Twenty years ago, Dr. Robert Weiss recalls having to manually sift through reams of typed sheets showing the heart rate, brain waves, oxygen levels and other sleep study results before formulating a patient’s treatment.
“We didn’t have computers back then,” Mount Desert Island Hospital’s pulmonologist and sleep specialist recalls. “It was very laborious.”
Even though that task and patient monitoring have become much easier in the electronic age, sleep studies still can take several months to conduct and analyze before treatment is prescribed.
Another advance in the field of sleep medicine has been the move to conduct sleep studies in the comfort of a patient’s home rather than in a clinical setting.
“Everything has been miniaturized,” Weiss noted. “It’s less costly and far more convenient for our patients.”
At Cadillac Family Practice, the practice through which he sees his patients, Weiss has encouraged the use of home- testing and therapeutic devices in order to screen for sleep disorders. He says that option appeals to some patients who otherwise would not have done it.
The portable device, about the size of a telephone handset, measures the flow of air, movement of chest and abdomen and screens for “an obstructed apnea.”
“They [Island residents] don’t want to drive to Ellsworth or Bangor if they have a choice,” he said. “They don’t want to be observed in a lab.”
Apnea, in which a person’s breathing is repeatedly interrupted while he or she is asleep, is the most common sleep disorder that Weiss deals with.
“They may not be fully conscious awake,” the physician explains, “But their sleep is very fragmented. When they get up in the morning, even though they’ve slept the full night, they’re not rested.”
Other classic symptoms include depression, lack of memory or concentration and irritability.
“It’s dangerous how much stress it puts on the body,” the doctor said.
Even though it has yet to be scientifically proven, a strong statistical link has emerged between apnea and a variety of different cancers.
“It’s still too early to say the apnea causes that,” he stressed, “but there’s good reason to believe it could lead to that [cancer] eventually.”
Self-diagnosis of obstructive sleep apnea is rare since it’s unlikely for a patient to be aware of the interruptions in their breathing while asleep.
“It’s one of those disorders when I see the patient, the most important person for me is not the patient, it is the bed partner.”
For Brooklin resident Joseph Hasselbrack, it was the bruises from the constant elbowing from his late wife that made him suspect that he had a sleep disorder.
Hasselbrack also complained of constantly feeling run down after a night’s sleep.
“It didn’t affect my work, but I wasn’t that refreshed,” he said.
After seeing Weiss a year ago, Hasselbreck was diagnosed with sleep apnea. An overnight home study was conducted and treatment began the next day.
Common treatment for obstructive sleep apnea involves using continuous positive airway pressure therapy (CPAP), which includes a small machine that supplies a constant and steady air pressure, a hose and a mask or nosepiece.
Weiss sends the patient home with the automated machine after he or she is fitted with a comfortable mask.
“We’re constantly trying to come up with a better solution because we want to make sure people are as comfortable as possible with the treatment,” he said. “Otherwise it just gets put in the closet and nobody uses it.”
Electronically monitored data from the CPAP machine is then recorded for 30 days, a standard observation period before the doctor assesses whether any changes have occurred.
An average adult, he says, requires seven to eight hours of sleep every night. Even though an hour or two less is unlikely to cause major health changes, a prolonged shift in sleeping patterns can contribute to a decline in a person’s life expectancy.
More sleep, he explains, can be just as harmful as inadequate sleep.
“It’s pretty much as bad to sleep too much as it is to sleep too little.”
Social media gadgets also can cause sleeplessness.
“They’re not favorable in any way,” Weiss says. “We’re not engaging or disengaging in a smooth normal way. We’re supposed to be winding down, but we keep having all sorts of social media interruptions to it and that’s not healthy.”
Another impact is a gadget’s light by itself, which “has a profound impact on our sleep cycles and our melatonin production.”
Sleep disorders not only leave one feeling sleepy and tired during waking hours, but can put people at higher risk for cardio vascular disease, high blood pressure, diabetes, strokes, congestive heart failure, heart arrhythmias and heart attacks, Weiss says.
To help avoid these outcomes, the pulmonologist offers specialized care for sleep apnea, insomnia, restless leg syndrome, narcolepsy, night terrors and behavioral sleep disorders.
“Technology has changed dramatically, so what we can do is test somebody at home,” he sums up. “In smaller hospitals in rural settings, there’s not necessarily a role for big, expensive sleep labs.”