Sleep(less) in Boston

It is my third time to visit Boston. This time I came to Boston to catch up on sleep.

No, I’m not saying that Boston is a sleeper city, for it is an exciting place to visit. Nor am I’m saying that it is a place most conducive for sleeping. In fact since we stayed in a hotel in the heart of the city, it was quite noisy, with all the cars honking and with loud police and ambulance sirens wailing. Added to that, we landed past midnight in Boston, contributing to my sleepy predicament.

Why I came to Boston is to attend a conference to catch up with the current studies, trends and technology in the practice of Sleep Medicine. Honestly I nap a little in some of the lectures, so I literally catch up on my sleep too!


theme poster of the convention

The science behind sleep has fascinated me since I was in high school, so it’s not a surprise that one of the subspecialty I pursued was on this field.

One of the fascinating sleep phenomenon that I wanted to learn more of are the Parasomias, which includes nightmares, night terrors, sleep walking, and more that goes bump in the night.

One Parasomnia is REM Behavior Disorder (RBD), in which people with this disorder reenact their dreams. Normally when we are in REM (Rapid Eye Movement) stage, a sleep stage when dreams usually occur, our muscles are disengaged and we are temporarily paralyzed, so we don’t move and act out our dreams. In people with RBD, for some reasons the muscles are not paralyzed, so they can kick, swing a punch, crawl out of bed, or even perform a complex activity while sleeping. Not only this put the patient in danger, but also the sleep partner.

One interesting fact I heard from one lecturer is that soursop which is a tropical fruit, or also known as guyabano in my home country, the Philippines, can potentially increase the incidence of RBD. I can almost read a headline news: sleeping wife punch husband, after drinking guyabano punch.


opening session

Besides the medical implications, there’s also societal implications of people having poor sleep. These are also topics discussed during the convention.

Research have shown that birds can sleep, as half of their brain can go to sleep, while on long flights. But not humans. We need all our faculties when we are doing complex task like flying a plane. Though aviator Charles Lindbergh, the first man to cross the Atlantic on solo flight was awake for more than 34 hours when he accomplished that feat, nowadays we have instituted regulations for pilots limiting their hours of flying and assuring they have a sufficient amount of sleep in between flight.

Same principle applies with operating any machinery or driving any motorized vehicle. Studies have shown that a significant number of vehicular accidents are due to driver fatigue and sleepiness. For instance a sleepy driver can have a slower reaction time. A decrease of even 50 milliseconds in reaction time in hitting the brakes means 5 feet more before coming to a stop, and that can mean safely stopping or crashing, or escaping an accident or dying.

For the medical community, especially the ones who are undergoing residency training, there’s now an imposed 16 hour limit for a first year resident for continuous work. Beyond that they should be relieved, for they need to go to sleep. During my residency training in the mid 90’s, the limit for continuous hospital duty was 30 hours. This regulations though are not enforced to doctors after they are done with their training.

We as a community really need to change our opinions. Staying awake all night to study or pulling an all-nighter to finish the job has become a badge of honor. We view sleep as only for slackers. When we should view that those people who get adequate sleep, that is 7-8 hours a night, should be the ones commended. So no more sleepless in Seattle, or Boston, or New York, or Tokyo, or any part of the world for that matter.

Just like when you’re hungry, the solution is to eat. For people who are sleepy the solution is not more coffee or energy drink, but getting adequate amount of sleep. Of course if you have a sleep disorder and not getting a restful sleep then you need to see your doctor.

Sleep is important in so many levels. Not only for health but also for safety and being more productive. In addition, dreams come when we sleep, and life without dreams would be uninspiring.

From Boston,


Boston Common (central public park in downtown Boston)



(*photos taken with an iPhone)

How Much Is a Good Night Sleep?

How much are you willing to pay for a good night sleep? A hundred dollars? Few hundreds? A thousand dollars?

Few nights ago, I was “rudely” awakened by a phone call. It was a weekend night, and it was 2 o’clock in the morning. And I was not even on-call!

The call was from our answering service, telling me that they cannot get hold of my partner who was supposed to be on-call. They also tried some other partners, but no luck. So they called me. Lucky me, I answered.

So even I was not on-call, I took care of what needed to be done. The trouble was the calls never stopped. I ended up admitting a total of 5 patients into the ICU in a short span of the unholy hours of the morning and I answered calls in 3 different hospitals the rest of the time I should be snoozing.

What happened to the one on-call? There was a snowstorm that night, and at that time, I was also concern if something happened to him. Anyway, I would not divulge any further details on that here, except that he was not abducted by the aliens.

You might say, I should have turned off my phone, which I was tempted to do. But people lives were on the line, as these patients were critically ill, and needed somebody to care for them. So I just suck it up.

That night, if only I could find somebody else to take the call, I was willing to pay more than a hundred dollars, so I could go back to sleep even for just a couple of hours more.

Ensuring a good night sleep is a big business. People are willing to shell out even several hundreds of dollars for a good mattress or bed. Come to think that you will spend a third of your lifetime in bed, why not get a good one. People also spend billions of dollars yearly for sleep medications. Yes, that’s billion with a B!

The cost of bad sleep is staggering too. In a study published in Time not too long ago, it was estimated that the productivity lost from workers in the US who are sleep deprived is about 63 billion a year. Again that is billion with a B!

One group of people who can suffer from sleep deprivation are people who travel a lot for work. From the changing time zones and dealing with jet lag, to the fatigue of travel alone, and to sleeping in different places or beds other than their home, all contribute to this. I’m sure they are more than willing to pay top dollars to travel business class or book in a decent hotel just to secure a good night rest. That’s a multibillion-dollar business too.


sleeping in the city that never sleeps

Last time I went home to the Philippines, I was on-call on the weekend before the day that I flew back to Manila. Knowing that I would be working for 3 days and 2 nights straight that weekend, and come Monday, I would be embarking on an almost 24 hours travel (total of 17 hours of flight time on 3 plane rides, and 6 hours of layover in airports), I just could not imagine my body taking the toll of that travel, after being on-call. So I was willing to pay a little more for a better night/day sleep on the airplane. The few inches of space and the few degrees of recline was worth it.

People with untreated sleep disorders and people who are chronically sleep deprived would do anything to get a better sleep. I know they do, for I deal with them everyday. They are like zombies in The Walking Dead. So getting a good night rest for them is something to die for. Sorry, pun intended.

If you are always not getting enough rest at night, over time you will pay for it dearly. For you pay it with your health. Poor health that is.

Ironically, doctors who should be giving advice on how to have a good night sleep, are among the most sleep deprived people in the world, according to a national survey. That may include me. A sleep-starved sleep specialist?

“Physician, heal thyself!” Or in my case, please just let me sleep.


PS. I’m keeping my dream alive. So I’m going back to sleep.

(*photo: most expensive condo in New York city, from