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Sunday, February 21, 2016

There’s Nothing Like a Good Night’s Sleep

Posted By: Advancing Care

Good health often starts with treating and managing sleep conditions.

By Melissa F. Pheterson


Tossing and turning. Snorting and gasping. Walking and talking—in your sleep. It’s sometimes difficult to know whether health issues aggravate sleep problems or if it’s the other way around. What is undisputed, however, is the link between restful sleep and better health, especially in the long run.

At the Bon Secours Sleep Disorder Institute at Good Samaritan Hospital, a Member of the Westchester Medical Center Health Network (WMC Health), Jack Horng, MD, and his colleagues Benjamin Chang, MD, and Jonathan Berg, MD, are treating and managing sleep conditions to help patients reclaim their rest, their health and even their lives. The Bon Secours Sleep Disorder Institute is one of several sleep centers in the WMCHealth Network (see sidebar).

“We try to be as much of a comprehensive program as we can, interacting with specialists in other disciplines,” Dr. Horng says. “As board-certified sleep specialists, we take the time to discuss options with patients and troubleshoot for many months afterward, to optimize their treatment.”

“If a patient responds and sticks with treatment,” he adds, “it’s life-changing.”

Sometimes, it’s a recommendation of cognitive-behavioral therapy to treat insomnia. Other times, it’s a CPAP machine that supports proper breathing; in still other cases, it’s a recommendation of surgery.

Sleep apnea

Dr. Horng says the center’s most commonly treated disorder is obstructive sleep apnea (OSA), a condition in which the patient’s airway collapses or dangerously narrows to obstruct breathing, sometimes hundreds of times per night. Affecting up to 4 percent of the population, OSA can exacerbate conditions both physical (diabetes, heart disease, epilepsy, asthma) and behavioral (anxiety, depression, ADHD).

Sometimes Dr. Horng helps fit patients with a CPAP (Continuous Positive Airway Pressure) mask, which pumps air pressure from a machine into the nose/mouth, keeping airways open to splint the airway obstructions and creating the improved sleep that seeds better health. “Sometimes, a patient will complain of the need for frequent urinating at night,” says Dr. Horng. “His urologist might suspect an issue with his prostate, but once he’s referred to our clinic, we may find that sleep apnea is the root cause, ruling out urological problems. Once the sleep apnea is corrected with a CPAP machine, the nocturnal urination can improve or even goes away. This is just one example of how we work with specialists across disciplines for excellent patient care.”

Other patients will require bariatric surgery.The connection between morbid obesity and sleep apnea can be described as a vicious cycle of weight gain, crowding of airways, compromised breathing, lack of sleep, sedentary lifestyle, changes in hormone levels and further weight gain,” says Dr. Horng. Bariatric surgery can halt the cycle. “When you have the vigor to reclaim your energy because you’re sleeping better,” he says, “you’ll have an easier time losing weight down the road.”

Insomnia

Everyone has a sleepless night once in a while, but chronic insomnia could point to a behavioral issue, such as depression or anxiety, with one condition worsening the other, leading to restless nights and daytime exhaustion. Sometimes, improving “sleep hygiene” — such as winding down before bedtime, using blackout shades, and avoiding caffeine or alcohol — can address the issue. Other times, therapy is needed.

“We have psychiatrists well-versed in depression to treat patients with poor sleep,” says Dr. Horng, “and, if needed, we send them to clinical psychologists for behavioral therapy and to realign sleep patterns for patients with jet lags, circadian rhythm disorders and shift work disorder.

Other disorders

In addition to treating sleep apnea and insomnia, WMCHealth’s sleep centers evaluate disorders and conditions such as the family of parasomnias, including sleepwalking, sleeptalking, restless legs syndrome and periodic limb movement syndrome; narcolepsy and R.E.M. behavior disorder.

Sleep Centers at WMCHealth

Westchester Medical Center, 914-493-1105

Maria Fareri Children’s Hospital, 914-493-1105

MidHudson Regional Hospital, 845-431-8214

Good Samaritan Hospital, 845-368-5512

Bon Secours Community Hospital, 800-540-4485

St. Anthony Community Hospital, 866-857-6080