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Sleepless

In Detroit

\ -

\—,

/— )

ichard Bloom felt like a
walking zombie. Fighting
to stay awake in his
Southfield insurance of-
fice had become a formid-
able struggle.
At home, his irritability, ab-
sentmindedness and general feel-
ings of ill health were taking a
toll on his family — a wife and
two children.
David Efros, a pharmacist in
West Bloomfield, experienced
similar fatigue. His wife, Susan,
complained about his abnormal-
ly loud snoring. No amount of
sleep helped him feel rested and
refreshed in the morning.
Portrait artist Cathy Barrett
of Novi suffered from exhaustion,
too. What all three individuals
had in common was severe ob-
structive sleep apnea, a poten-
tially fatal condition that blocks
airways and interferes with
breathing while its victims are
fast asleep.
"The most obvious symptom of
sleep apnea is a very loud, dis-
ruptive snore and a gasp as the
sleeping person struggles to re-
gain his breath," explains Dr.
Harvey Organek, a pulmonary
specialist and medical director of
Sleep and Respiratory Associates
in Southfield.
The condition occurs, he says,
when abnormalities — like
polyps, an unusually large uvu-
la or big tongue — exist in the
upper airway, an especially soft
and collapsible area of the
respiratory tract.

Apnea makes for
a distressing
bedfellow.

\—)

/

—

DEBBIE WALLIS LANDAU

SPECIAL TO THE JEWISH NEWS

Doctors aren't sure what trig-
gers episodes of apnea. When one
strikes, however, the blockage in
the upper airway prevents suffi-
cient oxygen from entering the
lungs. The blockage also reduces
the amount of carbon dioxide an
individual can exhale.
Hence, the content of carbon
dioxide in the blood increases.
This awakens the sleeper, who is
often short of breath. After
breathing deeply for a few mo-
ments, slumber encroaches again
and the cycle repeats itself.
Apnea patients never reach
that deep, restful REM (Rapid
Eye Movement) stage of sleep
that all people need for healthy
functioning. Dr. Organek gener-
ally sees people after their ex-
treme fatigue has interfered with
their short-term memory, as well
as their ability to concentrate
while reading, enjoy sex and par-
take in other normal activities.
A person whose breathing
stops five or more times for 10 or
more seconds per hour is classi-
fied as apneic. Several factors are
red flags for the condition: morn-
ing headaches, daytime sleepi-
ness, difficulty waking up,
sleeping during the day and rest-
lessness.
Richard Bloom was tested re-
peatedly for anemia, the Epstein-
Barr virus and other health
problems. The tests always came
back negative.
"I knew I wasn't well, but none
of my doctors seemed to know
what the devil was wrong," he
says.
Dr. Tom Roth, director of the
Henry Ford Hospital System's
Sleep Disorders and Research
Center, blames this on the lack
of information about sleep apnea,
as well as the lack of communi-
cation between primary care
physicians.
"We need to do a better job of
alerting health-care providers
that apnea is widespread among
the population," says Dr. Roth,
who also chairs the advisory

David Efros: No amount of sleep helped him feel rested.

board of the National Center of
Sleep Disorder Research, part of
the National Institutes of Health.
Mr. Bloom, still undiagnosed,
actually fell asleep at the wheel
of his car and caused an accident.
Fortunately, no one was injured.
He admits he was lucky.
Six and a half years ago, a
friend referred Mr. Bloom to the
Henry Ford Sleep Disorders and
Research Center in Detroit. The
visit led to the correct diagnosis:
sleep apnea.
"It was literally too late to save
my marriage," Mr. Bloom re-
flects. "But it certainly saved my
life. I could have had a severe
heart attack, stroke or other life-
threatening condition. It was an
enormous relief to know there
was actually a name and treat-
ment for what had been ruining
my life."
Indeed, statistics recently pub-
lished by the American Sleep Dis-
orders Association identify apnea
patients as much more likely to

die of a heart attack or stroke
than the rest of the population
because oxygen deprivation
places strain on the heart, lungs
and other organs. They're five
times more likely to fall asleep at
the wheel of a car, due to sheer
exhaustion.
Estimates published by the
Stanford University School of
Medicine indicate as many as 20
percent of males over the age of
40 may have some form of sleep
apnea. The male/female apnea
incidence ratio is estimated at
eight to one.
"More female patients seem to
exhibit apnea symptoms after
menopause," says Steve Miller,
the chief operating officer at Sleep
and Respiratory Associates. "It's
believed that estrogen might play
a significant role in respiratory
efficiency, and that the depletion
of the hormone might impede
breathing in some way."
In a Stanford University study,
based on tests performed on 159

For Help, A Few
Numbers To Call

The following Metropolitan sociates: Southfield (810) 350-
Detroit area facilities are sleep 2722
4. Sleep Disorders Institute:
testing and research centers ac-
credited by the American Sleep Troy (810) 879-0707.
5. University of Michigan,
Disorders Association.
1.Henry Ford Hospital Sys- Sleep Disorders Center: Ann Ar-
tem, Sleep Disorders and Re- bor (313) 936-9269.
6. Veterans Administration
search Center: Detroit (313)
Hospital, Sleep I Wake Disorders
972-1800.
2. Oakwood Hospital: Lincoln Unit: Allen Park (soon to
relocate to Detroit) (313) 562-
Park (313) 382-6165.
6000.
Sleep
and
Respiratory
As-
3.

❑

commercial truck drivers, 78 per-
cent were apneic, leading re-
searchers to believe that apnea
might be, in part, occupation-re-
lated. The truckers' sedentary
lifestyle, roadside eating habits
and often irregular sleep patterns
likely figured into their problem.
Most apnea patients are sig-
nificantly overweight.
"A substantial number of our
patients find their apnea reduced
when they reduce," Dr. Organek
says.
But doctors know that, in some
cases, heredity plays a role. A
very small jaw and narrow air-
ways are two traits predisposing
individuals to the condition.

S

everal clinics and programs
offer help to apneics local-
ly (see sidebar), and vari-
ous treatments are
available.
Mr. Bloom was fitted with a
Continuous Positive Airway Pres-
sure (CPAP) device, a mask-like
aid that fits snugly over a pa-
tient's nose and. forces his airways
open during sleep.
"When used properly, CPAP
corrects sleep apnea 100 percent,"
Dr. Organek says.
When Mr. Efros went for
help, he was examined with a
flexible rhinolaryngoscope, which
looked for obstructions in the
nose and throat. It also looks for
abnormalities in the palette and
back of the tongue.
"We can numb the inside of the
nostrils and the discomfort is re-
ally minimal. Most patients tol-
erate the five-minute exam very
well," Dr. Organek says.
If an obstruction is found and

SLEEPLESS page 70

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