EUSARNAD exchange in Southampton – reminiscing from the sleep lab, by Gosia Lipinska

I can’t believe it’s a whole week since I’ve been back in Cape Town. And I’m back in the sleep lab, watching the EEG of my sleeping participant as I reminisce about my exchange at the University of Southampton. Since I’ve been back I’ve been able to apply many things I’ve learnt already – especially related to the sleep lab. The exchange was a fantastic experience in acquiring international experience in the field of sleep research.

In terms of applying my newly acquired sleep research knowledge, I spent today adjusting my entire montage to represent a configuration that is more commonly accepted world-wide. A polysomnographic montage is the unique configuration of electrodes that makes up the EEG reading that you see on the screen. Because the technicians who set up our configuration were not sleep researchers and our team was too green in the field to know any better, our set-up was not optimal for our purposes.


Working at my computer!

I’m also in the processes of applying for an equipment grant so that we can update the kind of electrodes we use, as well as the method of attaching the electrodes. Currently we use a potent glue called collodian, which is pretty much amazing at keeping the electrodes stuck to the head. However it has some pitfalls – it’s very strong smelling, hard to apply and time consuming to remove. There are better products on the market, as I now know, and I’ve located a supplier in Cape Town.

I’ve also come back with lots of clinical knowledge, which will be immensely helpful when I start seeing patients again. I’m also really excited about working on the collaborations I built up during my time – I’m busy selecting articles from a large data base to be included in a Cochrane review of anti-depressant treatment for insomnia. I’m also writing a conceptual short article for the Journal of Human Psychopharmacology examining the treatment of sleep difficulties in posttraumatic stress disorder, collaborating with Cathy Hill on a sleep and high-altitude study and working out the details of future studies with a genetics researcher with an interest in psychiatric disorders. In summary, many papers and future projects to look forward to!


In front of College Keep, where I spent a good deal of time.

Many many thanks to Professor David Baldwin for facilitating this exchange and having me sit in on his outpatients clinic; to the administrative staff, especially Magda Nowak who worked out all the details; to Dr Cathy Hill, Michael Breen and Dr Topher Woelk and Dr Hazel Everitt for including me in their interesting projects; to Dr Jonathan Dakin and Dr Lars Hansen for including me in their clinics and to Sue Johnstone for hosting me!

With Sue, just before I left in a rare moment of sunshine

With Sue, just before I left in a rare moment of sunshine

And lastly may the sun shine in England again!

Cape Town: the best city in the world – by Nienke Pannekoek

One month in Cape Town is not enough. It just does not cut it. It is not enough to enjoy the city and all it has to offer, but also not to really get started on a big, international collaboration. Just when you start to find your feet and get into the topic of your project, it is already time to go. It should not be much of a surprise that I jumped at the chance to return for another, extended period of 6 months to continue working on the social anxiety disorder mega-analysis at the Groote Schuur Hospital!

Together with Jean-Paul (JP) Fouché I was coordinating a big international project on which we had already been working since JP’s visit to Leiden, The Netherlands, in early 2012. At this stage, the social anxiety mega-analysis (or, as we like to call it, the mega-SAD) involves MRI data of subjects with social anxiety disorder and control subjects from 11 research centres in five countries. This does not just mean trying to get the data from all these sites in one place, but it also means dealing with the ethics committees of each centre, which takes time and patience. During JP’s visit to Leiden and my first visit to Cape Town last year, we had been doing some necessary preparatory work. It took us a while, but once we were in possession of all the data, we could really dive in and my six months were spent doing quality checks, troubleshooting, preprocessing, troubleshooting, creating the analysis designs, and more troubleshooting. Did I already mention that there was a lot of troubleshooting? All this resulted in a final dataset of a whopping total of 458 subjects! Each step forward got us more and more excited about the project, and the initial preliminary results look extremely promising.


JP Fouche and I have spent a lot of time working together since early 2012

Unfortunately I am no longer in Cape Town, but some final analyses are now running, and we are looking forward to start writing up the results very soon. Apart from working on the mega-analysis, I have had the pleasure of attending meetings, seminars and lectures, and some new and exciting collaborations have been established with my colleagues at the Psychiatry Department of the Groote Schuur Hospital.


The stunning backdrop of Table Mountain

Of course, living in the most beautiful city in the world (it didn’t get voted ‘best city in the world 2013’ by the Telegraph for nothing…) means that there is more to do than just work. My free time was spent hiking and running on and around the Mountain, wine tasting (and even a combination of both, in costume!) failed attempts to win quiz night, making many great friends, spending time on the beach in front of my house, and enjoying fantastic food in the Mother City. It has been a journey with many ‘firsts’. When you come from a cold and rainy country like The Netherlands, spending Christmas in the sun is such a strange experience! And to celebrate New Year’s Eve ON TOP of Table Mountain is something you only do once in a lifetime.


