Sleep first pressed its way into my awareness through pulmonary rehab programs I ran more than twenty years ago. It seemed that many of the COPD patients I served had trouble sleeping. Then, upon starting up a lung health clinic in an adult primary care physician practice that served a rural region in Missouri, it took only two years to understand that sleep was playing a major role in the issues of health that surrounded the chronic diseases of the patients in our practice. A year later, the physicians had me start a sleep lab as a part of the lung health clinic.
I read like crazy to see what evidence-based medicine was saying about the vetting process for sleep disorders. I then boiled down the various questionnaires to a few choice questions for our own simple fifth-grade-level questionnaire. Since I had accidentally discovered that dreams were a matter of fascination with the patients in our practice, I included one peculiar question as a possible touch point: "Do you wake up at night with dreams of being trapped?" If nothing else, that question gave me many good stories of weird dreams and served as a way to personalize a very clinical process for some patients.
After three years of employing this questionnaire with patients during sleep evaluations, I could not escape the fact that some of the questions—bad dreams in particular—actually implicated me as a sufferer of at least a mild sleep disorder. Shoot! Slowly and surely, sleep pressed its way into my personal list of health concerns—diet, exercise, and now sleep. Tricky fellow that I am, I surreptitiously used my position as a way to vet my own disease. I had a new employee who was ready to do his first sleep study by himself. What better way to evaluate his readiness? Yep. That first sleep study revealed that I needed a sleep study for the valid record.
Long story short, my official sleep study revealed a specifically REM-related obstructive sleep apnea (OSA). The disorder had imposed itself on me in the form of midafternoon sleepiness, a recurring entrapment dream from which I would awaken with shortness of breath, and an increasing incidence of the migraines from which I had suffered since childhood. A second study (or third, if you will) showed that CPAP took care of my problem. Since treating my sleep apnea with CPAP therapy, I no longer suffer with entrapment dreams and frequent awakenings at night, and I have only had three migraines in the seven years since starting CPAP. Further, I have to believe that I am successfully staving off those potential, dreaded familial diseases of my aged years.
Now, as a registered polysomnographer, I get to spend an hour of set-up time with patients before their own studies. I find that my story provides a touch-point that can carry some frightened and/or skeptical patients through to successful therapy. I may not have bad dreams when I sleep, or many dreams of any sort that I remember; however, I do maintain many sweet dreams for the sufferers of sleep disorders.