The Test I Could Never Pass
As a sleep lab manager, I get to perform many different types of tests but the one that I am always amazed about is the MWT. I do not think even on my best day-having had a week of nights without being woken up by technicians, my son, or my dogs-I could pass that test. I need light and sound to keep me going.
The MWT, for those who are not in sleep, is the Maintenance of Wakefulness test. It is given to those who are on CPAP and need to stay awake for their job such as truck drivers, airline pilots, and train conductors. It is a series of 4 "naps" each lasting 40 minutes where you sit reclined in a low lit room with no noise and you are not to make any repetitive movements that might keep you awake.
Now if you have ever met me you know two things about me: One, I am a fidgeter, and, two, I am a foot tapper to end all foot tappers. I could probably get into the Guinness Book of World Records for tapping my foot so much. So the idea of taking those two behaviors away from me sounds like torture-even if it is only for 40 minutes. And if I could not tap or fidget I would probably end up tapping my fingers or falling asleep.
Now, just imagine you are doing a sleep study and it is totally quiet (that includes the fact that the patient you are watching is a quiet breather and does not snore) and you have the lights turned down to night light level. Now tell me: how you are supposed to stay awake for that?
I have technicians who turn the lights off during the night and I just can not imagine how they stay awake. I want light and noise. Otherwise it is nighty night time for me.
The last MWT I did, I was absolutely amazed at the guy. He came in as soon as he got up that morning. Skipped his morning coffee and followed all the directions. He was set up and ready to do his first nap. He got in the room, relaxed and I explained the test to him, turned off the light, and he did great. He stayed awake through the first three naps like a pro.
The fourth nap came after he had lunch. I should have known. I turn off the lights and started the test. Two minutes later, he is snoring away. I felt so bad. I wanted to help him but I had my job to do. I finished the test, scored it, and sent it to the doctor.
The worst part of my job is to call the patient to tell them the results of the test.
In the end, what I am really grateful for is that I do not have to take this test so that I can perform my job. I know that there are times I have to fight to stay awake, but at least I can get up and walk.
I just wonder how many truck drivers, pilots, and conductors really need this test and have not gotten it.