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New sleep wellness center at Laurel Regional offers expanded services to the sleep deprived

Global WarmingNational Institutes of Health

Beginning in 1995, 46-year-old Anita Sills of Laurel developed sleeping problems that worsened to the point that she would wake up in the middle of the night every two or three hours.

"I thought I was having nightmares because my heart would be beating real fast when I woke up," Sills said. "I also snored real loud and sometimes would wake myself up."

The restless nights Sills experienced continued over a 15-year period and deteriorated to the point that she was constantly tired, experienced headaches and could fall asleep almost anywhere.

At an appointment with her mother's neurologist last year, Sills mentioned her sleeping problems to the doctor, who recommended that she set up an appointment with a sleep center.

Sills went to Laurel Regional Hospital's sleep lab for an overnight stay last July and was diagnosed with sleep apnea, a condition where a person goes through periods throughout the night when they stop breathing while asleep. Their carbon dioxide levels become high and defense receptors in their brain send out signals that wake them up.

After being treated at Laurel Regional's sleep lab, Sills said, "I sleep much longer now, and I'm not tired anymore."

Sills is one of more than 600 patients who are diagnosed and treated annually at the hospital's sleep lab, which reopened June 23 in a newly renovated wing of the hospital as the Sleep Wellness Center. Unlike the hospital bed Sills spent the night in at the sleep lab, patients in the hospital's new Sleep Wellness Center will be placed in one of four spacious, private suites, complete with flat-screen televisions, lounge chairs, decorative rugs on hardwood floors, beds adorned with comforter sets that match the drapes, soft lights, artwork on the walls and a full, private bathroom.

"Some people are not comfortable sleeping away from home, so we wanted to make the suites as comfortable and normal as possible, with a hotel-like atmosphere," said Dr. Victor Grazette, director of cardiopulmonary and sleep medicine services at Laurel Regional.

Patients who come to the center can be diagnosed for two types of sleep apnea-the kind caused by an obstruction of the air passages, the most prevalent and most dangerous to the heart and other organs if untreated; and nonobstructive sleep apnea, caused by neurological or other problems. They can also be treated for insomnia, an inability to fall asleep; periodic limb movements of sleep (PLMS), such as uncontrollable leg twitching during sleep; nightmares or sleep walking; and narcolepsy, a condition where people fall asleep any time, such as during a conversation.

In addition to Grazette, the sleep center has two physicians who are certified in sleep, pulmonary and intensive care medicine. There are also two certified sleep technologists who monitor patients on computers as they sleep, documenting their oxygen levels, snoring, each time they stop breathing, and heart and respiratory rates. They can also talk to them through the computer and compile results in print-outs for doctors to review.

Grazette said the new center's services are more comprehensive than those they provided in the past.

"When we had just a lab with a hospital bed, you came and slept, we told you your diagnosis, and there was no follow up," he said. "That's the function of a sleep lab, but I thought that wasn't enough and was a disservice to patients. The center is more comprehensive, and we work closely with patients' primary care physicians to keep them in the loop."

Officials with the National Institutes of Health estimate that 40 million people in this country suffer from some type of sleep disorder, and 95 percent of them go undiagnosed. People often see as normal such symptoms as snoring, restless sleep or grinding their teeth while asleep, all signs that a person may have a sleep disorder.

"Not all who snore have a sleep disorder, but for those who do, snoring is a way for the body to try and move air through an obstructed air passage," Grazette said. "A lot of people who wake up several times during the night don't recall waking up but are tired the next day. Others think they woke up to go to the bathroom, but their body woke them up to save itself because they stopped breathing, their carbon dioxide got high and receptors in their brain woke them up."

According to Grazette, more men are affected by sleep apnea, the most common sleep disorder, than women. Many children suffer from sleep apnea, and obese people and those with short necks are more susceptible. A main cause of the disorder is the over-relaxation of a person's throat muscles, which are stiff and open when we are awake, allowing air to flow into the lungs. When the muscles are too relaxed during sleep, the airway may become blocked or narrowed. Other causes include over-relaxation of the tongue; enlarged tonsils or tongue; dental issues; an elongated uvula; and extra fat tissue in the wall of the windpipe of obese people, which can lead to a narrow air passageway.

Grazette said not detecting and treating the disorder can pose serious health risks.

"The danger of sleep apnea is that when the oxygen is low, it can affect the lungs and coronary vessels, and cause a heart attack," Grazette said. "Going through years of high carbon dioxide levels in your blood can cause pulmonary hypertension where the blood vessels in the lungs get narrow and will affect the right side of the heart where it can become dilated and ineffective."

Other dangers include having problems concentrating, a dangerous state for drivers and machinery workers.

"One of the big dangers of sleep apnea is car accidents; falling asleep at the wheel and errors at work are compounded, especially for machinists," Grazette said.

Those who come to the center and are diagnosed with neurological or other medical problems are referred to specialists, but those diagnosed with sleep apnea, which are the majority of patients, are treated at the sleep center. To help keep their air passages open while they are asleep, patients are fitted for a CPAC, continuous positive airway pressure device. A mask is fitted over the nose, mouth or both and air that the person breathes flows from a tube attached to the machine to keep their air passageways open during sleep.

"Patients who use it are not tired, they can concentrate better, are more productive and feel like they have a new life," Grazette said. "I knew a 13-year-old who couldn't concentrate in school and was a D student. After he was diagnosed with severe sleep apnea and used the CPAC, he became an A-B student."

Sills said she has had positive results as well since she was fitted last year with the CPAC device.

"I have the mask that fits over my mouth, and the air coming from the machine is so fresh. Even the sound of the machine is soothing, and I sleep good now," Sills said. "I'm not tired anymore, and I can drive out of town. It's wonderful."

Grazette advises clients to see their neurologist regularly and to periodically return to determine if their CPAC's air flow setting needs to be changed.

"As you get older or heavier, the (air flow setting for the) CPAC may need to be adjusted," he said. "I had one patient say her husband was snoring with the CPAC on. He'd gained 20 pounds and hadn't had it adjusted in years. In those cases, we bring the person back in for an overnight stay and reset the CPAC.

Sills said she sees her neurologist every three to four months and has lost more than 30 pounds, in hopes of being weaned off the machine in the near future. In the meantime, she's enjoying a more fulfilling lifestyle.

"I'm so glad God led me to the sleep center, and I wouldn't trade my machine for anything. I love it," she said. "I tell people, this has been a great experience."

Copyright © 2014, The Baltimore Sun
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