- The Washington Times - Sunday, December 3, 2006


Army veteran Joe Green gazes skeptically at the alien-looking vinyl mask that his respiratory therapist says will help him find the peaceful slumber he so desperately seeks.

“How long will I be on this?” Mr. Green asks therapist Amy Stanley. He’s wary of the device, designed to force air into his lungs while he’s asleep.

“Look at it as your new best friend,” says Miss Stanley, gently urging him to give it a try.

“I’ll have to see how it goes,” Mr. Green says. “I have trouble sleeping. I toss. I turn. I snore. … I’ve wanted to know myself what the problem’s been.”

A study released earlier this year showed that as many as 70 million Americans suffer from chronic sleeping problems, costing the nation billions in medical expenses, accidents and lost productivity. Although there’s no direct evidence that military veterans are afflicted with sleep disorders at a higher rate than the general public, most of the veterans’ sleep problems can be traced to obesity or post-traumatic stress disorder, respiratory therapist Don Craig said.

To find the rest that eludes them, Mr. Green and hundreds of other veterans in South Carolina are turning to specialists at a new sleep lab at the Dorn Veterans Affairs Medical Center. Most are referred by their physicians or prodded by spouses weary of their partners’ snoring or sleepless nights.

“Most of our patients suffer from what is known as sleep apnea. That’s when you wake up and feel as if you hadn’t slept at all because you are fighting to breathe all night,” Miss Stanley said.

After a night of evaluation, the patients attend a class to find whether continuous positive airway pressure, or C-PAP, machines might help them. The machines, which are small enough to fit on a bedside table, force air into their lungs through masks that cover their noses and mouths. The constant airflow prevents their airways from collapsing, allowing them to breathe — and sleep.

“Many of our patients actually stop breathing during the night. They may not move air in and out of their lungs because their airway is obstructed,” Miss Stanley said.

The reasons for this vary and include enlarged tissue or obstructions in the airway, such as large tonsils; a decrease in muscle tone that holds the airway open; or certain facial or jaw structures, such as recessed chins. The problems can be exacerbated by obesity.

After adjusting to a C-PAP mask and machine, Miss Stanley predicts that the patients “will be able to have … the deep, restorative sleep that they need.”

Mr. Craig manages the eight-bed, hotel-like lab where patients are evaluated. They are given a private room with a television, bed and sometimes a recliner. They spend a night attached to monitors and photographed by infrared video cameras.

The lab is open seven nights a week, working to slash the backlog of veterans from across the state and veterans’ facilities in Charleston and Augusta, Ga. The lab also is taking some active-duty military patients from nearby installations such as Fort Jackson in Columbia and Shaw Air Force Base in Sumter.

Mr. Craig said other VA centers have sleep labs in Atlanta and Augusta, Ga.; Birmingham and Montgomery, Ala.; and Charleston, but most have only two beds.

At the Columbia clinic, on any given evening, four to six patients are monitored from 9 p.m. until 5 a.m.

Data is collected on each of the 100 or so patients who use the center every month since it opened in April, Mr. Craig said. Tiny sensors are attached to a patient’s scalp, chest and legs, gathering information on heartbeat, leg movements, abdomen shifts and brain activity — revealing sleep patterns.

“We collect data on every second, whether they are asleep or not,” Mr. Craig said.

Two VA physicians who are certified sleep specialists evaluate the information, and about 95 percent of the patients seen so far have been told that they need “some kind of intervention” to help them get the sleep they need, Mr. Craig said.

That could mean use of the C-PAP machines, surgery or medication.

Mostly, the veterans and other patients are relieved to find a reason that explains why they are constantly so exhausted.

“They aren’t as irritable anymore,” Mr. Craig said. “We all know that good sleep makes you better during the day.”

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