No Rest For Techs
Yes, sometimes it is difficult to stay awake while monitoring patients [“Asleep on the Job” in the March/April 2006 issue], but we must understand that this is what we choose to do. We [technologists] made a decision to pursue this career, and being sleep deprived comes with the territory. Society dictates a 24/7 attitude. Some of us will never be able to catch up or get the sleep we have lost over the years. For myself, it has been about 19 years and counting!

It is very important that the technologist understands, in order for you to function at night, you must sleep in the day. No shopping, swimming, waiting until later, drinking alcohol, etc. You must sleep to function and to be able to act like a human being!

—A functional sleep-deprived technologist

Another explanation for REggie White’s Death
Years ago, it was obvious from Reggie’s very hoarse voice that he might have had GERD [gastroesophageal reflux disease], along with his sleep apnea [“Could Reggie White’s Death Have Been Prevented?” Sleep Review’s “Sleep Report” June 7 e-newsletter]. Sudden death in this setting is just as likely due to regurgitation and asphyxiation. We would need to know when and what he had last eaten before going to bed that fateful night. Ten years ago, I wrote him a letter, warning him about GERD along with apnea, but got no answer.

Edward S. Friedrichs, MD
Internal, Addiction, and Sleep Medicine, retired
Brown Deer, Wis

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SSRI Drugs must be used appropriately
In your article “The Sleepless Sex” [May/June 2006], Mary Ann Ty, MD, suggests:

“If, during the course of evaluation, it is determined that the insomnia is one of the symptoms of mood disorders, such as major depressive disorder, bipolar disorder, or anxiety disorders … it is then necessary to treat the underlying condition with antidepressants….”

Giving antidepressants to anyone with bipolar disorder is not considered a treatment. It is closer to malpractice. Unless treating the “underlying condition” includes trying to induce a full-blown manic episode, your readers would do well to disregard this advice. SSRIs and the like are a last resort and used only if the patient is properly titrated on a mood stabilizer (lithium, etc).

“SSRIs for anxiety” was created by the drug companies and has questionable benefits. The paragraph should be re-edited to focus not on “mood disorders” as a general category, but only for depression.

Jeff Horsager

SLEEPY TECHS Solution
I am lucky enough to work in a sleep lab where we sleep techs score our studies during acquisition.

Personally, I can say I have fallen asleep, and it was mostly due to boredom. Being able to score my test while I’m running it has made all the difference in the world. It has also saved our lab lots of money, and we never get backed up on our scoring. During CPAP trials, I don’t start scoring until the patients are fixed on their CPAP, usually by 2 am. I can easily score two records a night.

I have been doing sleep testing for more than 20 years, and I believe if we offered our night techs who score more money and respect we would give them the incentive to stay in sleep medicine.

—Deloris Acton, RPSGT

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