Sleep Disorders Center helps Iowa woman beat sleep apnea, exhaustion

Like many Americans, Betty Jane Woodward suffers from a sleeping disorder. Until recently, the problem was so exhausting that she was barely able to drive home from work in the evening without dozing off.

"Looking back now, I think I've had sleep apnea for quite some time," said Woodward, 59, who lives in rural North English, Iowa. "During the last 10 years, I have noticed much increased fatigue and waking up feeling like I've not slept at all."

Fatigue is a common complaint from those with obstructive sleep apnea, a disorder that causes people to stop breathing while they are at rest (the muscles of the chest become so relaxed that they stop functioning, much like an idling car motor that suddenly quits). The fatigue occurs when the apnea interrupts REM sleep: While the episodes do not always fully awaken a person, they cause micro-arousals that pull the body into a lighter, less restful stage of sleep.

Other common symptoms of sleep apnea include loud snoring, insomnia, morning headaches, difficulties concentrating, and loss of memory, often with complaints of progressive weight gain.

When Woodward revealed several of these symptoms to her UI Family Care Center physician, Lisa Kaufman, M.D., an internal medicine specialist, Kaufman referred her to the UI Sleep Disorders Center, one of the most prominent sleep labs in the world.

"I've been asked many times what makes the UI Sleep Disorders Center so successful," said Mark Eric Dyken, M.D., associate professor of neurology and the Center's director. "The answer is our interdisciplinary approach. Because lack of rest weighs heavily into so many health problems, every branch of medicine is involved with sleep medicine, and we've been good at cooperating here. Pulmonary experts, psychiatrists, neuropsychologists, pediatricians, and many other areas add to our overall expertise."

After confirming that Woodward had sleep apnea, the sleep lab experts performed a series of tests to determine frequency and severity before settling on continuous positive airway pressure (CPAP) therapy. The CPAP mask goes over or under the nose, or over the entire face if needed; the mask is attached to a machine that delivers a gentle column of air that acts as a stint to keep the airway open. The CPAP equipment is taken home and worn during sleep.

"If CPAP does not work there are other therapies for obstructive apnea, but in general, across the board with adults, it is one of the best therapies," Dyken said.

"Although I've only been on CPAP for a short time, it's unbelievable how much of a difference it has made," Woodward said. "It's quite a relief now knowing that I can finally get a good night's sleep and wake up alert and have some energy to face the day. That's a wonderful thing."

No problem too small

Like its adult-oriented predecessor, the Pediatric Sleep Disorders Center at University of Iowa Children's Hospital has earned a sterling reputation.

Deborah Lin-Dyken, M.D., associate professor of clinical pediatrics and director of the pediatric center, said, "As with other areas in pediatrics, children are not miniature adults. We have long felt that children's sleep problems should be addressed in a family-friendly setting, with sleep technicians and nursing personnel who are particularly attuned to the special medical, developmental, behavioral, and social needs of children."

As the only accredited sleep lab with a dedicated pediatric bed in Iowa, the UI center--located in the Center for Disabilities and Development--treats children with a range of sleep disorders, including obstructive sleep apnea, sleepwalking, and night tremors. Lin-Dyken describes obstructive sleep apnea, which frequently occurs as the result of large tonsils, as probably the most common sleep problem in children. "Treatments can range from surgical consultation for tonsillectomy, CPAP therapy, behavioral management, and in selected cases, medications," she said.

Who to call

For more information call UI Health Access and ask for the Adult Sleep Disorders Center or call University of Iowa Children's Hospital for the Pediatric Sleep Disorders Center. For consultation and referral, physicians should call UI Consult.

CPAP technician Don McKinney evaluates Betty Jane Woodward, who experienced sleep apnea until she recieved specialized therpay under the direction of
Mark Eric Dyken, M.D.