“Here,” said the doctor, pointing to a break in a stream of data on a computer monitor. “This is where the patient stopped breathing.”

The patient had not died – the jolting incident was recorded during a “sleep study” at the Sleep Center at Merrimack Valley Hospital. Such episodes had been troubling the patient nightly for years. What mattered at this point was that theproblem could finally be diagnosed and addressed.

The patient, like many who spend a night at the Sleep Center, suffers from sleep apnea – a cessation of breathing during sleep. An estimated 12 million Americans are affected by the disease. Its effects range from fatigue and poor concentration to motor vehicle accidents, high blood pressure and cardiac problems.

Opened in 2004, the Sleep Center at Merrimack Valley Hospital is a resource for individuals – and their primary care physicians – who are afflicted by a variety of issues that occur during sleep, from snoring and restless leg syndrome to night terrors and nocturnal asthma.

Reviewing data from a patient’s night of sleep provides many insights for Dr. German Iosif, director of The Sleep Center at Merrimack Valley Hospital and Caren Lawee, RN, the program’s clinical coordinator.

Sleep may be a universal experience, but until relatively recently there was little understanding of it in the medical community. Sleep Apnea, for example, was not recognized as a disease until 1965. Awareness began to increase in the 1980s but has yet to become widespread.

“Primary care physicians, but also the public in general, are becoming more aware of Obstructive Sleep Apnea Syndrome,” says German Iosif, MD, director of The Sleep Center at Merrimack Valley Hospital and a Board Certified pulmonary specialist at Pentucket Medical in Haverhill. “Sleep disorders are often masked by other symptoms, and this leads to a lot of misdiagnosis.”

The Sleep Center, a group of rooms on the fourth floor of Merrimack Valley Hospital, combines the amenities of a rather simple hotel with the equipment of a sophisticated laboratory. Patients “check in” in the evening, are connected via sensors to monitoring equipment, and go to bed. The
wires attach to an array of computers in an adjacent room that record information on of brain activity as well as air flow, chin movements, leg movements, eye movements, electrocardiogram, heart rates, chest and abdominal wall movement. The result, a complete picture of the patient’s
sleeping process is called a “sleep study.”

Despite the many wires attached to their body and the novelty of sleeping in a different environment, most patients report sleeping as well as at home.

“Many people complete the study at 6 a.m., go home and then on to work.” says Dr. Iosif ’s colleague, Caren Lawee, a Registered Nurse who is the program’s clinical coordinator. After the patients leave, the clinicians pore over the multitracked data that flows from left to right across a computer monitor.

On a recent morning, a click of a mouse zoomed in to view a few seconds of disruption in the visual pattern of the tracks. This is where the aforementioned patient’s breathing pattern revealed he had stopped breathing.

“This data tells us that, right here, breathing ceased,” Iosif says, and points to an adjacent track. “Here the brain reacts to the emergency, and sends a wakening signal to the sleeper that restarts the breath.”

A bit further along the timeline, a regular pattern resumes.“The subject isn’t really aware that this has happened,” he says. “But in the morning, he will be tired, after having been repeatedly awakened during the night by a brain that is trying to keep him breathing. When this happens several times a night, night after night, it takes a real toll. And there is often an interruption of the spouse’s sleep as well.” With wider awareness of the Sleep Center as a diagnostic resource in the community, demand for studies is increasing. This month, the center expanded from two to four beds. “The goal of the hospital is to meet the needs of our community, and the expansion of sleep-study services at Merrimack Valley Hospital will serve to meet that need,” says hospital CEO Michael Collins.

Once the initial sleep evaluation is completed, the sleep center team makes recommendations for treatment to primary care physicians and to specialists as needed. Depending upon the diagnosis, those specialists may include cardiologists, dentists, psychologists, psychiatrists, ear, nose
and throat specialists or neurologists. Patients who have been diagnosed at the center describe the process as private, painless and comfortable. Sleep diagnostics are covered by most health insurance programs.

The Sleep Center accepts patients by physician referral; appointments are initiated by their primary care doctor. For many, the results of diagnosis and treatment have resulted in better health and quality of life.

“We’ve had patients who have been able to keep their commercial truck driver’s license,” says Dr. Iosif, noting that the law prohibits licensing of professional drivers who have sleep disorders. “We’ve also seen couples return to sleeping in the same bedroom for the first time in years.”

More information is available by calling The Sleep Center at Merrimack Valley at (978) 521-8488.