Afraid Of The Dark

"When it is dark enough, you can see the stars." Charles Austin Beard

My patient was a middle aged successful financier. World traveler, well educated, articulate. I asked him what brought him into the sleep lab and he said 'I have insomnia.'
I talked to him about good sleep hygiene, including the fact that the 2 things that induce sleep, are temperature and light. The cooler the room, the darker the room, the easier it is to sleep.

'I'm afraid of the dark.' Naked confession.
'Do you sleep with the light on?'
'No, I can have the bedroom light off, but I can't handle it if I look out into the living room and I can't see. I have to have a light on out there. I'm not afraid of anything, ANYTHING! I've been in bar fights and always won. I figure anyone who breaks in to my house, is already on the losing side. I'm not afraid of anyone! But this, I've always been this way, ever since I was a child.'

'Seems reasonably to me, one of the first fears we have, is the fear of the dark.'
'Not everyone is as understanding as you. I've had girlfriends make fun of me.' He said this quietly and with no small amount of embarrassment.
'Are they STILL your girlfriends?' I was incredulous someone who was supposed to care about him, could mock him for this.
'No, not anymore.'
'Well, pooh to them. I can leave the nightlight on in the bathroom if it will help.'
'No, I'm fine when I'm not alone like when my girlfriend stays over. I'll be OK since I know you'll be down the hall.'
'You'd be surprised how many people sleep better knowing we are watching over them. And warm bodies do help. Have you thought about a dog?' ( I was thinking longingly about my white chihuahua, Courage, fast asleep at home. Mister Snuggle Bunny himself!)
'I travel too much, it wouldn't be fair. I always wanted to get another one, though. I had one when I was growing up.' he added wistfully.

'Do you have an alarm system?'
'No.'
'Then that's your number 1 priority. You can even get one that is portable and hangs on the door so you can take it with you when you travel. Some of them are motion sensitive, all it takes is touching the doorknob. They emit a PIERCING alarm.'

'Anything else causing problems?'
'I have nightmares. Someone is always trying to get me. Like in all those bar fights!' he laughed.
Ah, now we are getting somewhere. Often when people have sleep apnea and are struggling to breathe, their body does anything to get them to wake up and take a breath. Nightmares included.
'We'll figure out what's going on tonight. And you ARE safe', I reassured him. 'I'm in the control room monitoring you. The other tech and I are reg. respiratory therapists, have our BLS card ( basic life support) and we have an AED ( automatic electrical defibrillator) and resusitation bag with oxygen in the hallway.'

He did have sleep apnea. During REM (rapid eye movement), while he was dreaming. He woke up in he middle of it and I went into the room.
'Funny, I was just dreaming I was in that bar fight again!'

Afraid of the Dark? Perfectly good fear to me and the child in all of us.

'Discover The Gift of Sleep'-SleepCompass.com Jane