|
|
David Logan takes part in a sleep study
|
What is a good night’s sleep worth? Maybe your life. People who can’t seem to get a good rest, no matter how much they sleep at night; or who don’t feel as alert as they should; or feel fatigued during the day, may be suffering from something more ominous than a mere lack of sleep.
No one can determine exactly how many people have sleep apnea in any of its many levels of severity. “If you look at abnormal oxygen levels at night, there are 10-15 percent of middle-aged people who are symptomatic, but we don’t know how many have sleep apnea,” says Dr. Charles Koliner, medical director of The Washington Hospital Sleep Center. Half of one percent of sufferers has the most severe form, with studies showing a greater number with less severe symptoms can benefit from treatment.”
With a greater awareness among primary-care physicians and the general public, more sleep apnea sufferers are being treated. “It is still under-diagnosed,” says Koliner.
In sleep apnea, the most common sleep disorder, the sufferer’s breathing pauses from 10-30 seconds or more and can occur up to 400 times a night. In its worse form, it can increase a person’s chance of dying.
“In its milder form, it can lead to sleep deprivation or reduced quality of sleep so people feel tired during the day,” says Koliner. “Also, it can lead to significant physiologic stress such as fluctuations in blood pressure and stress to the right side of the heart, causing pulmonary hypertension. Low oxygen can mean an increased incidence of heart disease leading to strokes or heart attack,” he contends.
“In these patients,” notes Koliner, “there is a higher incidence of auto accidents, problems with performing or even keeping a job, and irritability which increases problems with social interactions.”
|
Facts on File
How many: Estimates of the number of sleep sufferers range from 10-15 percent of middle-aged people who are symptomatic. Half of one percent have the most severe form.
Symptoms: If an adult experiences daytime fatigue, there could be multiple problems in addition to sleep apnea, including being overweight or depressed, or having allergies which involve airway obstructions. Heart disease, lung disease, asthma, obstructive hypothyroidism (underactive thyroid), medications, obesity, depression, and, overwhelmingly, alcohol.
Most at risk: Although men are more likely to suffer from sleep apnea, more women are now being diagnosed. Koliner has seen babies in the Sleep Center. Children develop sleep apnea mostly from enlarged tonsils.
The center, open for more than decade, sees about 70-80 new patients each month.
|
Another social interaction problem is snoring. Frequently, the spouse of a snorer also suffers from sleep deprivation. Interestingly, although men are more likely to suffer from apnea, now more women are being diagnosed.
Looking for Symptoms
If an adult experiences daytime fatigue, there could be multiple problems in addition to sleep apnea, including being overweight or depressed, or having allergies which involve airway obstructions. Snoring is no longer seen as a benign problem, because it can worsen airway damage. “It is possibly better to treat mild cases early to prevent loud snoring from worsening airway muscle functions,” says Koliner.
Other medical conditions can contribute to the problem: heart disease, lung disease, asthma, obstructive hypothyroidism (underactive thyroid), medications, depression, and, overwhelmingly, alcohol. Koliner says that drinking over a long period is a major factor in developing sleep apnea.
Sleep-related breathing disorders can affect people of any age, but to determine how detrimental they may be to one’s health, a diagnosis by a sleep medicine physician may be the best answer.
Koliner has seen patients as young as babies at the Sleep Center. To put a baby through a sleep study is difficult because, “for every electrode you put on them, they seem to take two off,” he says. Children develop sleep apnea mostly from enlarged tonsils, and surgical removal of the tonsil can cure their apnea.
The center sees about 70-80 new patients each month and does 150-200 studies a month. “We do get referrals for people who have had car accidents, and many of them have sleepiness during the day, often caused by sleep apnea. If a person falls asleep for seemingly no reason, you should look for a cause,” Koliner explains. A pulmonary medicine specialist, Koliner became interested in sleep medicine about 15 years ago, before the explosion in sleep centers and sleep labs began. There is specific training and a rigorous exam given to physicians seeking certification in the field.
Sleep centers also should be certified by the American Academy of Sleep Medicine. In the area covering Washington County, Greene County, southern Allegheny County and Wheeling, W.Va., the only one certified is The Washington Hospital Sleep Center in Washington and its two satellite offices. UPMC in Pittsburgh runs the only other certified sleep center in the region.
Koliner says that at his sleep center, there is a high level of accurate diagnosis and a rigorous process for handling patients. After an intake history and physical, a plan is developed for diagnosing the problem, and Koliner interprets the results of all the sleep studies. “We also have six certified sleep technicians who perform sleep studies, a higher number than at many other centers,” says Koliner. “Plans are made for therapy, depending on what the studies show.
“We also ensure that whatever therapy is recommended is paid for and covered,” he says. “We always follow up if an insurance company denies coverage. If we recommend the therapy, we have zero tolerance for denials. We will not let a symptomatic patient be abandoned. In rare cases, where there is complete denial, we work with medical equipment companies or other companies to get appropriate treatment for our patients.”
The Washington Hospital Sleep Center locations are: WR Cameron Wellness Center, 84 Wellness Way, Bldg. 3, Washington; Waterdam Commons Office Park, 159 Waterdam Road, Suite 240, McMurray; Greene County Memorial Hospital, 350 Bonar Avenue, Waynesburg.
