Hi, CET! Let’s Talk About Sleep

When asked why I went into sleep medicine 36 years ago, I reply, “Sleep is what I like to do best.” It was during my first two months as a rotating intern in 1974 in Obstetrics and Gynecology, when I learned that the shift rotation of 36 hours on duty, and 12 hours off duty, was not a good fit for me. While I loved delivering babies, the long nights up “on call,” left me tired and exhausted. I even fell asleep, face first, into my fondue dinner one night. Another night writing an Intake note about a new person, I wrote, “This 36 year old picnic coca cola…” Clearly I had had a “micro-sleep,” while writing my report.

Rather than becoming an OB-GYN, I became a psychiatrist and Sleep Medicine specialist. When I returned to Dartmouth-Hitchcock Medical Center, I had the good fortune to do my sleep medicine research fellowship with Peter Hauri, PhD, who had just authored a book in 1977, in which he coined the term, “Sleep Hygiene.” While he never particularly liked this term, it stuck. Sleep hygiene has come to be well known as the behavioral ways we can help our healthy natural abilities to sleep, and feel well rested the next day. On April 5, 1978, I passed the first Clinical Polysomnographer certification exam with an auspicious certificate number of “007,” next to the likes of Dr. William Dement and Dr. Elliot Weitzman, both pioneering sleep researchers. (Polysomnography uses brain wave measurements to measure changes in neural activity – normal or abnormal – as a patient stays overnight in a sleep lab.) As the field of Sleep Medicine developed, this term was updated to Board Certification in Sleep Medicine by the American Board of Sleep Medicine in 1991. Continue reading

Your Doctor Is In, But Is She Awake?

Untitled5Last week, to my delight, a returning patient whom I have followed since 2011, began our session with a smile, “I am still cured.” This Ob-Gyn physician, had come to me with a simple request, “I want to get off Ambien and get back to a normal ability to put myself to sleep.” She had been a good sleeper as a child and through college. In medical school, she would manage occasional bad nights of sleep with relaxation breathing and white noise machines. During her residency in Ob-Gyn, she was up 24 hours, at least once a week.

During other stretches of her residency, she would work 6 weeks of 12-hour night shifts (which of course stretched out to 14 hours). But life was simple while in training, work long hours, eat, and sleep from exhaustion. If she had an occasional bad night of sleep, a simple OTC (over-the-counter) sleeping medication, typically containing some form of Benadryl-like medication, would do the trick. Continue reading