Staying Awake to Help People Sleep

Posted: December 8, 2010 in Community Reporting, Technology
Tags: , , , ,

Wisconsin Sleep is located at 6001 Research Park Boulevard in Madison

In Madison, a trendy building boasting a glass façade stands tall inviting visitors to occupy vacancies in the 19 total rooms, some specialized for children. Walk through the doors and a spiral staircase leads a guest to the front desk to check in for the night, or even a daytime nap. Once led to led to the room a door opens to a room featuring a flat screen with satellite television, a DVD player, computer, bathroom and all the amenities one asks for when spending a night away from home appears. And all these deluxe amenities feature a price tag of $4,500 a night.

Now take a closer look and a camera beams down from the ceiling. Next to the bed wires dangle off a poll and strange machines lie inside a cabinet close by. This is no hotel, instead a place known as Wisconsin Sleep.

Opened on Sept. 10, 2007, the University of Wisconsin Medical Foundation and Meriter Hospital closed their sleep centers and joined forces to create Wisconsin Sleep, doubling the size of both previous centers combined. Wisconsin Sleep joined a rapidly growing industry in the midst of a large upswing. In 1999, over 400 accredited sleep institutes existed in the country. Today that number exceeds 1,500 an increase from over 1,237 when Wisconsin Sleep opened just two years ago, according to the American Academy of Sleep Medicine.

According to Dr. William Kohler, medical director of the Florida Sleep Institute and former chairman of the American Academy of Sleep Medicine accreditation committee, an increase in the attentiveness to sleep contributed to this movement.

“We have become aware of the significant problems that can occur to our health if we do not get the proper sleep,” said Kohler.

At centers like Wisconsin Sleep, patients show up for issues like insomnia, narcolepsy or a rapidly growing problem, sleep apnea. Apnea obstructs an individual’s ability to breathe during sleep.

With these issues rising, the industry itself saw an average of 13 percent patient growth amongst centers in 2007, today that number hovers closer to 6 percent according to a Sept. 2009 study in Sleep Review.

With more people concerned about shuteye, Wisconsin Sleep entered the market with a unique approach.

Wisconsin Sleep Approach

From the beginning the $3.9 million facility wanted more than to just be another clinic.

“It was created to be able to offer the option to have research and clinical studies done,” said Linda Jelinek, Team Leader of Sleep Technicians at Wisconsin Sleep. “The dream of Dr. Ruth Benca how a lot of it all came together.” Dr. Benca is the Wisconsin Sleep medical director with a vision of helping patients and increasing learning in the field of sleep.

The profit driven center contains 16 clinical rooms and three additional rooms for research purposes. Inside the center 25 different sleep technicians, double the amount of the previous centers, help the building stay awake at various points of the 24-hour day, including a 7 p.m. to 7 a.m. shift. The workers focus on monitoring visiting patients and subjects.  On the research side, subjects are used for discovering advanced techniques in treatment and developing scholarship in the field.

By allowing both research and clinical work done in the same building, the two sides must maintain a working balance and still learn from each other.

“You see patients not only within that cocoon of this is a patient problem, but also how understanding the physiology and the problem of the patient can be reflective on overall sleep health for many other people,” said Dr. Cami Matthews, who focuses on pediatric sleep at the clinic.

But obstacles exist between the two as well. Complementing research with clinical work, in the same place, presents challenges.

By having so much happen in one place, the staff must remain organized and balance the two sides without overstepping boundaries.

“The staff has the interaction with both clinicians and researchers and that can be challenging at times,” said Matthews. “It’s hard to have a busy clinical practice and then if you have a busy research practice that can be difficult.”

But what happens on each side?

Clinical

When the lights go out, strange occurrences happen. From a sleep singer belting out happy birthday, a grandma talking about her grandson’s baseball achievements to a farmer simulating driving his John Deere or a man faking seizures for eight hours many stories have developed over the past couple years.

Unfortunately, many of these stories look at the lighter side of sleep health. As previously mentioned, awareness and issues in sleep health have flown to the forefront.

The most commonly seen issue, sleep apnea, is often accompanied with snoring throughout the night. Many look at snoring as an annoying habit of people, but it could be an indication that person is suffering from the illness.  Apnea affects all ages, but one of the prime reasons for an increase in patient visits is a growing problem in health in general.

“The obesity epidemic, I don’t like to always put it in those terms,” said Matthews. “But adults have increased weight gain and we are definitely seeing that in pediatrics as well.”

With obesity, sleep apnea may directly feel the effect by having excess body fat limit air passageways. Indirectly, sleep apnea may accompany illnesses like diabetes, which often form in overweight individuals.

The process a patient goes through to reach a sleep clinic varies. Some may receive recommendations from their personal physician while others contact the sleep center directly. Once approved for an overnight study the real testing begins.

The patients arrive at either 7 or 9 p.m. then proceed back to their room for the night. Once in the room a variety of objects are attached to the individual to measure brain waves, heartbeat, breathing, and body movements. Then the techs, usually assigned two patients each, monitor to see if a person requires a continuous positive air pressure device, or CPAP to help counteract the apnea.

“They have to meet certain criteria that’s been established by our guidelines and insurance guidelines too,” said Jelinek.

Wisconsin Sleep adheres to growing guidelines from the AASM, a very important piece of keeping the clinical side active in helping patients. While economic questions often enter into health decisions, many insurance companies refuse to deal with non-accredited institutions. These do not face the same guidelines like Wisconsin Sleep and may cost a patient more in the end.

“The tendency in many labs is to decrease the quality [for economic purposes],” said Kohler. “One of the things that an accredited center does, it insures that you have at least a minimum degree of quality present.”

With quality playing such an important role at Wisconsin Sleep, the research side helps the center remain on the brink of advancing techniques and technologies.

Research participant B139 being hooked up to the EEG

At Wisconsin Sleep a wide array of studies have already taken place. Some research involves drugs, connections between sleep and depression, or regular brain activity. The most important factor in all this research is brain measurement.

The research side boasts a high-density EEG monitoring system, making Wisconsin Sleep the first sleep laboratory to use such technology.

The high-density monitoring system involves a contraption with 256 suctions that must fit the subject’s head and each filled with gel before full attachment. According to Jelinek, depending on the staff putting the device in place, “it can take up to about two hours to get someone set up.”

But researchers and techs feel the tedious work is worth it with the new technology.  The technology allows researchers to look at sleep in a different light. New areas of the brain can be measured and more data gathered than ever before.

The University of Wisconsin seeks research subjects of all ages, often times posting the opening on the UW job board. Then a traditional job process takes place, interviewing subjects to see if they qualify for the particular study. The most recent study at Wisconsin Sleep received over 100 responses to the ad.

The sleep center compensates those who participate varying per project. Over the summer a drug study doled out $5,000 to participants who completed the 3-week period.

A current study looking at depression and sleep included a 23-year-old student known as subject B139*.

While at times the connected wires provided a nuisance to sleeping, the student found participating a beneficial experience. According to the B139, she discovered ideas not previously considered revolving around her sleep deprivation from questions asked by researchers in the process.

While monetary gain is motivation for many participants, B139 was not one of them.

“I am entering the [UW] counseling program for graduate school, so in order for me to help others I felt it was necessary for me to investigate my own problems,” said the research participant.

*The research participant asked if this article were ever published not to use their real name, but the identification used at the sleep facility. I observed her and the staff on November 24, 2009 from 7 p.m. prior to her arrival to approximately 12 a.m after the subject had gone to sleep.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s