Device allows patients to rest easy

Lengthy trips to Florida sleep centres are a thing of the past for Cayman Islands residents.

Dr. Robert Glatz has for years sent his patients to Florida centres where they would spend the night and be tested for Obstructive Sleep Apnoea/Hypopnoea Syndrome.

Dr. Glatz

Dr. Glatz holds the Stardust, a portable device that allows patients to tested at home for sleep disorders.
Photo: Tammie C. Chisholm

They would then return to the Cayman Islands for treatment.

Now Dr. Glatz has a Stardust, a portable device that lets patients be tested at home.

‘The fact that we can now do it on an outpatient basis is new technology,’ said Dr. Glatz.

The device is about the size of an iPod and has several sensors that measure respiration, sleeping position, heart pulse rate, snoring and the percentage of oxygen saturation in the blood.

Patients wear the small Stardust device on their chest while sleeping in the comfort and privacy of their own beds. Readings are taken through a sensor attached to a forefinger. And they don’t have to sleep on their backs.

‘It follows every breath,’ he said. ‘It measures how they sleep by comparing respiratory effort with the amount of air flow in the nose. We can monitor airway obstructions.

‘The problem with airway obstructions is that the patient is never able to get into deep REM (rapid eye movement) sleep.’

The advantage of taking the sleep study at home instead of overseas at a sleep centre are that travel isn’t necessary, patients may sleep better at home in their own environment, patients can regulate their own sleep times, diagnosis is faster and it’s cheaper.

Patients in which 10 or more sleeping problems are diagnosed have Sleep Apnoea.

‘People with sleep apnoea wake up tired, they fall asleep easily during the day, have problems with high blood pressure and forgetfulness. They’re chronically fatigued.’

Sleep apnoea can be a serious sleep disorder. People who have sleep apnoea stop breathing for 10 to 30 seconds at a time while they are sleeping.

These short stops in breathing can happen up to 400 times every night and the periods of not breathing can make people wake up from deep sleep.

Sleep apnoea can cause serious problems if it isn’t treated. The risk of heart disease and stroke is higher if serious sleep apnoea goes untreated and traffic accidents are more likely if the person is driving while sleepy.

‘While snoring is a big problem, the thing we’re most concerned about is that in sleep apnoea the oxygen falls below a safe level. The oxygen saturation staying too low can lead to cardiac irregularities and strokes,’ said Dr. Glatz.

One of his patients had 2,400 snoring events in one night. They were detected with the portable sleep testing device.

Because snoring is one symptom of sleep apnoea, bed partners usually alert the person with the problem first.

‘At least one-half of the people with a problem come in because of a partner’s complaints.’

Sleeping with a partner who has sleep apnoea can be scary, especially when they stop breathing.

Managing sleep apnoea is relatively easy.

Behavioural therapies are an important part of the treatment for sleep apnoea, especially in cases where a doctor has identified a specific cause of the obstructed airway.

The following are the most effective home remedies you can try.

Lose weight: One of the most significant remedies for sleep apnoea is weight loss. Overweight individuals who lose even 10 per cent of their weight can reduce sleep apnoea during the night and dramatically improve the quality of their sleep.

Eliminate the use of alcohol, tobacco and sedatives such as sleeping pills: Avoiding the use of alcohol, tobacco, and sleeping pills can reduce the likelihood of airway closure during the night.

Sleep on your side: People who experience sleep apnoea only when they sleep on their backs can benefit from special pillows or folk remedies that encourage side-sleeping, such as the tennis ball trick.

Regularize your sleep hours: Irregular sleep hours can throw off your sleep cycles and lead to breathing problems during the most important sleep stages. Stabilizing bedtime hours across the week and eliminating disturbances to your sleep can reduce sleep apnoea.

Learn to play the didgeridoo: Swiss medical scientists, publishing in the British Medical Journal, found that regular playing of the didgeridoo (an Australian wind instrument) improved snoring, sleep apnoea, and daytime sleepiness, and reduced sleep disturbances to bedroom partners. The reason for this improvement may be that training to play the didgeridoo decreased the collapsibility of the upper airways.

There are also mechanical and surgical remedies.

Continuous Positive Airway Pressure is one of the most common long-term treatments for severe sleep apnoea.

The therapy requires the person to wear a mask over their nose during sleep. The mask blows air through the nasal passages, and the pressure is adjusted to keep the airway open during the night. CPAP is often successful in treating sleep apnoea, although for Continuous Positive Airway Pressure to be effective, patients must consistently use the nasal mask and commit to other lifestyle changes as well, such as losing weight.

Dr. Glatz uses information gleaned from the Stardust unit to properly set the CPAP unit.

‘Once we have a sleep study we can programme the CPAP to fit exactly their needs so they won’t be bothered by over pressure.

‘Not only can we offer the CPAP machine, but we can offer them surgery,’ he said. ‘I’m very proud we can offer this on the island.’

FYI

To learn more about diagnosing sleep apnoea contact Dr. Glatz at 945-3822.

Signs and symptoms of sleep apnoea

• Frequent cessation of breathing (apnoea) during sleep. Your sleep partner may notice repeated silences from your side of the bed.

• Choking, gasping, or gagging during sleep to get air into the lungs

• Loud snoring

• Waking up sweating during the night

• Feeling unrefreshed in the morning after a night’s sleep

• Headaches upon awakening

• Daytime sleepiness, including falling asleep at inappropriate times, such as during driving or at work

• Lethargy

• Rapid weight gain

• Memory loss and learning difficulties

• Short attention span

• Poor judgment

• Depression

• Personality changes

Take the test

The Epworth Sleepiness Scale

The following questionnaire will help you measure your general level of daytime sleepiness. Answers are rated on a reliable scale called the Epworth Sleepiness Scale – the same assessment tool used by sleep experts worldwide.

This test was developed by Dr. Murray Johns at Epworth Hospital in Melbourne, Australia in 1991.

Each item describes a routine daytime situation. Use the scale below to rate the likelihood that you would doze off or fall asleep (in contrast to just feeling tired) during that activity. If you haven’t done some of these things recently, consider how you think they would affect you.

Please note that this scale should not be used to make your own diagnosis. It is intended as a tool to help you identify your own level of daytime sleepiness, which can be a symptom of a sleep disorder.

Use the following scale to answer the questions:

0 = would never doze

1 = slight chance of dozing

2 = moderate chance of dozing
3 = high chance of dozing

Sitting and Reading
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Watching Television

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Sitting inactive in a public place, for example, a theatre or a meeting

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

As a passenger in a car for an hour without a break

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Lying down to rest in the afternoon

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Sitting and talking to someone

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Sitting quietly after lunch when you’ve had no alcohol

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

In a car while stopped in traffic

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

To check your sleepiness score, total the points:

1 – 6: Congratulations, you are getting enough sleep!

7 – 8: Your score is average

9 and up: Seek the advice of a sleep specialist without delay