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Health

CPAP Therapy and sleep disorders

BY KIM DAME
Hernando Today Correspondent

Published:   |   Updated: August 5, 2013 at 10:17 AM

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Carol Anderson has lived with sleep disturbances for the majority of her adult life. She learned to cope using a mask and a certain type of gel to help clear her airway as she slept. But when she moved to Florida from Buffalo and could no longer obtain the supplies she needed to maintain that regiment, Anderson was forced to look for options.

"My doctor told me I have sleep apnea and my problems were because I wasn't using the (CPAP) machine," said Anderson, who traveled from Zephyrhills to Florida Sleep Institute on Mariner Boulevard after being encouraged by her physician to be studied. She underwent a sleep study and had returned to review the results.

"I'm going on CPAP therapy," she said.

According to the American Sleep Apnea Association, an estimated 22 million Americans suffer from sleep apnea, with about 80 percent of moderate to severe obstructive sleep apnea (OSA) undiagnosed. When left untreated, OSA can lead to high blood pressure, chronic heart failure, atria fibrillation, stroke and other cardiovascular problems. OSA also is associated with Type 2 diabetes, depression and persistent drowsiness that may lead to traffic accidents.

Three types of sleep apnea include:

Obstructive sleep apnea is caused by a blockage of the airway, including when the tongue collapses against the soft palate, which then collapses against the back of the throat during sleep.

Central sleep apnea occurs when there is no obstruction but the brain fails to signal the muscles to breathe.

Complex sleep apnea is a combination of the two. The brain partially rouses the sleeper to signal the need to breathe. This can occur several times a night, most intently during the late sleep cycle of rapid eye movement (REM). Sleep is extremely fragmented and oxygen to the body is reduced continuously.

Signs of sleep apnea, as outlined by the Mayo Clinic, might include:

Excessive daytime sleepiness (hypersomnia)

Loud snoring, more prominent in obstructive sleep apnea

Breathing cessation during sleep

Abrupt awakenings accompanied by shortness of breath

Morning headaches

Awakening with dry mouth or sore throat

Insomnia

Attention problems

It is recommended that you see a doctor if you experience the following:

Snoring loud enough to disturb others

Shortness of breath that awakens you

Intermittent pauses in breathing during sleep

Excessive daytime drowsiness

Anderson visited Florida Sleep Institute three times, initially to meet with the doctor and to schedule her study. "I was impressed with the doctor because he acted like a doctor," she said with a little chuckle. "He looked at my eyes, my ears, my throat. He weighed me, did my height. I've done this before and most of the time they didn't care what I looked like."

Florida Sleep Institute is a medically sound facility that focuses on the health of their patients, providing the highest quality of medical skill and techniques. Yet the atmosphere is less clinical in appearance, which Anderson also praised.

Her experience during the study was equally impressive, she said. "The gentleman that did the sleep study test was fantastic. He was so courteous and he really wants to please you."

Anderson described being hooked to a multitude of wires that were connected to a head box and plugged into the monitoring equipment controlled from a separate room. Microphones and video cameras were in the room to alert the monitoring staff of any problem or issue. She was able to move around comfortably when necessary by removing the plug and using the bathroom inside her private room.

Monitoring comprises the whole body, including leg movements, brain waves, heart, breathing and snoring. Patients are monitored for about eight hours on continuous data feeds that transmit to a central information location inside the facility.

Instructions are given to the patient through a speaker system, explained Liz Kohler, Florida Sleep Institute's technical director. "We tell the patient to look up, look down, look left or look right and you can see the eyeball movements as they respond to the instruction." The data is constantly gathered into the patient's results and monitored constantly from the computer monitors.

"We try and do most studies in one night if possible or do split nights," said Dr. William C. Kohler, Medical Director of the Florida Sleep Institute. "We run up to four patients a night six nights a week. With those who have severe apnea we'll do a couple of hours of baseline to see how bad they are and then we put them on CPAP."

The rooms inside Florida Sleep Institute are very inviting, similar to a top resort accommodation. Everything is designed to mimic the comfort of the patient's home environment while offering minute-by-minute monitoring.

The data is gathered, from various points on the patient's body, and evaluated. Those items looked at include snoring, leg movements, gaps in breathing and activity during REM (rapid eye movement) sleep.

Anderson had been through a sleep study once before, she said. But the experience was completely different. The atmosphere was typical of a clinical setting, with hospital-type beds and equipment around the room that was cold and intimidating. "I had to use the bathroom down the hall," she remembered.

Florida Sleep Institute was the first accredited facility in the region, said Kohler.

"We do teaching here as well as research and patient care." They have been visited by physicians from Egypt, Cambodia and Honduras, Kohler added.

Anderson came in to go over her results, and CPAP therapy was recommended.

"We ordered the equipment," Kohler said, which consists of a machine with a hose attached to a mask worn by the patient. The machine acts as an air compressor to open the airways during obstructive sleep. There also is a card inside the machine that records data, which Anderson will bring on her next visit, scheduled after six weeks on the therapy.

"I really need it," Anderson said, surrendering to the idea of finally getting some relief. "I do feel tired during the day. I was wiped out."

Florida Sleep Institute is located at 4075 Mariner Blvd. The office can be reached at (352) 683-7885. You can visit their website at www.flsleep.com.

Hernando Today correspondent Kim Dame can be reached at dame writes@yahoo.com

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