Let's Make a Deal Pt. 10

"Your brain patterns were pretty normal until the time came to wake up, and then they just stayed in sleep mode for a long time. To be honest, I've never heard of a case quite like this, and I did a little research. There are some things we can try, but most of the things we prescribe just don't seem to apply. Melatonin at bedtime? You didn't really have trouble going to sleep, allowing for the strange setting. On the other hand, you weren't falling asleep the instant you lay down, as if you were seriously sleep-deprived. Stimulants first thing in the morning might help, except that you aren't awake to take them. Nonetheless, you may want to try keeping caffeine pills by your bedside and taking one as soon as you possibly can, and see whether that helps you wake up faster thereafter. Should you try that, please let me know if it does any good. It doesn't appear that you have any need of stimulants to keep you awake for the rest of the day. On that, I'm going by the answers you provided us to the questionnaire and by what you've said today, of course. We didn't make you stay in the lab all day."

He discussed a number of other things that helped other people with problems Martha didn't seem to have. He suggested that an earlier bedtime and a longer night's sleep might make a difference. He and Martha discussed that a little. She said that she thought she was getting enough sleep, and that earlier in her life she had thought that might be the problem and tried getting more sleep. It hadn't seemed to help her wake up any more easily, when she'd tried it. He suggested that she try it again, but agreed that the lack of signs of daytime sleepiness made this an outside chance at best.

He gave her a diagnosis of primary hypersomnia without EDS. Scott intervened to ask, and learned that EDS was excessive daytime sleepiness, and that the diagnosis was tentative and rather anomalous since hypersomnia was often just defined as including EDS. In any case, hypersomnia, it seemed, was not all that well understood, when it wasn't due to some other condition.

Both Scott and Martha were relieved to be told that she hadn't exhibited any signs of sleep apnea or any other breathing or heart difficulties. Scott wasn't really surprised, though. From the one night he'd spent with her, he had been fairly confident that he would have known if she'd been having that kind of interrupted sleep.

At the end, the doctor said, "I would greatly appreciate it if you would let me know of any additional data. If you try something, whether it helps or not, or if something changes seemingly by itself, I really do want to hear. I will continue to look for something helpful, including consulting colleagues, in the hopes that someone has encountered a case like yours. We all see cases that don't fit the typical patterns, from time to time, but I have never heard of one like this. I wish I could help you.

"About the only other suggestion I can think of is this. Conditioning can do all kinds of things one wouldn't normally expect, things that are not under conscious control at all. If you can find something that will work to wake you up quickly—things like ice cubes on the back of the neck come to my mind, and yes, that is extremely unpleasant—then if you can have an assistant apply whatever it is as soon as your alarm comes on, you may be able to condition yourself to wake quickly to your alarm." He looked at Scott as he said, "an assistant." Scott said that he'd be happy to try it, except that if anyone woke him up with ice that person wouldn't be around very long. He also said that they hadn't had any plans for him to be sleeping with Martha all night on a frequent basis, but that they would have to consider it.

They called Lynda to ask her to close up, set the alarms, and just drive home in Martha's car. There wasn't enough of the afternoon left that Scott felt it worth while to go back to the office. He was grateful that Lynda was now checked out on the procedures and that he could trust her to see to everything. One unexpected thing he had gained from the deal was another assistant. In many ways Lynda was now functioning in that role, still learning but doing well, and he was thankful for it.

Martha pressed Scott to stay for dinner. The three of them discussed what the doctor had had to say. It seemed as though there wasn't any real hope for improvement. Lynda offered to get up a few minutes early for a few days, to grab some ice and at least see whether it worked to wake Martha quickly, and to continue with it if it did. She also said, "Scott, I know Martha would love to have you sleep over any time. I'm not sure how you'd be able to have ice waiting for her alarm, but other than that you would be better for this than I will."

Scott said, "I'd love to do it. I know my nosy neighbors have already figured out that something's up. I've had to dodge some not so subtle questions already. So I guess that my being gone all night a lot will just give them more to gossip about."

They agreed that Lynda would try ice in the morning and let Scott know how it went. Scott did ask for sex before he left, leaving it to them to decide on the details. Rather to his surprise, Martha pushed him at Lynda. While it wasn't exactly a quickie, they didn't dawdle. Both enjoyed it very much, though they agreed that it would have been nice to take more time.

At the last minute, it occurred to Scott to try to schedule another weekend with them. They agreed on that weekend. Scott kissed them goodnight, drove home, and fell into bed.

Continue to Part 11