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SEEKING the SANDMAN

What does a person need to do to get a decent night’s rest?

If you’re tossing and turning as the new year gets under way and counting sheep isn’t doing the trick, a trip to Tuality Healthcare’sby: HILLSBORO TRIBUNE PHOTO: CHASE ALLGOOD - Julie Goodrich, a registered polysomnographer, watches a heart rate monitor during at Tuality Healthcare Sleep Lab in Forest Grove. Sleep Lab might be in order.

Located at Tuality’s Forest Grove Hospital, the lab has been open since 2009. It offers most of the indulgences of a fine hotel — private bathrooms, cable TV, comfy recliners and top-quality queen-size beds — to help guests relax and rest.

In the lab, specialists and technicians perform overnight sleep studies on patients with sleep and fatigue-related issues — from occasional insomnia to restless leg syndrome to debilitating cases of obstructive sleep apnea.

“No problem is too small,” said Dr. Peter Hahn, a specialist in sleep medicine and pulmonary medicine who has directed the lab for more than three years. “Any degree of sleep trouble is worth an evaluation.”

The lab can handle two overnight sleep-study patients at a time, usually by referral from a primary care physician. Arriving at 8 p.m., a patient is “hooked up to a number of monitors,” Hahn said, and technicians “basically watch them while they sleep.”

Over the next 10 hours or so, various data, including brain activity and breathing patterns, are recorded by lab staff. The next morning, Hahn reads the study and schedules a follow-up appointment with the subject to discuss various approaches to solving his or her problem.

“We run studies every night of the week, and our patients come from all over the Portland metro area,” noted Hahn.

Sasheen Pack, who has managed the sleep lab for the past two years, said she’s particularly gratified by feedback from patients who spend the night at the facility.

“When they arrive at the lab, sometimes they’re very fearful at first,” said Pack, a respiratory therapist who has worked at Tuality for 11 years. “They’re not sure what’s going to happen. But after they talk to our technicians and hear about the equipment and what will be happening overnight, they start to relax.”

Some patients prefer a portable study, which takes place in the comfort of their own home.

“We’re big believers in portable studies. The patient picks up the [monitoring] device, takes it home and sleeps with it,” explained Hahn.

The home studies are less detailed, but are especially helpful to people with an already-diagnosed problem such as sleep apnea. Symptoms include loud snoring, gasping for air and restless sleep.

“The prevalence of sleep apnea has been skyrocketing since the 1980s,” said Hahn, who pointed out that obesity is often a factor.

Even more serious in terms of its long-term negative health implications is obstructive sleep apnea — the collapse of a person’s airway as often as once every 60 seconds while asleep. This type of apnea can lead to high blood pressure, strokes and heart disease.

“Some studies show that up to 25 percent of the population has this condition,” said Hahn.

Lab techs sometimes apply a “continuous positive airway pressure” (CPAP) device to patients with apnea to help them avoid airway collapse. For some, the treatment is heaven-sent.

“Many times these patients comment how much better a night’s sleep they got in the lab than they do at home,” said Pack.

Insomnia — trouble falling asleep or staying asleep through the night — is a big issue these days, Hahn said.

“The most common causes are underlying depression or anxiety,” he pointed out.

With life in the 21st century proceeding at warp speed, almost anyone can fall victim to occasional sleeplessness.

Still, it’s nothing to yawn about. Chronic insomnia at night can lead to daytime symptoms of sleepiness, fatigue, irritability, short-term memory loss, sexual performance issues and loss of concentration.

Sleep deprivation can also put drivers at an increased risk for accidents — and push already-weary and fatigued folks into a real funk.

“Eight hours is sort of what we’re ‘supposed’ to get each night, but a lot of people have fragmented, poor-quality sleep,” Hahn said. “The less sleep you have on consecutive nights, the more likely you are to develop secondary ills, like depression.”

Over-the-counter medications to put oneself to sleep — Benadryl, Tylenol PM and Nyquil are among them — aren’t necessarily bad, according to Hahn. But there are some drawbacks.

“The problem with self-medicating is that it will work for only a short period of time,” he said.

Patients might be better off taking advantage of the Sleep Lab’s cognitive behavioral therapy program, which teaches them better ways to fall — and stay — asleep.

Hahn, who joined Tuality’s medical staff in 2010, came from the Mayo Clinic in Rochester, Minn., where he was a consultant in pulmonary, critical care and sleep medicine. He specializes in sleep disordered breathing, periodic limb movement disorders, parasomnias and narcolepsy.

One of only a handful of fellowship-trained sleep medicine doctors in Oregon, Hahn said it’s a “relatively new, exciting field” that lends itself to measurable results.

“We can actually see the change in our patients from day to day,” he said.

Those with health insurance are typically covered for up to 80 percent of the charges related to a sleep study, he said.

Here’s how some local folks sleep ... or don’t

Karen Thias, Forest Grove, teacher

I’m not a good sleeper. Even as a child I would wake up often during the night. Sometimes I have trouble falling asleep, and most nights I wake during the night. Several years ago I spoke to my doctor about it. She prescribed something to help with sleep which worked well the first few nights, but then stopped working, so I quit using it. Usually stress/worry keeps me from sleeping. Now, I read when I can’t sleep. I keep a night-light and a pile of books by my bed. I read when I go to bed.

Bill Geddes, Aloha, insurance account executive

For most of my adult life, I’ve struggled to fall asleep and get more than four quality hours of sleep per night. There are mornings when I feel a bit fatigued, and an occasional afternoon when I’d like to be able to take a power nap, but as a general rule I feel like I operate quite well. To try to adapt I’ve tried several things: Have a glass of wine before bed. Don’t have anything for a couple hours before bed. Exercise before bed. Don’t exercise after noon. Watch TV. Don’t watch TV. Read. Pray. Meditate. When I feel tired I try to get to bed, and when I’m awake I try to get productive.

Debby DeCarlo, Forest Grove, writer

I go to sleep pretty easily, but if I wake up in the night, I focus on my breathing. I count 10 breaths and start over — pretty much my meditation routine. The interesting part is that when I am meditating during the day, I can sit for 40 minutes, but if I do it when in bed, in the night, I fall asleep within a few minutes. Watching a Kindle movie at bedtime usually puts me to sleep in minutes. If I’m fretting about something, I write it down, put it in a box and tell God to take care of it. It works pretty well. I haven’t had to do that for a long time, but I used to regularly. Now that I’m getting older.

Debra Bratland, Forest Grove, public transportation driver

I feel so blessed that I usually sleep soundly through the night. I was sleep-deprived for almost 16 years while caring for my disabled son, who sometimes required assistance a dozen times a night. Perhaps my sound sleep now is to make up for all of the sleep I didn’t get then.




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