Until recently, Emmanuel Michael thought his unusual sleep patterns were nothing more than amusing quirks.
In college, he once woke up from a library snooze to find a note on his chest complaining about his loud snoring. On lunch breaks, the database programmer would eat quickly so he could also take a half-hour nap.
But when he read online about sleep disorders, Michael discovered that his snoring and daytime drowsiness might be a sign of sleep apnea — a disorder that interrupts a sleeping person’s breathing, sometimes dozens of times a night — and that his health might be at risk.
“The thing that was striking and really frightening was if you do have sleep apnea, you run the risk of higher possibility of heart disease, high blood pressure and diabetes,” said Michael, 29, of Chicago. “I’m not going to let my sleep be the thing that does me in.”
Young and otherwise healthy, Michael is among a growing number of people who are turning to doctors to solve their problems with sleep — a surge fueled in part by economic woes that are stressing out an already sleep-deprived nation. But doctors say people also are becoming more aware of the relationship between adequate sleep and overall health, as medical studies uncover additional reasons to get a full night’s rest.
The result is a rapidly expanding business in sleep medicine, with a host of new sleep centers opening around the Chicago area where poor sleepers can be hooked up to machines that help diagnose their troubles while they try to rest.
In the latest twist to the business, some centers are now offering the tests in hotel-style rooms featuring amenities designed to put visitors at ease: comfortable beds, flat-screen televisions and private bathrooms with travel-size cosmetics.
Michael’s tests were performed in a new, hotel-style clinic opened by the University of Chicago this year. Resurrection Health Care and Merit Sleep Centers recently announced a plan to create a network of 25 testing sites across the area by the end of this year, each outfitted with posh, private rooms.
Other centers put up patients in hotels or even provide take-home equipment that can record subjects’ sleep patterns in their own beds.
Some experts, however, say the new offerings may erode quality of care while increasing costs.
“There are many more practitioners in the field that are not actually certified to treat these patients,” said James Wyatt, director of the Rush University Sleep Disorders Service and Research Center. “There really isn’t justification, I think, to have a tremendous number of new sleep centers or to throw the doors wide open to having home studies.”
Sleep testing, called polysomnography, traditionally takes place in a hospital room, where a sleeping patient is videotaped while brain activity, heart rate, respiration and blood-oxygen levels are measured. In another room, a technician watches as many as 20 different channels of information, looking for interruptions in breathing, involuntary muscle movements and other symptoms.
But the equipment is often uncomfortable, with more than a dozen wires and sensors attached to a patient’s head, nose, chest and legs.
“Imagine coming to the hospital and trying to sleep normally with 16 different wires on your scalp and on your legs and arms,” said Dr. Michael Friedman, co-director of the Sleep Diagnostics Center in Chicago. “It was really an awful experience most people dreaded.”
So Friedman’s center offers tests in rooms at the Crowne Plaza in the Loop, while Northwestern Memorial Hospital purchased an entire floor of rooms and suites at the luxury Avenue Hotel on the Gold Coast.
“We wanted to better provide an environment more conducive to sleep,” said Dr. Phyllis Zee, director of Northwestern’s sleep center. “We were able to provide an experience that would be closer to their home.”
Soon the home itself may be the setting for many sleep tests. Several home-use devices designed to detect obstructive sleep apnea have been released, and in March the Centers for Medicare & Medicaid Services approved reimbursement for treatment ordered after a disorder is diagnosed in the home.
Doctors say the home devices don’t measure nearly as many parameters as an in-lab test. But they acknowledge that the appeal of being tested in one’s own bed may help the many people suffering from undiagnosed apnea get needed treatment.
As part of a nationwide study comparing the home tests to hospital tests, Chicagoan Terrence Link, 39, took a device home that he could attach himself before going to sleep. The test revealed more than 25 breathing interruptions per hour, enough to diagnose severe sleep apnea.
“The kids found it to be kind of funny, all the wires running here and there,” said Link, whose snoring was so bad that his wife had threatened to put him in another room. “But it was definitely more of a comfortable setting being at home doing it. Honestly, I wish I had found out about it a long time ago.”
Some sleep specialists remain skeptical of the home tests, saying the data often are unreliable because of sensors coming loose during a night’s tossing and turning.
“We’re spending a lot more of our time now seeing cases for follow-up where we’re the second or third opinion, or testing somebody who’s failed out of one of these home-study sleep programs,” Wyatt said. “Had the patient been treated correctly in the first place, they would have saved time and money.”
Michael was tested through a new, streamlined program launched at the U. of C.’s new downtown clinic. Patients are diagnosed in the first half of the night, fitted in the second half for a CPAP machine that keeps airways open during sleep and allowed to take the machine home in the morning.
After being recorded as having 40 breathing interruptions per hour — a very high rate — Michael went home with one of the machines. Three days later, he said, he was sleeping better than he had thought possible.
“It sheds light on the past 10 years of my life, why I was a little more lazy than usual,” he said with a chuckle. “It’s kind of a clean slate for me.”
– – –
Warning signs
*Persistent daytime drowsiness.
*Frequent daytime naps.
*Loud snoring (louder than talking or audible in the next room).
*Waking often during the night.
*Waking too early in the morning.
*Difficulty falling asleep once awake.
*A strong urge to move legs while sitting or lying down.
*Interruptions in breathing during sleep (as observed by someone else).
– – –
Few sleep centers offer treatment for children
While sleep centers for adults are becoming a common sight, the few pediatric sleep centers in the Chicago area said they are drowning in demand as more children are sent for tests.
Sleep studies in children require more measurements, closer care and special rooms, so many centers decline to treat patients younger than adolescents.
At Children’s Memorial Hospital, where Chicago’s first pediatric sleep center opened in 1995, new patients can wait six months for a consultation, director Stephen Sheldon said.
“In our sleep laboratory, we are studying more than 1,000 children a year, and I can safely say that if we were able to have twice the number of beds, we would fill them overnight,” Sheldon said.
The shortage has become more glaring as more doctors realize the importance of sleep in a developing child. Some even speculate that attention deficit hyperactivity disorder is often diagnosed when children actually have a sleep disorder.
“They can be identical symptoms,” Sheldon said. “To see all the symptoms of ADHD, all you need to do is keep a child up late one night.”
Loss of sleep also can affect a child’s daytime performance. Carol Kelley, 36, of Westmont said her daughter Kristy, 15, saw her grades plummet since developing breathing problems while sleeping.
“She would just gasp for air; it would wake me up and it wouldn’t wake her up at all,” Carol Kelley said.
Kristy Kelley’s pediatrician sent her to the Merit Center for Sleep Health in Streamwood, where rooms are outfitted with toys for children and video-game systems for teenagers, and parents sleep either in the same room or in an adjacent room. The teen’s stay led to a diagnosis of obstructive sleep apnea, and she will have surgery to remove her adenoids.
“I’ll probably get a lot more sleep, too,” her mother said.
— Robert Mitchum
————
rmitchum@tribune.com
