Being a bit sleepy because a busy schedule permits too few hours of recuperative slumber is a common complaint. For some people, however, the inability to get a good night's sleep is more than a matter of allocating sufficient bed time. There are an assortment of medical maladies that can make it difficult - or impossible - for those they afflict to sleep properly. That's when the specialized medical expertise at Trinity Regional Medical Center's Sleep Disorders Center can be an invaluable resource.
Evaluating and treating people with sleep problems has been part of the agenda at Trinity for nearly two decades, but the medical center's capabilities in this field have been enhanced significantly in the last several years. That led to the Sleep Disorders Center receiving accreditation this fall by the American Academy of Sleep Medicine. There are fewer than two dozen accredited sleep centers in Iowa.
Sue Thompson, president and chief executive officer of Trinity Health Systems, said this is a major milestone in the center's evolution and is a tribute to the hard work of its clinical team.
-Messenger photo by Hans Madsen
Dr. James Meyer and Dawn Byrne, sleep disorder supervisor, look over a sleep study on the computer in the Trinity Regional Medical Center’s Sleep Disorder Center.
"The accreditation ... is a testament to our dedication to provide quality care," Thompson said. "Physicians and staff worked diligently to prepare our accreditation application and played an integral role in our successful site visit."
Dr. James Meyer, a Fort Dodge pulmonologist who is the medical director of the Sleep Disorders Center, said accreditation acknowledges the growing strength of the sleep program at Trinity.
"It shows that we've been doing excellent work for a number of years and we're being recognized for it," he said.
What accreditation means
Accreditation by the American Academy of Sleep Medicine "assures quality patient care through comprehensive clinical evaluation and treatment. An accredited sleep center must demonstrate compliance to a detailed set of standards and practice guidelines, including (1) employing skilled, licensed and qualified staff, (2) oversight provided by a Diplomat of the American Board of Sleep Medicine, (3) creating an maintaining a clean, comfortable and safe environment for patients and (4) developing and maintaining a quality assurance plan, and adhering to evidence-based practice parameters."
Source Trinity Regional Medical Center
Rapidly evolving program
The Sleep Disorders Center is on the medical center's third floor. It includes four sleep rooms used for evaluating patients while they sleep to diagnose problems and once treatment is prescribed assess its impact. The staff is led by two physicians - Meyer and Dr. Mark Berry, a cardiologist - both of whom are board certified in sleep medicine. There are four nonphysician members of the clinical team.
Dawn Byrne, sleep disorders supervisor, said the unit typically handles 60 cases a month. There are a variety of sleep problems the center can evaluate and treat. Among them are insomnia, sleep apnea and snoring, oxygenation problems, nocturnal myclonus, nightmares and night terrors, bedwetting, sleepwalking and sleeptalking. Infantile apnea can be evaluated to determine the risk of sudden infant death syndrome.
Meyer said by far the most common condition treated at the center is obstructive sleep apnea, which he said is the No. 1 sleep disorder both nationally and locally.
"That's what we specialize in," he said. "That's what we see day in and day out. ... Patients that have loud snoring and interrupted breathing at night. The definition of an apnea is cessation of air flow for 10 seconds. Patients snore and stop breathing multiple times throughout the night. They're generally unaware of it."
Meyer said the breathing interruptions result in snorts and gasps while a person is asleep. He said this is caused by an anatomic problem related to a person's airway being so small that when he or she falls asleep and the head falls back the airway becomes obstructed by tissue. The problem can be exacerbated by weight gain.
"They have these arousals where the brain wakes up, but the patient doesn't," he explained. "That's why the patient's really unaware of it. ... It's manifested by excessive daytime sleepiness, cognitive impairments, memory problems ... high blood pressure, diabetes, stroke, heart arrhythmias - those are associated with obstructive sleep apnea."
Treatment for the condition often involves positive airway pressure masks. The goal is to facilitate restful sleep without constant arousals by forcing air to the back of the throat, Meyer said. He said he takes particular pride in the success the team at Trinity has had in treating this disorder.
"Our patient satisfaction scores are really high," Meyer said. "Our compliance here is much better (than national rates) because we really spend time with the patients. We go over different types of masks to get a good mask for the patient and try to educate the patient about the importance of getting this disorder treated."
Byrne and Meyer both stressed that the technology for addressing obstructive sleep apnea is evolving rapidly. They said today it is usually possible to find a solution the patient finds palatable, noting that in years past less-advanced options were hard for some people to tolerate.
Contact Terrence Dwyer at (515) 573-2141 or firstname.lastname@example.org