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September 30, 2015When is the Time Right for Comfort Care?
September 30, 2015Seventy million Americans suffer from a sleep disorder. Ninety percent of sleep disorders remain undiagnosed, and for every undiagnosed sleep disorder the quality of life for that person is decreased.
“Not only does a sleep disorder decrease the quality of a patient’s life,” Lauren Toman, director of the Texas County Memorial Hospital cardiopulmonary department, said, “Sleep disorders are linked to cardiovascular disease, diabetes glucose regulation, sudden death at night from fatal arrhythmia and increased morbidity and mortality.”
Risk factors for a sleep disorder include snoring, daytime sleepiness, obesity, hypertension and the use of hormone replacement therapy for menopause.
“The cycle of breathing at night leads to excessive daytime sleepiness, impaired concentration and memory loss and mood and behavioral changes,” Toman explained.
One of the best tools for detecting a sleep disorder is the basic sleep study, medically referred to as a polysomnogram.
Sleep studies are performed at special medical facilities set up as sleep laboratories. While a person sleeps in a room set up like a home bedroom, sensors are placed on the body to monitor how the body reacts while the person sleeps. A computer records physical measurements during sleep including brain waves, heartbeats and breathing.
TCMH opened a sleep studies laboratory in 2008 to accommodate the growing need for sleep studies in the area. The two-bed laboratory is part of the TCMH cardiopulmonary department.
“With our lab, area residents don’t have to drive long distances or wait a long time to get a sleep study,” Toman said.
A patient must have a physician’s order for a sleep study. TCMH takes appointments for studies which are done on Monday, Tuesday and Wednesday evenings.
Patients are asked to come to the sleep lab in the evening and go through their normal bedtime rituals such as reading or watching television prior to falling asleep.
“You can’t ‘fail’ a polysomnogram,” Toman explained, noting that while most people fall asleep, some people do not sleep as well at the sleep lab as they sleep at home. “How well you sleep will not affect the results of the test.”
A polysomnogram doesn’t require a full eight hours of sleep to find the source of the sleep disorder. “Patients need just four hours of continuous sleep for the study to be effective,” Toman said.
To run day to day operations in the sleep lab, TCMH employs registered sleep technologists to assist patients by helping them get comfortable in the sleep study rooms, hooking up the various sensors, and monitoring the patients while they participate in the study.
During the test, computers record the patient’s sleep in 30 second “pages” of results. The test results are scored by the technologist. Scoring involves going through the pages of the study to find various “stages of sleep”.
“Technologists look for things like leg jerks and when patient’s stop breathing,” Toman said. “They prepare a summary of what happened during the study before the test is sent to the doctor.”
The scored tests are then sent to Essam Elkady, MD, pulmonologist with The Ferrell Duncan Clinic of Springfield for an interpretation and diagnosis. Elkady is a board certified pulmonologist that sees patients at TCMH.
Typically, it takes about two weeks to receive the results of a sleep study. Results are sent to the patient’s referring physician, and usually the patient needs to be seen by Elkady for proper treatment of the sleep disorder.
Sometimes the polysomnogram doesn’t completely diagnose a patient’s condition, so he or she may be required to come back for additional, more in-depth sleep studies.
“Unlike some medical treatments, patients don’t return for another sleep study until they become symptomatic again,” Toman explained. Weight gains or losses or other physiological changes may determine a patient’s need for future sleep studies.
The TCMH sleep study lab sees patients of all ages. “As patients discover the benefits of a good night’s sleep after having a sleep disorder diagnosed, sleep studies continue to gain in popularity,” Toman said.
Additional information about the sleep study lab and appointments can be made by contacting the TCMH Cardiopulmonary department at, 417/967-1247.