Evaluating sleep disorders

For years the simple act of getting a good night's sleep escaped Jerry Nickels.

As if caught in the same bad dream night after night, he went to bed tired, but each morning he got up feeling like he'd barely slept the night before.

Over the years, Nickels found that it hampered his day-to-day life. He would come home after work so tired he would sit down and fall asleep on the couch.

The lack of sleep became such a problem that once he fell asleep standing at a counter while talking to someone.

But after seeing doctors and undergoing a variety of tests, no solution for the problem presented itself.

That is, until a co-worker told Nickels about a sleep test he had been through.

“Finally I said, maybe I'll go get checked too,” he said.

What the testing found was somewhat surprising.

“I was told I stopped breathing for up to one minute 300 times in that one night,” Nickels said.

He was suffering from sleep apnea, a medical disorder that causes a person to stop breathing for periods of time during sleep, keeping the person from getting into the deepest level of sleep.

Rusty Byrd, a registered respiratory therapist/sleep technologist at Beatrice Community Hospital and Health Center's sleep testing center, said it is estimated that 45 million people in the U.S. have some sort of sleep disorder.

The majority of sleep problems can be linked to trouble breathing while sleeping, particularly an obstructed airway, he said.

Byrd said what happens is as a person with such a problem passes into deeper sleep, they will start to snore, which is due to a partially obstructed airway. As the person continues to go deeper into sleep, they will reach rapid eye movement sleep, the deepest level.

“We see most of the problems in REM sleep,” he said.

For a person with this problem, as they relax, the tissue of the neck area closes against the trachea, cutting off the airflow which causes the brain to rouse the person from that level of sleep so breathing can begin again, keeping the person from getting to that deepest level of sleep that the body needs.

“The body needs 45 minutes to an hour of REM sleep four times per night,” Byrd said.

He said while anyone could have sleep apnea, it's more common among people who are overweight, and people over age 40. In addition, it may be linked to other health problems like high blood pressure, heart problems and strokes.

In many cases, a sleep disorder is the problem for people who regularly feel tired during the day, don't have a lot of energy or are generally fatigued on a daily basis, although in many cases people don't realize they have a problem because they believe they are getting a good night's sleep each night, Byrd said.

To increase the availability of sleep testing locally, BCHHC recently purchased stand alone equipment for its two-bed sleep center.

“There's an increasing need in this area,” he said.

Byrd said BCHHC's sleep center was expanded from a one-bed unit to two beds about a year ago, but the wait was still six to eight weeks before a patient could get in because the hospital was using portable equipment from BryanLGH Medical Center in Lincoln.

With the new equipment in place, Byrd said they now run the sleep center three days a week and the wait is now only two weeks at most.

Patients at the sleep center are referred by their doctor or a specialist, he said, and are admitted for an overnight stay, or about 10 hours.

During the stay, the person is hooked up to a variety of sensors that monitor brain waves, heart beat, breathing, and the movement of the eyes, chin, jaw and legs, Byrd said.

After going through the test, then a treatment can be chosen.

Nickels uses a continuous positive airway pressure machine, a small bedside pump that pushes a steady stream of air through the mask that the person wears, the pressure keeps the person's airway open.

“It has definitely improved my life,” he said. “I would recommend it to anyone, if your spouse says you snore at night and quit breathing, to have the test done, it's for your own benefit.”

Nickels said with the machine he's now able to get a full night's sleep each night.

Byrd said the CPAP machine is the least invasive and most effective way to treat sleep apnea, although surgery and dental devices are also options.