Véronique, a nurse at the Toulouse University Hospital since 1991, welcomes her with a smile. She takes a history, notes in particular the existence of a syndrome of restless legs. And soon presents him with the comfortable seat in which he will have to spend four times 40 minutes until 5 p.m. Objective, to measure his level of vigilance once the blackout curtain of the room is completely down.
For this, she must install 17 electrodes. Two are placed on either side of the eyebrows to measure eye movements. Sensors are also installed on his skull and chin, while an abdominal strap goes around his chest. The cables connected to the repeater make Bertrand look like a porcupine, who doesn’t seem stressed.
Dr. Rachel Debs in a room testing patients’ sleep.
Véronique checks that everything is working. And here we go for the first three electro-oculograms, electroencephalograms and electromyograms of the day. A night-vision camera shines its round, cold eye on Bertrand, who does not once glance at her. He is already busy fighting once morest the drowsiness that is gaining him. The proof, the eye movements which were relatively fast during the first minutes slow down. The muscles in his face relax. Immediate result, the spindle waves – hitherto narrowed – draw increasingly ample waves on the screen, a sign of the first delta waves. At the very bottom of the screen, no trace of snoring yet. But, following 18 minutes, Bertrand switches to theta rhythm.
“He fell asleep,” translates Véronique, who gestures to Dr. Rachel Debs. “He struggles, he opens his eyes from time to time. But he’s sleepy. You’ll have to see him,” slips the nurse to the head of the department. It’s hard to be in the oven and in the mill when you’re the only doctor on duty. But Rachel promises to find a moment in the followingnoon. We must first check whether the other three tests of the day confirm or not the impression left by the first.
A medico-legal problem
Twenty-two minutes later, Véronique returns to the room, opens the blackout curtain and asks Bertrand for his impressions. “I dozed off, but I didn’t sleep.” Surprise when Véronique tells him otherwise. “And if you were on a bicycle, what would happen”, asks the nurse, as often when faced with patients in denial. “I would fall”, answers sheepish Bertrand, not unhappy to be delivered from the machine.
Dr. Rachel Debs under screens that monitor patients during tests.
He takes advantage of the break to go and stretch his legs and smoke a cigarette which will perhaps help him resist better during the second test. Like a number of patients in his case, he may as well be declared unfit to drive if the tests are not good. “There is a medico-legal problem with driving, for specific sleep pathologies such as narcolepsy, idiopathic hypersomnia or Klein-Levin syndrome”, explains Dr Debs.
Bertrand may not be there yet. But with her DU “sleep technician”, Véronique still intends to send messages on good practices to the patients she accompanies for several hours during these day hospitalizations. “Sleep is not just regarding rest. People who work at night, like those who have trouble sleeping, often have weight problems and impaired immune defenses.”
Unless there is a serious genetic problem, it is therefore better to listen to it to sleep soundly.
Attention to children also affected by sleep concerns
Of the five beds in the sleep unit at the Pierre-Paul Riquet hospital, two are regularly occupied by children under 5 years old. “The youngest patient we received with 6 weeks,” says Dr. Rachel Debs, the head of the department, who works in connection with pediatric endocrinology. “They send us children with obesity for whom we will look for sleep apnea.”
Here too, a Covid effect was noticed in toddlers. There is a before and an following health crisis. “We had children who, during the first confinement, took up to 20 kg. It’s complicated, because it is the translation of a malaise and it accentuates fragilities.” The care of children, the Toulouse University Hospital did punctually in Rangueil, “but it was mainly developed when we arrived at the Purpan site, specifies Dr. Debs. The problem in children was little taken care of before “.
And it got worse with the evolution of society. “In 90% of cases, insomnia problems arise because people don’t slow down their brain activity before bedtime. They don’t change their behavior, so the brain doesn’t go into automatic mode. His attention is often taken up by the screens. The movies are getting later and later at night when they start. But in fact, when you’re a heavy sleeper and you need to sleep 9 to 10 hours, it doesn’t fit within the allotted time in relation to the supposed wake-up time.”