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A Good Night’s Sleep

by Mary Ann Romans
…From the pages of Art of Living Well…

If you have trouble staying asleep and never seem to feel well-rested in the morning, it could be more than just a lot on your mind that’s preventing you from catching some Z’s.

Adam Girardo was a poor student. He stopped paying attention in class and even fell asleep during lectures. He wore his instructors’ patience to the breaking point and was issued detention on a frequent basis. Due to the difficulties, his grade point average was just a 1.4. It wasn’t until Girardo had a sleep study done that he realized there was something bigger going on than just struggling in school. Eventually, he was diagnosed with a severe case of sleep apnea. Girardo received treatment, and in his words, found a new life.

“It was almost like first seeing the world in color,” Girardo says. “It was amazing.” After addressing the issue, his GPA went from barely surviving to an impressive 4.0, the equivalent of straight A’s. Now, he is better known as Adam Girardo, BS, RPSGT, RST, a technician with Advantage Sleep Centers, one of the premier sleep disorder centers with locations in Voorhees, Cherry Hill and Washington Township.

Girardo’s story is like many others; men, women and even children can go undiagnosed for a long period of time, suffering through a sleep disorder that they don’t know exists.

“It’s not normal to feel sleepy during the day, to have problems getting to sleep at night, or to wake up feeling exhausted. That is something that most people don’t realize,” says Paul Lifschutz, RST, RPSGT, also with Advantage Sleep Centers.

“The main reason that people don’t get treatment is that they don’t know they have a problem,” agrees Jonathan E. Kass, MD, a board-certified physician of pulmonary diseases, critical care medicine, internal medicine and sleep medicine at Cooper University Health Care. “You do not know what is going on with you. The brain is working, but the mind is not awake.”

Getting the diagnosis
Sleep apnea is one of the more common sleep disorders, occurring especially as we age, although other risk factors include being overweight, being male, or suffering from asthma, COPD or other respiratory illnesses.

“Sleep apnea is basically due to the relaxing of the muscles in the back of the throat,” Lifschutz says. “Breathing is affected and the patient keeps waking himself, although he may not be aware of it.”

Many of the symptoms of sleep apnea get missed. They include: headaches, forgetfulness and difficulty concentrating, irritability or depression, and daytime sleepiness. In addition, someone with sleep apnea may not know they have any of the most telling symptoms: loud and chronic snoring, choking or gasping during sleep, and long pauses in breathing.

“I think when people come in to see their doctor, they may complain about being tired, but they don’t think that their snoring is a disorder,” Lifschutz says. “Yet it really could be an important sign.”

To check for sleep apnea, a patient must undergo a sleep study, which usually takes place in a hotel- or home-like setting, and their sleep is monitored throughout the night. “A series of electrodes monitor brain waves, breathing patterns, movement, blood oxygen levels and more,” Lifschutz says. “Everything is non-invasive. Our facility is set up to put the patient at ease, while using all of the most advanced equipment.”

Finding relief
If surgery is required, Advocare ENT Specialty Center offers a treatment called TORSA (transoral robotic sleep apnea surgery), a unique approach to improving the collapse of the tongue base, which contributes to sleep apnea in the majority of adult patients.

“We trim the bulky tissues at the back of the tongue, increasing the airspace in a way not possible without this exciting technology,” says Dr. Scott R. Schaffer, adding Advocare ENT Specialty Center is the only surgery center performing TORSA in the area.

Sometimes the solution is more simple and involves the use of a CPAP (continuous positive airway pressure) device that gives respiratory support. While many may be put off by the idea of wearing the mask that is part of it, experts say it is no big deal, especially when it’s properly fitted. “Having the right mask and the right support is important,” Girardo says. He says that he now puts the mask on and forgets about it until he wakes up. “Plus, the results are worth it,” he says.

And as Kass says, “It is better to feel good during the day than look good at night.”

Kass says patients will feel better the next day, but says full recovery can be experienced more quickly. “Many can expect maximum improvement in a month to six weeks.”

Most insurance policies do cover all or part of the costs involved in diagnosis and treatment.

While feeling well and functioning better is important, there is a more compelling reason to seek out diagnosis and treatment: Some sleep disorders can cause health problems or make existing conditions worse, sometimes with deadly consequences.

“Sleep apnea, untreated, greatly increases the risk of cardiovascular problems, high blood pressure and stroke,” says Kass. “It makes blood sugar worse, and it even increases the risk of serious disease over time. So, not only is diagnosis and treatment important for quality of life, but it is also important for medical purposes, medical morbidity.”

Less common, but no less deadly, is the risk with the symptom of sleepiness. “Auto accidents can occur when someone is tired behind the wheel or has the inability to pay attention,” says Lifschutz.

Other disorders to consider
Sleep apnea is not the only sleep disorder that affects people. There are three types of sleep disorders, according to Kass. They are disorders of fragmenting sleep (the most common being sleep apnea), sleep stages disorders (such as nightmares or acting out in sleep), and something called somnambulism, or sleep walking.

Not included in the list above is insomnia, which is difficulty falling asleep or maintaining sleep. While most people have experienced bouts of insomnia, it is usually psychological for most people and can be treated accordingly, he adds.

Sleep disorders can affect children, too. “The most common pediatric sleep disorders in order are parasomnias, night terrors, bedwetting and sleep walking,” says Kass. Parasomnias are categorized as sleep that involves unnatural movements, behaviors, emotions or perceptions. “They are usually considered normal and not a cause of concern until after puberty. Sleep apnea does also occur in children, although it is often caused by enlarged tonsils and adenoids.”

According to the National Institute of Neurological Disorders and Stroke, at least 40 million Americans each year suffer from chronic, long-term sleep disorders. Given these statistics, chances are high that either you or someone you love has a sleep disorder.

When seeking diagnosis and treatment, Lifschutz recommends patients look carefully for a qualified provider. “You want someone who is accredited with the American Academy of Sleep Medicine, a board-certified sleep specialist,” he says. “Make sure the facility has a medical director and technicians who are registered and experienced.”

Kass recommends patients persevere and find a doctor who is willing to work with and educate them.

“[Getting treatment] really changed the way I do my job, the way I live,” Girardo says. “My recommendation to other patients is: Find the right people and get better.”


Advantage Sleep Centers
Locations in Cherry Hill, Sewell and Voorhees
1 (866) 867-1333

Advocare ENT Specialty Center
406 Lippincott Drive
(856) 435-9100

Cooper University Health Care
One Cooper Plaza, Camden
1 (800) 8-COOPER

Published (and copyrighted) in the Art of Living Well pull-out section of Suburban Family Magazine, Volume 4, Issue 4 (June, 2013).
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