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Things That Go Bump In The Night When Mike first came to me he told me that he was using an extra bed sheet to tie himself into bed each night. He expressed that he was terrified to go to sleep each night and reasonably so on two occasions he awoke from sleep just as he was trying to jump from his second story bedroom window. He could vividly recall dreaming of his days in World War II. He was dreaming that he was in an airplane in combat that was crashing and he had to jump out. In addition to trying to tie himself into bed, he had moved much of his furniture in front of the window. Robert’s dreams were a little different. …

The sleepless child poses a diagnostic challenge to the sleep specialist for a number of reasons. Often the younger child is not able to adequately express the problems affecting his or her sleep. There are a number of influencing environmental factors not under the child’s control. Often, the interactions between the child and the caretakers need to be taken into account. The evaluation often starts by assessment of issues that are related to the child’s age and development. The infant starts to sleep more soundly by the third to sixth month. Unfortunately, there is usually an increase in awakenings from six months, which can go on past the first birthday. In fact, about a quarter or more of one and two year olds, are waking at …

About 20 precent of the American workforce are involved in some form of a shift-work system. This proportion is on the rise as more industries move to 24-hour operations to become more efficient and cost effective. Workers engage in shift work for a variety of different reasons ranging from convenience to availability of employment. Unconventional shifts are inherent in the nature of certain occupations such as bakers and newspaper printers, who must make their products daily before the morning deliveries. With the continuing trends of growing rural “bedroom communities,” the loner commute times result in workers having to get up very early in spite of conventional work hours. Shift work is not natural, however. Shift workers force themselves to be awake and active when their …

Retrospectively, Rachel felt that her sleepiness began in high school. She would fall asleep in class and while doing her homework. She attributed her sleepiness to “burning the candle at both ends.” She would get up by five each morning to catch the bus by six. Her afternoons were spent doing homework, practicing lacrosse, or participating in drama class. Bedtime was rarely before 11. For Rachel, sleepiness was just the consequence of her busy schedule. In college, she continued her busy class and activity schedule and found herself falling asleep at any hour of the day. One morning she had a terrifying experience. She awoke with the telephone ringing. She could not, however, move. About two minutes later, she felt as if a huge weight …