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Lisa Catanese:
Writing Sample

How a Sleep Study Center Can Help
By Lisa Catanese

Do you feel tired after a good night’s sleep? Experience morning headaches? Snore throughout the night? Nod off frequently during the day? Feel irritable, forgetful or lethargic?

These are some signs that a sleep disorder could be disrupting the rest your body needs to stay healthy. But the good news is that help is available right in your community, at the Sleep Study Center at Manchester Memorial Hospital.

It is estimated that nearly one-third of all Americans snore or have a problem sleeping. "Sleep disorders are almost a universal problem," says pulmonary specialist David Hatch, MD, medical director of the Sleep Study Center. "Untreated, sleep disorders can lead to loss of employment or risk of injury if you are driving or operating a machine. There’s pretty good evidence that people with moderate or severe sleep disorders are more likely to experience stroke, heart attack and a shorter life span. It also can be one of the treatable causes of high blood pressure."

The Sleep Study Center was established at MMH in 1995, when the hospital’s pulmonary services department saw a need for such services closer to home. "There were patients who needed these services but did not want to travel, and we had the expertise right here," Dr. Hatch explains. "We also knew of patients who had to wait months to be tested elsewhere. Because we serve a smaller community, there essentially is no waiting list at our hospital."

Patients require a physician’s referral in order to participate in a sleep study. Most authorized sleep study center procedures are considered medical procedures and are covered by many insurance companies, including Medicare.

"We seem many people who don’t necessarily have any other impairment except for a sleep disorder," Dr. Hatch says. "Very often it’s spouses or other family members who identify the problem. People often have trouble recognizing the symptoms on their own. If seems to them as if they’ve had a good night’s sleep, but they wake up feeling tired or fatigued, as if they’ve just worked a full day."

At the Center, which is located in a quiet wing of the hospital, a patient arrives at 9 p.m. for an overnight evaluation. A respiratory therapist connects equipment which monitors the patient throughout the night while the patient sleeps. The test concludes between 6 and 7 a.m. All patients fill out a pre-sleep and a post-sleep questionnaire.

The goal of the Center is to identify sleep-related breathing disorders. Throughout the night, state-of-the-art computerized equipment measures the body’s sleep pattern through EEG (brain wave) activity, respiratory monitoring, heart rhythm, eye movements, chest movements, arm and leg movements, and pulse oximetry, which measures the amount of oxygen in the blood. Pulmonary specialists on MMH’s medical staff analyze the test results and provide recommendations to the patient’s referring physician.

The three major sleep disorders diagnosed at the Center are sleep apnea, narcolepsy, and restless leg syndrome. Sleep apnea, the most common disorder, is a condition that occurs during sleep and is characterized by abnormal breathing or loss of breath. It is almost always accompanied by loud snoring or gasps as the sleeping person struggles for oxygen. Some people with sleep apnea can actually stop breathing for up to 90 seconds, and some people can stop breathing up to 500 times a night.

Sleep apnea can go on for years, Dr. Hatch says. The most common causes are obesity or a physical problem such as a deviated septum. Physical problems in some cases can be corrected surgically, or with an oral appliance that people wear at night to move the jaw into a more open position. In other cases, a laser can be used to remove some of the soft tissue at the back of the throat in order to open the breathing passage.

Some patients benefit greatly from the use of a device called CPAP – continuous positive airway pressure – which involves a mask placed over the nose and connected to a respirator to apply air pressure into the body. Although it takes most patients some time to adjust to wearing the mask while they sleep, the device has proved extremely successful in the treatment of sleep apnea. "If obese patients are able to lose some weight, they usually can come off the CPAP," Dr. Hatch says. "In cases of very obvious sleep apnea during the sleep study, we’ll start a CPAP mask right away to see if it helps."

Narcolepsy is a chronic ailment identified by excessive daytime sleepiness. It affects about one in 500 people. A person will experience recurrent attacks of drowsiness and sleep throughout the day and night. The person is unable to control these spells of sleep, but is easily awakened. Narcolepsy, once identified, can almost always be successfully treated.

Restless leg syndrome is a sleep disorder in which a person will experience an intolerable creeping and internal itching sensation in the lower extremities, which becomes more intense at the end of the day when the person is in bed. The person experiences a compulsion to move the legs in order to bring relief, and will wake frequently throughout the night because of it. This condition can be successfully treated with medication.

Treatment of sleep disorders is a relatively new field of study that dates back only to the 1970s. "We still don’t know what sleep does for us," Dr. Hatch says. "Medical science doesn’t really understand the chemistry of sleep or the biology of the brain very well. But we do know that someone deprived of sleep will just develop a stronger urge to sleep, to the point where they can actually fall asleep standing on their feet."

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