It’s a Living: Polysomnographer
The Journal Record
March 9, 2011
By Brian Brus
To say Arnn Hixon works the night shift isn’t as accurate as to say he works the sleep shift. He watches as other people dream, looking for some telltale hint of why they might not be breathing.
And this week is particularly significant to Hixon and others polysomnographers: National Sleep Awareness Week, an effort by the National Sleep Foundation to spotlight the importance of healthy rest and the problems that can develop in its absence, is March 7 to 11.
For example, a recent survey conducted by AAA found that two in five drivers reported falling asleep while at the wheel and one in every six fatal crashes involve a drowsy driver. Other sleep-related concerns include bed-wetting, insomnia and narcolepsy. Researchers have found links between sleep and heart disease, obesity and diabetes.
Hixon is a sleep detective of sorts, delving into mysteries that potentially ruin lives. Some of his most challenging work at the Lynn Institute in Oklahoma City involves tracking down the causes of sleep apnea. Simply put, apnea is a pause in breathing.
“You’re looking for clues, which can be pretty subtle if the patient has restless leg syndrome or periodic limb movements, for example,” Hixon said. “You’ve got to look at the EKG and the person’s cardio and pulmonary history. You need to know what kind of drugs they might be taking and pay close attention to their breathing rhythms.
“And you have to see if maybe they’ve got complex obstructive sleep apnea, which is potentially very dangerous because it means they’re not breathing at all. If you’ve got a case like that, it can get pretty entailed quickly. There’s a lot of elements to consider,” he said.
Patients check in at the institute’s sleep laboratory about two hours before their usual bedtime for acclimation and preparation with a technician. Hixon said the private rooms are designed to feel like a comfortable hotel room with a full-sized bed, television, chair and clothes bureau. After they dress for bedtime, a sleep technician hooks up various monitor wires, air flow sensors and pressure-sensitive belts to be as unobtrusive as possible.
If everything goes according to plan, the person will sleep, perchance to dream. And there’s the rub that gives Hixon pause, because sleeping should be peaceful and reinvigorating, but for some it means the risk of death.
Hixon collects the data and analyzes it the next day to prepare it for a physician for interpretation and diagnosis. Apnea often requires treatment by continuous positive airway pressure, or CPAP, a form of respiratory ventilation via a mask to keep the airway open. Hixon said a less experienced specialist may simply treat the problem by increasing the air pressure instead of considering other potential factors, yet another potential twist in his medical detective work.
“I do get a lot of patient contact at the end, if they have to wear CPAP gear,” he said. “You can expect a lot of trouble-shooting will be needed to help them get as comfortable as possible. … But that’s OK, because I want to be there for them. What I do is very inclusive as a sleep technologist. Sleep is vital in our lives. ”