A Dream Job

When Mark Mahowald says he got in on the ground floor of sleep medicine, he’s not kidding. “I used to have to make the equipment in my living room, run the studies myself all night, and then wake up the next day and go to work,” he says. Books and journals on the topic and manufactured equipment simply did not exist.

Mahowald and Milton Ettinger, MD, retired Hennepin County Medical Center chief of neurology, started the multidisciplinary Minnesota Regional Sleep Disorders Center—the first sleep disorder center in the Midwest—in 1978. Before the center opened its doors, patients with sleep disorders had to make their way to either coast for treatment.

Mahowald, a graduate of the University of Minnesota Medical School in Minneapolis, helps meet the needs of patients with insomnia, sleepwalking, daytime sleepiness, or other sleep behaviors that prevent a good night’s rest. In fact, he and his colleagues were the first to identify and treat REM (rapid eye movement, or dream state) sleep behavior disorder, which causes a person to not experience the paralysis that normally occurs during dream sleep. As a result, sufferers often act out their dreams, attacking their bed partners or jumping out of a window.

In general, sleep disorders are prevalent, disabling, diagnosable, and treatable, says Mahowald, who advocated later school start times in Minnesota so kids could get more sleep. “Sleepiness is viewed as a defect of character, which it’s not,” he says. “Sleep is a biological imperative.” People are fooling themselves if they think that they can remain productive and healthy long term while not getting enough sleep. “Our entire society is sleep deprived,” he says. “If you use an alarm clock, you’re sleep deprived.”

Mahowald is so interested in sleep medicine because treating a sleep disorder can turn someone’s life around. For example, people with sleep apnea (4 percent of the population) often lose their jobs and get into car accidents because they fall asleep at inappropriate times. “You can immediately reverse the sleepiness,” he says of treatment. He advises anyone with excessive daytime sleepiness to seek help.

In the long term, Mahowald may be able to make another significant impact on the lives of people who have REM sleep behavior disorder. Studies have shown that 75 percent of people with this disorder go on to have Parkinson’s disease within a dozen years. “As soon as we develop a neuroprotective drug for Parkinson’s, everyone who has REM sleep behavior disorder will take this drug,” And that, he says, will prevent the disease from developing.