Sleep technologists are detectives. We are often the first to notice brief runs of atrial fibrillation, the first to see the evidence of disruptive periodic limb movement in patients who think they are not benefiting from their CPAP, or the first to identify wayward seizure activity. To do this, we have to train our observational skills, keep them sharp. Detective instincts, once honed, will likely cross over into our daily lives. For me, noticing the little things makes walking the pathways of my favorite nature area more than just a doctor-prescribed exercise routine.
I recently walked on a snowy path in the woods. I started early because I hoped to be the first; however, four other hardy souls had tramped through the snow before I got there. Speaking of souls, or at least soles, I came to know those mysterious early hikers by the tracks they left. Two of them traveled in the same direction as I, and the other two had come the other way.
One small set of tracks, coming toward me, clearly told of a runner training for some mad race. The heel was built up with a compression pad and the rest of the sole had small, deeply furrowed, rectangular cleats, and the grippers proceeded in a slow curve up and around the edges of the shoe--a shoe made for running in a slippery setting. Then there was a large set of shoe prints, also coming toward me—five swaying ridges ran across the bottoms of each simple-patterned sole. Ten inches of heel dragging preceded every step this big fellow took. This might have been a large man who walked the path to lose weight. Then I realized that these were the imprints of over boots that fit somewhat loosely on the hiker’s feet, and the loose fitting boots dropped each heel to the path with every step, well before the man's heft lent itself to the resulting imprint. I always like to "see" people working to stay in shape.
Another early hiker had gone my way that morning whose hiking boots left marks much like mine and almost the same size. This could have been my hiking doppelganger. Finally, I "met" a hiker out of place. This person left tracks that looked like dress shoes, completely flat with a relatively high heel. Whoever wore those shoes must have been nimble footed because I never saw the print slide or the stride greatly altered no matter how treacherous the rocks beneath the snow lay. Thus did I share my winter hike with people I only know by the marks on the soles of their shoes.
Night after night, we sleep technologists walk with sleep-tortured patients. We watch them closely and see the telltale signs of paths long trod. Occasionally we catch the smallest piece of evidence, and sometimes our detective work makes all the difference. Some think sleep technologists have a boring job. Very likely, most good technologists believe the upcoming night is an adventure. If not, we probably would not stay the course, with our eyes wide open.