Sleep labs offer measurable hope
From the first days of their marriage, Rhonda Bahr suspected something was wrong with the way her husband, Eric, snored. "He actually stopped breathing," she said. "It’s a gasping, and it’s really loud," she said as she waited at a sleep lab for two of her children to undergo a second round of tests.
The kids, Erica, 9, and Kyle, 7, offered a demonstration, making sounds somewhere between a pig snorting and a dog growling. Bahr smiled wanly. "They have that down." And they should. All but one of the seven members of the Bahr family has had sleep difficulties ranging from insomnia and sleep eating to sleepwalking and sleep apnea.
They are among a growing number of Treasure Valley residents who go to sleep labs to find relief from disorders including apnea, restless legs and narcolepsy — in which patients suffer sudden daytime "sleep attacks." Patients sleep in the labs’ bedrooms, tethered with wires and electrodes, while technicians in separate rooms track breathing, brain waves, eye and muscle movements, and more as they sleep.
"I think it reflects a recognition of sleep disorders in the medical community, which I think is good," said Dr. Janat O’Donnell, a pulmonologist, or lung specialist, whose work includes interpreting sleep studies at Saint Alphonsus Regional Medical Center and at St. Luke’s. "We are a very sleep-deprived society."
The No. 1 disorder diagnosed in sleep studies is obstructive sleep apnea, in which patients repeatedly stop breathing, sometimes hundreds of times a night, as their upper airway collapses again and again during sleep. Apnea can cause daytime sleepiness and irritability and can increase the risk for heart disease and stroke.
Rhonda Bahr brought Erica and Kyle to the sleep center at Saint Luke’s Meridian Medical Center. The kids arrived in pajamas, clutching their pillows. They broke out snacks and turned on the TV. They knew the ropes. This was their second visit.
Kyle watched a "Phineas and Ferb" cartoon on the Disney Channel while technicians attached wires and electrodes. His sister got the same treatment in another room. They were there to figure out the settings for their CPAP machines. CPAP machines provide Continuous Positive Airway Pressure. A flexible tube connects the machine with a mask a patient wears over the nose, mouth or both. CPAP machines, and their variations, push air through the upper airway at a pressure high enough to keep the airway from closing.
After using the machines for a couple of weeks, Mom noticed a difference in both kids. Both were sleeping better, and Kyle’s almost daily headaches disappeared. Erika didn’t get so tired at school and didn’t need to take naps. Brothers Zachary, 12, Ryan, 10, and the kids’ father, Eric, already sleep with the machines. Bahr herself suffers from insomnia. She used to take the prescription sleep medication Ambien. Then she discovered, through her husband, that she was getting up during the night to eat without knowing it. Studies have linked Ambien to sleep eating. She started to gain weight and her husband showed her the remains of her overnight kitchen raids. Now, she has switched to a combination of ropinirole (brand name Requip) for restless legs and clonidine, a generic version of a blood-pressure medicine.
Obstructive sleep apnea, once diagnosed mainly in overweight men with large necks, is increasingly being diagnosed in post-menopausal women and in children, said Mary Gable, manager of the St. Luke’s Sleep Institute. Kids with large tonsils are at the highest risk. If they still have trouble after their tonsils are removed, the next step could be a sleep lab. Sleep apnea and other sleep disorders often go undiagnosed in children, O’Donnell said. Snoring is never normal in children, she said. Up to 30 percent of kids diagnosed with attention deficit hyperactivity disorder may have sleep disorders instead of ADHD, she said.
"Children are different because they often don’t appear sleepy," O’Donnell said. "They just sometimes get hyperactive or get defiant or have behavioral issues." Many pediatricians and other Treasure Valley doctors don’t think about sleep when they examine young patients. "I think if they were educated, that the floodgates would open," O’Donnell said.
