SLEEP DISORDERS A SHADOWY LOT

Sleep disorders can be a shadowy lot.

They can transform what is supposed to be a period of mental and physical restoration into hours of struggle.

Sleep disorder sufferers may trudge through working hours without a clue of what is causing their discomfort. They are often unaware that their sleep is being interrupted.

Symptoms like sluggishness, forgetfulness, anxiousness, depression and morning headaches may be shrugged off or blamed on aging or other factors, noted Cindy Neely, a certified respiratory therapist and registered sleep technician.

Neely works in the St. Francis Medical Center Sleep Well Program. Founded in 1990, the program is designed for the diagnosis and treatment of sleep-related breathing disorders. Through sleep studies conducted in the two-bedroom sleep program facilities at St. Francis, the sleep patterns of people of any age can be monitored and evaluated, and treatment begun.

Sleep studies are typically completed during a single overnight stay in the rooms outfitted for comfort.

Of the varied sleep disorders that afflict millions of Americans, sleep apnea is the most commonly diagnosed and easily treated, explained Dr. Kahlid Khan, a pulmonologist in private practice, and co-medical director of the Sleep Well Program.

Sleep apnea is a condition caused by the collapse of pliable throat tissues during sleep. Because of the repeated breathing obstructions, the sleeper experiences disturbed, restless sleep.

Excessive daytime sleepiness and snoring are the two top symptoms of people with sleep apnea, Neely said. "Not all snorers have sleep apnea, but all people with sleep apnea snore," she said. The condition affects people of all ages.

In a period of some five years, Preston McKinley of Benton experienced those symptoms and more. "I would notice that during the day I was very tired, very sleepy," he recalls. Gradually his condition escalated. "I would wake up several times a night just literally gasping for air."

Plus, he began to experience periods of inappropriate sleep. "I would literally fall asleep driving down the highway," he said. "I would even fall asleep standing and talking to someone."

While McKinley's wife, a registered nurse, recognized the symptoms, McKinley was, for a period, unable to acknowledge his problem. "It was just a matter of facing up, of hoping it would go away when you probably knew it wouldn't," he said.

Because he was diagnosed with sleep apnea during a sleep study at St. Francis about 1 1/2 years ago, McKinley's life has taken a radical turn.

He has dropped some 200 pounds from his former body weight of 378 pounds and his sleep apnea symptoms have disappeared. "The tissue in my throat has shrunk remarkably, the airway is much more open," McKinley said. "I'm 40 years old, but I feel as well or better than I did when I was 20."

McKinley attributes much of the success of his efforts to attain better health to the treatment he received, primarily to treatment involving a mechanism called CPAP (continuous positive airway pressure.)

For sleep apnea, Dr. Kahn said, "by and large the mainstay of treatment is the CPAP," though there are other avenues of treatment that may be called for, depending upon the patient and many variables.

In CPAP treatment, the patient wears a mask over the nose during sleep. Pressure from an air blower forces air through the nasal passages to prevent the throat from collapsing during sleep.

The majority of patients tolerate CPAP well, Kahn said. However, he stressed, "there is a learning period involved. You have to work at it."

McKinley remembers those rough spots. "There were a few nights I didn't think I could do it," he said of the CPAP treatment. "Once I got used to it, after the first week or two, I felt so much better and I felt rested. My energy levels came up even before I lost weight. I was more alert, everything was more clear. I could go to sleep and sleep all night."

While in McKinley's case there was a direct correlation between weight and sleep apnea, that may not always be the case. Plus, in many if not most instances, lifetime CPAP treatment may be called for.

On the other hand, McKinley noted, "Even conditions less severe than mine can cause you to have a lot of problems."

Besides the apparent social and physical problems that sleep disorders can cause, there may be other, less apparent yet serious side effects. For instance, sleep apnea has been associated with such side effects as high blood pressure, premature heart disease and stroke.

People who suspect they may be experiencing sleep disorder symptoms should talk with their physician, Neely and Kahn said. People who get treatment for their sleep disorders, Kahn said, "are some of the most satisfied people you will meet."

Good sleep habits

The following guidelines, published by the American Sleep Disorders Association, should be used for all types of sleep disorders. For more information, contact the St. Francis Medical Center Sleep Well Program at 339-6276 or 1-800-455-9999.

-- Get up about the same time every day.

-- Go to bed only when sleepy.

-- Establish relaxing presleep rituals such as warm bath, light bedtime snack or 10 minutes of reading.

-- Exercise regularly, at least four hours prior to bedtime.

-- Keep a regular schedule.

-- Avoid caffeine within six hours of bedtime. Do not drink alcohol when sleepy, nor smoke before bedtime.

-- Try to nap at the same time every day.

-- Use sleeping pills conservatively.