pattern is important,” he said.
After reviewing the night's data, I told Pelayo it looked like I'm a better sleeper than I thought. He disagreed. His take: My breathing is slightly irregular throughout the night -- nothing severe, but he suggested a few things I could do to get a better night's sleep.
“People with sleep problems, though, sometimes don’t realize they’re sleeping. They sleep so lightly - they’re in and out of sleep. Since they’re not sure if they’re sleeping or not, sometimes they think, ‘If I’m dreaming, then I must be having a good night’s sleep,’ ” Pelayo said.
Sleeping is such a personal thing, right? When you sleep, how you sleep, whom you sleep with. After I had all those wires attached, I posted a photo on my Facebook page. I was surprised by how many people -- friends, acquaintances, work colleagues -- sent messages describing their own sleep issues.
I realized that sleep is kind of complicated. It's not just an on/off switch -- either you're sleeping or awake. Your mind can play tricks on you -- making you think you're not sleeping when you are, or that you're getting better sleep than you are. The only way to know for sure is to get some data.