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Home Diagnostics And Treatment Help Veterans Sleep Easier

by Kimberly Gearhart

Registered Respirator Therapist Karen Armour, right, checks the fit on Vincent Santalla's continuous positive airway pressure mask during a follow-up visit to the sleep medicine clinic in August. (Photo by Kimberly Gearhart)

 

Are you tired during the day or have trouble concentrating? Does your spouse complain about your snoring? You may be suffering from a condition known as sleep apnea.

Sleep apnea is a common disorder that causes a person to stop breathing or breathe shallowly during sleep. This often disturbs the sleeper enough to cause tiredness upon waking.

“Lots of people have sleep apnea and may not even know it,” said Robert Pace, a registered respiratory therapist (RRT) and sleep diagnostics coordinator for the Southeast Louisiana Veterans Health Care System (SLVHCS) sleep medicine clinic.

Army Veteran Vincent Santalla didn’t know he had sleep apnea when he came to SLVHCS to see his doctor about what he thought were signs of asthma.

“My wife complained that I kept her awake at night because I’d stop breathing and scare her. I was tired all the time,” Santalla explained.

His physician recommended a sleep study. It was determined that Santalla was experiencing upwards of 30 apnea events an hour on a nightly basis. In other words, he stopped breathing nearly every two minutes.

Santalla’s test was carried out on an inpatient basis in a sleep lab. Waiting lists for such procedures can be long. To combat these waits and expedite treatment for Veterans suffering from apnea, SLVHCS’ sleep medicine clinic staff pioneered the widespread use of home testing machines.

“After Hurricane Katrina, we had a huge backlog of studies we needed to complete, but our facility was damaged and many community health care providers were similarly affected. We needed an alternative,” said Nathan Dion, RRT and pulmonary supervisor.

Dion and his sleep medicine team researched possible alternatives and proposed to begin using home diagnostics to fill the gap between needed and available care. At the time, home tests were not reimburseable through any insurance program, including Medicaid and Medicare.

In 2007, Dion received $20,000 to purchase five home testing units. Within four months, the testing backlog had been cleared and Veterans in need were being treated.

“When you consider that it can cost over $2,000 per patient to outsource a sleep test, we saved hundreds of thousands of dollars. But more importantly, we got our patients the care they needed, even without a hospital,” Dion said.

Once patients are diagnosed as suffering from apnea, treatment can begin.

“We use a continuous positive airway pressure, or CPAP, machine. This helps keep the airways open at night and allows the patient to breathe, but it’s not a cure,” Pace explained. Rather, using the CPAP is a lifestyle change. Patients will likely continue to use the device for their lifetime.

“Our goal is to stabilize the patient and deal with the current symptoms. When we can do that, the patient has fewer sleepless nights,” Dion said.

Santalla has been using the CPAP machine since spring of 2010, and he notices a big difference.

“I have more energy,” he said.

Santalla’s wife Susan has noticed a difference as well, although at first it was almost as scary as his apnea.

“I couldn’t hear him at all. I’d wake up and check to see if he was still breathing,” she said. The CPAP machine, which sits at their bedside, was so quiet she couldn’t hear it either.

The CPAP machine records Santalla’s nightly use and keeps track of any apnea episodes he may have. The goal is to get him down to five episodes of apnea per hour per night. During a follow-up visit in August, RRT Karen Armour found that Santalla is experiencing less than three episodes an hour.

“He’s doing really well and using it consistently. That’s why he feels so much better. It’s great,” Armour said.

For more information about sleep medicine or home diagnostics, contact Dion at 504-412-3700 ext. 8483 or by e-mail at Nathan.dion@va.gov.

 

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Posted by on Aug 23 2011, With 0 Reads, Filed under Health. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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