Working (slash-running-slash-wine tasting) with colleagues

One thing I will never forget is being in South Africa when the beloved Nelson Mandela passed away. Knowing beforehand that this was a possibility during my stay, I was not sure what to expect in the unfortunate event of his death. However, the unity that I witnessed in Cape Town was astonishing. I went to several events remembering Madiba, including an interreligious service that featured speakers each of a different faith, where all people had gathered as one to remember him. Apart from expressing profound sadness of his passing, South Africa paid respect and gratitude to the Father they loved. But there was also joy, and Mandela’s life was energetically celebrated. Several memorial concerts were organised nationwide, and I attended the one at the Cape Town Stadium. The speeches by politicians were moving and heartfelt, the artists were visibly proud to pay a musical tribute to Madiba, and the crowd was celebrating his life. The message of all speakers and performers was clear: South Africa must never forget this great man and build upon the foundations he laid for a better future.


The mega-SAD analysis is still in full swing and there are countless opportunities to continue this project. I am looking forward to presenting the results in the near future, and this is only going to be the first of many publications that can be based on the international database resulting from this exciting collaboration.

For me, this opportunity has meant more to me than I could have ever imagined. The project has been challenging and educational, and I have learned a lot. As for living in the Mother City, Cape Town has fully embraced me and I have fully embraced Cape Town. After my previous visit last year, I knew within 24 hours after arriving in Leiden that I would be back in South Africa a couple of months later. This time I do not know exactly when I will be back, but I can guarantee that it will not be long. Once one has experienced life in Cape Town, once simply cannot stay away!

– Nienke




Don’t fall asleep! Sleep Research and clinical experience exchange – by Gosia Lipinska

As I’m writing this I’m on the train back to Southampton and its almost 1am. The reason I’m coming home so late is not frivolous first year party escapades, rather it’s a late night in the sleep laboratory in Portsmouth. And that’s one of the reasons I’m here – to experience the running of sleep laboratories in an international context.

The sleep laboratory at the University of Cape Town is brand new. We managed to build it when our department moved from one side of the campus to the other. It has a control room, two dedicated sleep study rooms complete with beds, polysomnographs, intercoms and cameras. Members of the UCT Sleep Sciences team have trained locally but it’s important to know that our lab meets international standards. I’m here in Southampton to check whether our laboratory set-up and techniques of electrode placement and scoring polysomnography are correct, and to pick up some tips.


Queen Alexander Hospital, where I attended the night-time sleep studies and outpatients sleep clinic.

My experiences here so far have been incredibly positive. I’ve met with Dr Cathy Hill who is taking me under her wing to show me the world of clinical sleep disorders in children. I’m attending her clinic and a sleep course she’s giving later in my month’s stay. I am also going to get involved in writing a paper on sleep at high altitude and whether this affects cognitive functioning. I’ve also been working with the sleep technologist at Cathy’s laboratory – Johanna, who has been wonderful in helping me go through sleep scoring.

And now I’ve been to the Queen Alexander Hospital’s laboratory, which also sees clinical patients. There I’ve been working with a technologist, who’s actually from my home country, South Africa. We’ve been in the laboratory together doing sleep polysomnographic set-up. I’ve picked up some handy tips and have also been reassured that what I know is indeed useful.  Furthermore I’ve started to do some work with Dr Hazel Everit and a number of other collaborators on a Chochrane review of anti-depressant treatment in insomnia.

The team here at the University of Southampton has been incredibly welcoming and supportive. Professor Baldwin has shown me around and introduced me to many of his colleagues, and facilitated lots of meetings, case presentations and journal and film club meetings, which have been wonderfully stimulating.

Another big part of my time here is spent with Professor Baldwin seeing clinical psychiatric outpatient cases, which has been extremely valuable. As part of my clinical training back home, I’m seeing patients with brain injury. However, I don’t get to see a lot of psychiatric cases, so this exchange is filling an important clinical gap for me. I’m seeing a variety of cases including individuals who are diagnosed with anxiety and mood disorders. I may also see patients with psychotic disorders as well as observe a session of ECT (electro-convulsive therapy).

On a personal front I’ve also managed to catch up with some family here – taking long walks in the British countryside. We even managed to get a good day of whether in – perfectly sunny skies.

UK with mama Lin

So far it’s been an exciting time! Looking back at the 10 days I’ve been here I can’t believe how much has happened already and I’m excited for the upcoming 18 days – its certainly
going to be busy – just the way I like it!

– Gosia