May 4, 2006 — Most individuals don't know they have sleep disorders, and the only way to really find out is to take a sleep test, according to Dr. Adam Shapiro, program manager at the St. Thomas Sleep Center, a small clinic located in the Paragon Medical Building in Estate Thomas.
During an interview last week, Shapiro said sleep disorders affect about 50 percent of individuals in any given population, with 25 percent of the population suffering from sleep apnea, a condition in which people stop breathing while they sleep. "In the territory," he said, "that adds up to about 25,000 people."
He said that sleep apnea is commonly linked to obesity, affects men more than women and is seen frequently in children. It can also be hereditary, he added, explaining that he once had a patient who said that high blood pressure ran in his family. "I told him it's really sleep apnea that runs in his family."
Shapiro explained that people with obstructive sleep apnea – a common form of the disorder which develops as a result of an airway blockage at the rear of the throat during sleep – are two times as likely to develop hypertension, three times as likely to develop heart complications and four times as likely to suffer a stroke. "That's in addition to feeling like they're not getting enough sleep," he said.
Sleep disorders like sleep apnea also manifest themselves in behavioral patterns (like hyperactivity in children), affect concentration and can be associated with depression. "A recent study also revealed that 50 percent of individuals with Attention Deficit Hyperactivity Disorder didn't need to take their medication after they were treated for sleep apnea," he said. "And many psychiatric problems are made worse by sleep disorders."
He also outlined specific populations which are more prone to developing sleep disorders – such as older adults, who often complain about insomnia; or infants who are born with developmental problems such as an enlarged tongue or tonsils. "Obesity can also add to someone's sleep problems – although we do have people who are slim and trim that are affected by them as well," Shapiro said, adding that individuals with Down syndrome also frequently develop sleep disorders because they have extra tissue in their throats.
Shapiro said that these reasons are what prompted him to open the sleep center along with Dr. David Weisher, the facility's medical director. "We see a lot of people in our practices that come to us and ask what to do about snoring, or what to do when they wake up at night and can't go back to sleep," he said. "I used to have to send them to the states or to Puerto Rico to get treated, which some were hesitant to do. And I wanted to make a nice center for people, where they can come and get tested, and we can help them figure out what's wrong."
On a tour around the facility, Shapiro pointed out two bedrooms, which are designed to simulate an individual's own sleeping environment. Included in the rooms are a full-size bed with soft pillows and blankets, a television, radio and handicapped-accessible bathrooms.
At the bedside, there is also sleep equipment, which patients wear while they're being monitored during the night. "A person will come in here at about 7 or 8 p.m. and our sleep technician will show them to their rooms where they can get changed into their nightclothes," he explained. Once in the rooms, patients are fitted with electrodes which are attached to their foreheads to monitor brain waves, to the chest to monitor heart rate, and to their arms and legs to monitor movements made during the night. A chest strap is also attached, which measures how much effort an individual puts into breathing during the night.
Shapiro said that the technician would particularly look at breathing patterns and sleep planes, which show how deeply the individual is sleeping. "There are various stages of sleep, and during those stages a lot of processes occur which are very important to the body," he explained, adding that when a person takes sleeping pills or consumes alcohol before going to bed they won't be able to sleep as deeply. "The body uses that time to replenish itself," he added.
Once the information generated from the electrodes is transmitted to the clinic's computer, then Weisher compiles the information and generates a report outlining the disorder and possible treatment.
If diagnosed with sleep apnea, for example, Shapiro said patients are often given a device called a continuous positive airwave machine (CPAP) that they can take home with them. The CPAP blows a constant stream of air into the patient's airway through a mask worn either over the nose, or over both the nose and mouth. "About 25 to 30 percent of people who wear the mask said they can't handle it," Shapiro said. "And for those people, we think of other surgical options."
Such options include removing the patient's tonsils, shrinking the tongue, or taking care of existing nasal problems, he said.
However, there are some things individuals can do at home to help with sleeping, he said, including:
–not drinking alcohol close to bedtime.
–avoiding caffeine products such as coffee, tea or chocolate.
–not eating close to bedtime.
–using the bedroom just for sleeping.
"While all those things are great, however, the only way to really be sure if you have a sleep disorder is to take a test," Shapiro said. "That way we can make sure that it's properly treated."
For more information on the St. Thomas Sleep Center, visit their Web site or call (340) 777-7533.
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