BME summer immersion 2010 week 2

In the second week of summer immersion, I became more familiar with the fundamentals of sleep, sleep disorders, and sleep medicine. I also developed a greater appreciation for the importance of sleep medicine, both to the individual as well as to society at large. A not insubstantial portion of my week was given over to conducting background reading on sleep and sleep disorders so that I would make better sense of what I encountered in the clinical setting. In order to identify sleep disorders, assess their severity, and prescribe efficacious treatment, the ability to read and interpret electroencephalographic (EEG), electrocardiographic (EKG), and electromyographic (EMG) waveforms is essential. Toward this end, I have been familiarizing myself with the considerable existing body of knowledge on the subject.

I was able to be present during several “hookups” of patients for nighttime recordings. I was also able to sit in on consultations between my advisor and patients. I was impressed by the meticulous nature of these consultations and the exacting way in which medical history, family history, and lifestyle details were teased out of the patient in an effort to ensure proper treatment. One individual with severe sleep apnea was prescribed a CPAP device to alleviate the frequency of breathing cessations (and associated arousals that disrupt sleep). The device will not only make this individual – who was feeling torpid and lethargic throughout the day – feel refreshed and invigorated, but may also serve to lower his high blood pressure, a possible consequence of the labored nature of breathing during obstructive episodes.

A refinement of my probable research topic also emerged. Dovetailing nicely with my undergraduate education in electrical engineering in general and my interest in biomedical instrumentation in particular, my advisor and I agreed that design and construction of a novel sensor would represent an important contribution to the existing bevy of sensors. Several possibilities emerged including an incontinence sensor to detect bed wetting and concomitant interface of it with the commercial system currently in place, an accelerometer-based periodic leg movement sensor, or most likely, a new implementation of elastomeric plethysmography, a technique used to noninvasively track thoracic (chest) and abdominal contractions and expansions while breathing. The latter is essential for accurate diagnosis of several important medical conditions including paradoxical breathing in which the chest and abdomen contract and expand in an antagonistic manner as well as discriminating between central and obstructive sleep apnea. A project involving the design of a novel device to diminish the severity of sleep apnea is also emerging in collaboration with Dr. Arthur J. Spielman of the Center for Sleep Medicine.