Meanwhile, the man is less restless than the average patient But suddenly, at 2.03 a.m. he putts off his chin monitor and tugs on his nasal airflow indicators McMahon swings into action.
"It's only me and I'm putting these back on." she says quietly slipping into the dimly room and reattaching monitor to chin "And these have to go back into your nose," she murmurs repositioning the apparatus.
Stakes leaves minutes later satisfied that she has it under control. Often say McMahon the doctor will stay especially if there is a patient who might encounter some sort of difficulty during the night and grab sleep when he can Stakes serves as a neurologist as well as an internist in day light and on nights when the lab is in service he says "I fit sleep in someplace".
The study of sleep explains Stakes is an extension of my internal medicine and neurology interests--it blends the training together.
As for McMahon she says generally enjoys but I only do it two nights a week, but she says of the hours, "that's one of the problems with working in a lab like this you tend to develop a sleep disorder yourself."
When there are no patients in the lab McMahon spends her time "scoring," that is translating the scribbling on the one third to one-half mile of paper generated in a night's monitoring into readable numbers. Each 20-second unit is assigned a number corresponding to the depth of the sleep during the period, and then marked on a grid. Those numbers can be led into a computer to aid the diagnosis of the disorder. The strips of paper are used so that both sides are written on, and they are microfilmed and thrown away. The microfilm is kept, however, because there may be recurrences of disorders.
Disorders sometimes overlap into other fields Sleep disturbance and over rapid REM sleep on set characterize depression, and manic depressives in a manic state can go many nights with only one or two hours of sleep, according to Stakes.
Relationships like these move into the area beyond disorders and into the actual meaning of sleep. Why, for instance, do viral infections like mononucleosis or even the common cold cause sleepiness?
Stakes does not have an answer, and there may not be one for a while, at Mass General or else where. The underlying problem, he says, is "not understanding the basis of the alteration of consciousness."
'That's one of the problems with working in a lab like this-you tend to develop a sleep disorder yourself.' Margaret A. McMahon