DGMC sleep laboratory wakes up to upgrade Published Feb. 17, 2006 By Tech. Sgt. Austin Delacruz Jr. 60th Medical Operations Squadron TRAVIS AIR FORCE BASE, Calif. -- Have you dozed off at work, driven while drowsy or awakened more tired than when you went to bed? Have you ever received comments from your spouse or family members that you snore? If you answered “yes,” you may be among the millions of Americans who suffer from sleep apnea, a highly treatable condition. The cardiopulmonary sleep laboratory at David Grant USAF Medical Center is among the three leading Air Force laboratories in the diagnosis and treatment of sleeping disorders. The sleep lab originally opened as a one-bed, hotel-style laboratory in March 2005. Currently, a bed expansion process and systems upgrade to accommodate at least two or more patients per night is ongoing. “The acquisition of an additional state-of-the art Alice 5 Diagnostic Sleep System has put DGMC in the lead,” said Staff Sgt. Michael Hermon, cardiopulmonary technologist and NCOIC of the sleep laboratory. “This will provide better services to our Tricare population and will also save the Air Force a lot of money and lives.” Currently, civilian hospitals charge $2,000 to $3,000 per study. “We are looking at saving the Air Force approximately $15,000 to $20,000 per week up to $750,000 to $1 million per year once the expansion and system upgrade is completed,” said Master Sgt. Curtis Maley, manager of cardiopulmonary services. “An estimated five to eight-percent male and three-percent female Americans suffer from sleep apnea, a chronic but treatable condition,” said Lt. Col. [Dr.] Donald Woloszyn, the 60th Medical Group’s pulmonary element chief and sleep laboratory medical director. “If left untreated, it can lead to cardiovascular-related problems including an accelerated risk of heart attack, stroke and hypertension.” Sleep apnea is usually caused by excessive tissue in the upper airway that causes patients’ airways to close, especially when sleeping on their backs. They struggle to breathe during sleep when the upper airway becomes more susceptible to closing. Sufferers must awaken to resume proper breathing and this process can occur several times per minute, which can lead to excessive daytime drowsiness. “Obviously, if you can’t get restful sleep, it’s going to affect your productivity,” Colonel Woloszyn said. “Moderate to severe cases of sleep apnea can affect your world-wide deployment eligibility.” Patients “check in” about 8 p.m. and are connected to monitoring electrodes. They follow their regular routines until bedtime. When they go to sleep, the sleep technologist monitors the patient and acquires data from 55 different channels that record airflow, blood oxygenation levels, heart rate, brain activity, eye movements and snoring. The patients shower and leave the next morning. There are 85 recognized sleep disorders, which include narcolepsy, restless legs, insomnia and sleep apnea. Sleep apnea patients comprise the majority of patients seen at DGMC. “We have them use a device called a continuous positive airway pressure mask that keeps their airway open by continuously blowing air and causing what we call a pneumatic splint, allowing a patient to sleep better and more restfully at night,” said Colonel Woloszyn. The CPAP mask is one of three primary treatments recommended for sleep apnea. Sufferers are also encouraged to lose weight because as they shed pounds toward their ideal body weight, the symptoms tend to disappear. Additionally, use of specially designed oral prosthetics or undergoing laser surgery is also recommended. Clearing nasal passages before bedtime to better facilitate airflow and not sleeping on your back is a common suggestion by sleep technologists to alleviate symptoms. However, sleep apnea sufferers also should not take sleeping pills as that can worsen their condition. People who find themselves falling asleep very easily while they are working are usually doing stationary or sedentary jobs, like working at a computer. People tend to fall asleep less if they are working jobs where they are more physically active. “The condition can be very dangerous to others because it causes more than 1,400 vehicular deaths a year. Some commuters are going to work tired and coming home more tired because they aren’t getting restful sleep,” said Colonel Woloszyn. For more information about sleep disorders, contact your medical provider or call the cardiopulmonary sleep laboratory at 423-2389. How to sleep well Sleep isn’t just “time out” from daily life. It is an active state important for renewing your mental and physical health each day. The following tips will help you sleep well: - Maintain a regular wake time, even on days off work - Try to go to bed only when you are drowsy - If you are not drowsy and are unable to sleep for about 20 minutes, leave your room and engage in a quiet activity elsewhere. Do not permit yourself to fall asleep outside the bedroom. Return to bed when, and only when, you are sleepy. Repeat this process as often as necessary throughout the night - Use your bedroom only for sleep, sex and times of illness - Avoid napping during the daytime. If you nap, try to do so at the same time every day and for no more than one hour. Mid-afternoon [no later than 3 p.m.] is best for most people - Establish relaxing pre-sleep rituals such as warm bath, light bedtime snack or 10 minutes of reading - Exercise regularly. Confine vigorous exercise to early hours, at least six hours before bedtime and do mild exercise at least four hours prior to bedtime - Keep a regular schedule. Regular times for meals, medications, chores and other activities help keep the inner clock running smoothly - While light snacks before bedtime can help promote sound sleep, avoid large meals - Avoid caffeine within six hours of bedtime - Don’t drink alcohol when sleepy. Even small dose of alcohol can have a potent effect when combined with tiredness - Avoid the use of nicotine close to bedtime or during the night - Sleeping pills should be used only conservatively. Most doctors avoid prescribing sleeping pills for periods longer than three weeks - Do not drink alcohol while taking sleeping pills or other medications