They see you when you’re sleeping. They know when you’re awake.
So with paste and electrodes and cameras and microphones, how is someone supposed to nod off, for goodness sake?
Patients arriving at Mercy Medical Center’s Sleep Lab for medical tests often claim they won’t be able to get any shut-eye, according to lab Director Wendy Lanier.
“What I always tell them is 99 percent of patients I speak with say they will not be able to sleep with someone watching, and then 99 percent of them have no problem, even without a sleep aid,” Lanier said. “But the majority of them are so sleep-deprived, we’ve had many people fall asleep while we are putting wires on them.”
The Sleep Lab is stocked with technology to assist in diagnosing sleep disorders, but patients tuck into its beds primarily for one reason. Their doctors suspect these men and women — and sometimes, children — have sleep apnea.
A hard day’s night
The disorder takes two forms.
Obstructive sleep apnea is one in which breathing is interrupted briefly and repeatedly through sleep. Not everyone who has it snores, and not everyone who snores has sleep apnea, according to the National Sleep Foundation, based in Arlington, Va. One type of snoring, however, is a dead giveaway.
“Interrupted snoring almost always means it is sleep apnea,” said Dr. Razman Gosman, a board-certified sleep specialist and member of DCIPA, The Physicians of Douglas County. “The most prevalent symptom is sleepiness during the day, which is not the same as tiredness. It’s falling asleep when (the person) shouldn’t.”
In obstructive sleep apnea, muscles at the back of the throat fail to keep the airwaves open. In another form, called central sleep apnea, the brain fails to regulate breathing during sleep. Though less common than obstructive sleep apnea, it’s appearing more frequently in patients, particularly those with other health problems, Gosman said. He described it as a sign of heart disease and a more difficult condition to treat.
Specialists say men traditionally are more likely than women to experience apnea, as are people with short, thick necks and the overweight. Nevertheless, the National Sleep Foundation reports more people of all backgrounds are being diagnosed as awareness spreads.
Estimates of the number of Americans experiencing some form of sleep apnea range from the single digits to as high as nearly a third. Gosman said he believes in Douglas County, the figure is in the higher ranges due to factors including an aging population, higher rates of obesity and a spike in the use of opiates, which decrease muscle tone.
More than an annoyance to others in the household, the condition can lead to low blood oxygen levels, hypertension and heart disease. Sleep apnea also increases the risk of traffic accidents.
Dozing for data
Whether it’s a desire to avoid such health risks or the desperation of the sleep-deprived, patients usually will land at a lab such as Mercy’s Sleep Lab after being referred by a physician. The only such testing center in Douglas County, the Sleep Lab resembles a motel staffed by scientific researchers.
The lab’s four bedrooms often are booked most nights of the week, Lanier said. Patients arrive between 7 and 7:30 p.m. and have a chance to get comfortable before technicians begin hooking them up to the various monitors collecting information about brain waves, eye movements, breathing patterns, muscle tension and leg motion, among other data.
Patients are encouraged to bring their own pillows if they prefer, as well as books or magazines. Each room has a television and videocassette recorder. Each room also has a private bathroom.
Lanier said bedtime is usually from 10 to 11 p.m., or whatever time the patient is used to going to sleep.
On Friday night, Roseburg’s Troy Anderson went from being a Sleep Lab polysomnographer (sleep technician) to being a patient. Anderson, 39, said prior to the test that for some years he’d been waking with a racing and irregular heartbeat. He also has awakened feeling as though he’d been holding his breath. A career change and return to school delayed his decision to get a sleep test until he had health insurance, which usually covers much or all of the procedure.
His occupational experience kept him from being anxious about the test in advance, Anderson said. Afterward, he admitted he didn’t sleep very well on Friday night.
“Not because of the wires, because I’m used to that,” he said. “I’m used to working nights and my whole circadian rhythm was flip-flopped.” Though Anderson said he could have requested a daytime test, he misjudged his body’s adherence to its usual schedule. Nevertheless, he said co-workers told him they collected enough data to aid in a diagnosis, which Anderson said he’ll get in about two weeks.
“I’m looking forward to (treatment), because I would love to be able to sleep on my back and breathe correctly,” Anderson said.
Help for the sleepless
The most common treatment for sleep apnea is the nightly donning of a device providing continuous positive airway pressure, called a CPAP. This is a mask that fits over the nose or mouth or both, guiding oxygen into the airway to help keep it open during sleep.
Not everyone is enchanted with the idea of wearing such a contraption. However, Gosman said that “like any other bitter pill,” understanding the benefits of the device helps a patient to get used to the idea.
“Once they understand that it’s keeping them healthier, and accept it’s needed, they will put effort into it and tolerate it better,” he said.
Roseburg’s Valrey Harris said when her doctor recommended she get a CPAP about four years ago, it was unnerving at first.
“I was thinking, ‘Oh, my gosh, do I have to sleep with this ugly machine on my face for the rest of my life?’” she said. But after the first night of use, Harris was sold.
“Now if I go somewhere without my machine, I just can’t sleep. I even take it camping,” said Harris, 44.
She advises that anybody who has trouble adjusting to the device work with a respiratory therapist to find the best-fitting mask and equipment.
Other sleep apnea treatments are a mouth guard appliance that projects the lower jaw during sleep and surgery to cut away excess tissue. However, these measures not only are more intrusive but also less effective, Gosman said.
Back at the Mercy’s Sleep Lab, Lanier said she sometimes teases the occasional patient about one of the sensors placed on the head at bedtime.
“I have said, “This one records your dreams,’ but actually, we can’t do that,” she said.
You can reach assistant city editor Tricia Jones at 541-957-4216 or firstname.lastname@example.org.