Did you know? The Sleep Center in Gillette opened in 1994 with two beds. Based on patient demand, Campbell County Health expanded the facility to four beds and updated its equipment in 2013. In 2014, it was accredited by the American Academy of Sleep Medicine.
Several years ago, Campbell County Health Sleep Center Coordinator Dessie Hoxie tried out a home sleep test, so she could put together instructions for patients.
In the process, she discovered she had mild sleep apnea.
“It was a pretty funny experience,” she said of the revelation. “And I was able to see that the home sleep test really does work.”
Sleep Center services
“We’d like to think we have a one-stop shop as far as (treating) sleep problems go,” said Dr. Michael Nolledo, who runs the Sleep Center.
Home sleep tests like the one Hoxie used record patients’ breathing through a device like an oxygen cannula and detects sleep apnea by sensing how often breathing stops.
For a more comprehensive test, the Sleep Center offers sleep studies. During these, patients spend a night on the third floor of Campbell County Memorial Hospital while technologists remotely monitor and record sleep patterns, physiological activity and body movements.
Technologists often discover sleep apnea when patients start snoring more or when the air flow monitoring device flatlines while they’re still trying to breathe.
“We get a lot of sleep apnea patients who refer themselves to the Sleep Center because their spouse is sick and tired of 10 years of snoring, so they threaten to kick them out unless they see the doctor,” Nolledo said.
As common as asthma
One of the most common diagnoses at the Sleep Center is sleep apnea. Nolledo estimates that 8 percent of the population — about 3,500 people in Campbell County — has sleep apnea.
“The frequency of sleep apnea is similar to something like asthma, and we think of asthma as a fairly common problem,” he said.
In fact, sleep apnea is on the rise nationally.
Between 1993 and 2010, sleep apnea diagnoses grew nearly 15-fold from 420,000 to 6.37 million a year, according to a 2016 study in the Annals of the American Thoracic Society.
This increase is partially because diagnosis through facilities like the Sleep Center is becoming more common.
Obesity also contributes to the increase. Seventy-one percent of American adults older than 20 are overweight, and as people gain weight, they have more fat in their bodies, including in their airways. With this additional fat, airways narrow and become prone to collapse.
Sleep apnea is a problem because patients’ stop breathing while they sleep, often forcing them awake and preventing a restful night’s sleep. More seriously, sleep apnea is linked to medical conditions like coronary artery disease, high blood pressure and high blood sugar.
“Essentially, sleep is a time when you should restore yourself both in mind and body, so if there’s something that interrupts that and prevents you from getting a good night’s sleep, then your body is not rested and is actually stressed instead of rested,” Nolledo said.
To treat sleep apnea, doctors typically prescribe a CPAP device, which has to be plugged in and has a mask patients wear while they sleep. About the size of a shoe box, CPAP devices pump air through a person’s nasal passages, preventing them from collapsing and ensuring the patient continually breathes.
“The short-term benefit to treating sleep apnea is lifestyle, because if you sleep deeper and better, you wake up and feel well-rested. Then, you have more energy during the day and you’re actually able to do things more efficiently,” Nolledo said. “Many patients pursue these short-term benefits, but in my mind, the bigger benefit is what you don’t get.
“You’re less likely to get a heart attack, you’re less likely to have a stroke and you’re less likely to have high blood sugar or high blood pressure.”
Although sleep apnea is a common problem, it is often undiagnosed and untreated with as many as 80 percent of cases likely remaining undiagnosed.
“It’s vastly undiagnosed because patients don’t put too much concern in it, and doctors, even with all this awareness, it’s not on their radar,” Nolledo said. “I would say we spend about one third of our lives sleeping, but the vast majority of doctor-patient interactions center on when you’re awake.”
A larger issue
Nolledo urges people — especially those who have trouble sleeping — to get tested for sleep disorders because they can become a public safety problem.
He knows this well as he came to Gillette from New Jersey where last year, an engineer with undiagnosed sleep apnea crashed a train, killing one person and injuring about 100 others. The engineer said he did not remember what happened and that drowsiness — a symptom of sleep apnea — contributed to the crash.
In response to the crash, the Federal Motor Carrier Safety Administration (FMCSA) proposed regulations that would have required truck and bus drivers and railroad engineers to receive sleep apnea screenings. In August, Present Donald Trump canceled the proposal and the FMCSA stated that safety standards are adequate.
“It’s unfortunate that it would take a tragedy before we acted,” Nolledo said. “I think it starts by educating patients and educating doctors that sleep disorders are very important and how you do during the day is greatly affected by how you do at night.”