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Got Sleep Apnea?

Posted on December 4, 2019 | No Comments on Got Sleep Apnea?

Snoring is considered the trademark of sleep disordered breathing. As one respires, a harsh, disturbing resonance caused by vibrations in the soft palate and the surrounding throat structures, indicates a resistance in the flow of air. Snoring implies that an interruption of airflow in the lungs during sleep may be at hand as well. This condition called sleep apnea, according to the World Health Organization (WHO), is a preventable, chronic respiratory disease and the most common organic sleep disorder.

However, although it is common among men, sleep apnea often goes undiagnosed since those who have it are sound asleep—not realizing that they already have such condition.

According to the “Global Surveillance, Prevention and Control of Chronic Respiratory Diseases: A Comprehensive Approach,” sleep apnea affects an estimated number of 100 million people worldwide. It has become a widespread condition that almost anyone, of any age, gender, race, and nationality can be affected. But, with innovation, one can have a chance of getting a good, hushed slumber.

Available diagnostic facilities
Dr. Agnes Remulla of the Department of Otorhinolaryngology at the Asian Hospital and Medical Center (AHMC) said, “Filipinos have a misconception that snoring and being able to sleep easily are hallmarks of a good sleeper.” But, they are entirely wrong. “These may indicate a sleep disorder,” explained Dr. Remulla who is the founder and current head of the AHMC Sleep Laboratory.

The AHMC Sleep Lab, opened in 2008, has two bedrooms for testing and a control room in between. The testing rooms, which do not look like normal hospital rooms, are deliberately designed to make patients feel comfortable. They are comprised of queen sized beds, recliner, breakfast nook, and entertainment set.

There is also a crib available for children who need to be treated. Meanwhile, the control room serves as the monitoring area where sleep technicians and physicians stay as they conduct the study, evaluate, and interpret the patients’ cases.

With its up-to-date facilities, AHMC Sleep Lab offers various services to its patients. Dr. Remulla explained that they do polysomnography (sleep testing) for both children and adults. She said the tests, which are usually done at night, are diagnostic, therapeutic (with continuous positive airway pressure or CPAP) and combined (the two tests in one night). For their shift-worker patients, Dr. Remulla said testing is done during their usual sleep time that may be in the morning or afternoon.

AHMC Sleep Lab, following protocols based on local and international guidelines, facilitates referrals to device suppliers and physicians as needed. On average, they test one to two patients per night, five days a week. The usual cases they see are snorers suspected of having obstructive sleep apnea; however, they also entertain patients who are diagnosed of having unusual behavior during sleep or unexplained daytime sleepiness.

Nonetheless, Dr. Remulla stressed that not all sleep disorders need to undergo sleep studies. Cases of insomniacs and those who complain of sleep difficulty are initially evaluated in the clinic but, Dr. Remulla said the lab, for these cases, may not get information pertinent to their treatment.

“We also avoid testing critically ill patients. These include intensive care patients and those at risk for sudden emergent management,” Dr. Remulla explained. “If the scheduled patient unexpectedly develops an acute illness, usually cough or cold, they are advised that the study should be deferred until he or she returns to normal.”

Affordable sleep study
With the existing financial situation in the country, it is apparent that not all sleep apnea patients can afford to pay the services being offered by private hospitals. That is why the Lung Center of the Philippines (LCP), a government-owned infirmary, established in 2004 a Sleep Lab and Sleep Disorders Clinic. The founding was headed by LCP Director Dr. Juanito Rubio, along with the Head of LCP Respiratory Services Dr. Vincent Balanag, who arranged the lab’s set up.

LCP Sleep Lab aims to provide patients the expertise and the resources at the most affordable cost. Dr. Virginia Delos Reyes, the current head of the lab said, “It is 50% cheaper [here] because it is subsidized by the government, but we assure the public that the quality of sleep studies is of great value.”

By means of the latest machines: Alice 5 Polysomnogram, Electroencephalography (EEG), CPAP, Bilevel Positive Airway Pressure (BiPAP) or breathing mask, and the expertise of accredited sleep technicians and physicians, the laboratory provides comprehensive diagnostics and treatments for both children and adults.

“The youngest patient we’ve treated is a 1 and a half year old boy,” said Dr. Delos Reyes, who specialized in Internal Medicine-Pulmonary and Sleep Medicine. She said they regularly see young apnea patients infected with enlarged tonsils and adenoids.

Housing one queen-sized bed and other home appliances, LCP Sleep Laboratory exudes a relaxing ambience for the overnight sleep studies. At present, it can hold only one patient a day, but Dr. Delos Reyes said they might expand the laboratory due to the 4.1-7.5 percent rising prevalence of apnea patients in Asia.

LCP Sleep Lab is in accordance with the AASM (American Academy of Sleep Medicine) Standards for Accreditation of Sleep Disorders Centers, which is also adopted by the Philippine Society of Sleep Medicine.

Future with sleep apnea
“Sleep apnea is severely underdiagnosed in the Philippines,” said Dr. Remulla. According to her, there is a lack of interest and indifference to its importance from physicians and patients alike. Seeing things the same way, Dr. Delos Reyes said no local researches have been conducted yet–despite the serious effects the condition might cause. She explained that the country faces obstacles with regards to apnea, as follows: (1) some doctors are not fully aware of it; (2) apnea is not known to the public; (3) there is a misconception that apnea is a trivial disease; and (4) only the rich can have it.

“Let’s try to put sleep apnea down as much as possible by conducting our own studies,” Dr. Delos Reyes said. “It is worth investing on.”

Through further research and development of novel technology, “sleep apnea evaluation and management can be made accessible to all,” said Dr. Remulla.

Some dos and don’ts
Aside from seeking treatments and medication from sleep centers, sleep apnea patients can do some home regimen to aid them. Dr. Remulla and Dr. Delos Reyes enumerated some:

  • Reduce some weight or aim for your ideal body weight.
  • Do not smoke
  • Avoid alcohol intake close to bedtime
  • Recoil from sedating medications
  • Get enough sleep
  • Lie on your side or with your back elevated
  • If you are prone to colds, nasal allergies, or sinusitis, have it treated
  • Treat acid reflux

AHMC Sleep Laboratory and LCP Sleep Lab and Sleep Disorders Clinic offer a comprehensive range of diagnostic tools and treatment procedures to help Filipinos understand if they are already suffering from sleep apnea, and what they can do about it.

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