Hundreds of patients each year diagnosed via local sleep lab |

Hundreds of patients each year diagnosed via local sleep lab

Ruby Rose, supervisor of respiratory therapy at UCHealth Yampa Valley Medical Center, shows part of the testing equipment in the hospitals in-house Sleep Lab during a tour this week. (Photo by Suzie Romig)

Pulmonologist Dr. Brent Peters, medical director of the Sleep Lab at UCHealth Yampa Valley Medical Center, considers his work in sleep medicine fun because of the positive changes he can see in patients.

Peters points to older male patients who are “dragged” to the sleep lab by their wives because the men have suffered from poor sleep for many years. But after the men are diagnosed, often with obstructive sleep apnea, and receive treatment, some tell the doctor, “I haven’t felt this much energy in 25 years,” Peters said.

“Sleep medicine gets referrals from every practice for issues, such as headaches, depression, anxiety, low energy and brain fog,” Peters noted.

The pulmonologist said the local Sleep Lab, which started in 2001 at the Steamboat Springs hospital, helps to diagnose conditions, such as two types of sleep apnea, the common obstructive sleep apnea and the less common central sleep apnea. Peters said sleep apnea is more common at higher elevations, noting 10% to 15% of the adult population has the medical condition.

The mountain town lab is advantageous because patients should undergo sleep testing at similar elevations to where they live, said Ruby Rose, supervisor of respiratory therapy at the hospital.

“It’s important for accuracy to get the study done as close to home as possible,” said Peters, who serves at the UCHealth Pulmonology Clinics in Steamboat and Loveland. He said the next closest sleep lab at a similar elevation is in Estes Park.

The local lab, which includes two basic sleeping rooms with monitoring equipment and a remote video monitoring station for a sleep technician, is tucked away in a quiet side hallway at the medical center. The lab sees some 275 patients per year who can be tested overnight Mondays, Tuesdays or Wednesdays, Rose said. The lab is booked out two to four weeks in advance, drawing patients from across the region from Winter Park to Baggs, Wyoming. The sleep lab also issues equipment for many home sleep studies for patients to try first.

“We see patients who are exhausted during the day. They get the study and later treatments with CPAP, and a few months later they are feeling so much better.” – Ruby Rose, respiratory therapist

At the lab, therapists may help patients use a CPAP, or continuous positive airway pressure therapy machine, that increases air pressure in the throat so the airway does not collapse when the person breathes in. The lab also has a variety of CPAP breathing masks to try, including newer versions that meet the nose from below instead of sitting on top of the nose, Rose said.

The doctor said a sleep lab can help diagnose other conditions such as periodic limb movement disorder and REM sleep behavior disorder, where patients physically act out vivid dreams. The sleep lab can help catch undiagnosed conditions earlier, such as emphysema or seizures, since 10% to 12% of patients with seizures start while sleeping, Peters said.

Apnea is a disturbance of sleep that causes a myriad of symptoms, such as excessive daytime sleepiness, intense snoring, trouble staying asleep at night, pauses in breathing and gasping for air during sleep. Obstructive sleep apnea happens when throat muscles and the airway relax and collapse, and thus, breathing repeatedly stops and starts. The condition can be caused by a small, narrow or floppy airway, or patients being overweight.

Ruby Rose, respiratory therapist, shows some of the CPAP masks available. (Photo by Suzie Romig)

Peters said untreated sleep apnea can lead to risks of workplace or auto accidents, stroke, heart attack, diabetes or atrial fibrillation, which is an irregular and often rapid heart rate that occurs when the two upper chambers of the heart experience chaotic electrical signals.

Before a sleep study is considered, doctors ask patients to fill out an Epworth Sleepiness Scale survey, which ranks their severity of dozing off during normal activities, from watching TV to stopping in a vehicle in traffic. In the sleep lab, patients will undergo polysomnography, or a test to record a variety of body functions during sleep, including the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, air flow and blood oxygen levels.

For some qualifying sleep apnea patients who have not been successful after long trials with a CPAP machine and other avenues, Peters can evaluate patients for a relatively new procedure where a small medical device is implanted in the upper chest for hypoglossal nerve stimulation therapy, which the doctor has performed for the past five years. The procedure can be completed at UCHealth Poudre Valley Hospital in Fort Collins.

The implant works by stimulating the hypoglossal nerve during sleep to restore the tone to key tongue muscles that when relaxed can block the airway. The battery-powered stimulating device is implanted in the chest and connected to a lead that touches and gently stimulates the hypoglossal nerve. Patients turn on the implant with a small hand-held remote control as they are going to sleep and turn off the implant when they wake up.

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