When the sun sets in Los Angeles, there's more to the city than just quiet streets, night watchmen, and 24 hour diners. Off-Ramp's Kevin Ferguson visited the sleep lab at the UCLA Medical Center in Santa Monica.
It's 9:30 and Sleep Center technician Paula President is waiting in a small office. All of the other patients have been checked in, hooked up, and tucked into bed except for a man who is on the way from Gardena. So for now, she watches. "I don't think anybody fully understands what I do," she says. "They just go 'you watch people sleep for a living?' It's a little more than that, but yeah. Basically."
The sleep lab is the only active part in an otherwise deserted wing of the hospital. And active is a relative term: There's no music, no doctors running from room to room, no patients on gurneys, and no visitors. On any given night there are no more than four patients -- all asleep -- and two technicians. Paula has done this for 14 years. "I kind of like it here because it's quiet at night," she says. "There's not a lot of hustle and bustle or bosses or anybody running around. But that also means you have to be really responsible for what you're doing, you have to know what you're doing, because there's no one else to blame if you mess up."
Paula is married, with 5 kids. She wakes up at 5pm at her home in Lancaster and drives about 70 miles to work. It's a brutal schedule, but Paula says she had plenty of warning. All aspiring sleep lab technicians learn early on that being a night shift worker is literally a sleep disorder. She can even point to the exact condition (a circadian rhythm sleep disorder) in her operations manual.
The tardy patient arrives after a little bit of time. His name is David Shao and he's not a typical sleep center patient because he's only 30,and healthy. But he snores a lot. "My wife complained to me for about 8 years that I stop breathing at night," he says.
His condition could be sleep apnea, which is serious, but treatable. Soon after, Paula comes in with a handful of long, colorful wires for David. They go on his legs, over his chest, forehead, temple, nose. Once he's hooked up, it's lights out. Paula heads back to the office where she can see everything David does: when he snores, when he wakes up, even when he dreams. "We actually ask that on a questionnaire in the morning," she says. "And a lot of times they had a dream about being here. I had a few patients tell me that it was me and them and we went out and we came back and we got our hair and nails done and then their mother showed up. it's usually something crazy, usually about the lab."
While David dozes off, Paula checks in with a different patient who hasn't yet fallen asleep. On the security camera monitor, the patient looks asleep but her brain tells a different story: one of the patient's primary brain waves is showing a pattern known as "black grass," which indicates that while the patient's eyes may be closed, their brain is very much awake. As the night progresses, the patterns will change, indicating each of sleep's different stages. This particular patient is here because she's had trouble sleeping. The wires and the strange bed make it even harder.
Lab technician Paula President (left) monitoring patients
The displays also show breathing patterns and oxygen levels. That'll help assess David's condition. Paula says that sometimes can be the scariest part. "Some of our patients will have severe obstructive sleep apnea," she says. "They have the long pauses in breathing, your airway is blocked, you're struggling to breathe, and finally your CO2 rises high enough to where your body wakes you up and you gasp for breath."
She says it makes her nervous, but that she has to remember the patient does that every single night. And when they have it that bad, they'll get a mask for the night so they can breathe easier. But that doesn't happen too often, and she'll spend most of the night keeping an eye on the patients, helping them with bathroom trips and keeping in touch with family, any way she can.
When the morning comes, Paula will drive back home to Lancaster, get her kids ready for school, and finally--after a long night's work--go to sleep.