Transcription:
Sleep is Important for Overall Health

Joey Wahler (Host): We hear a lot about the importance of getting enough sleep, but what if certain factors, either within or out of your control are preventing that? You may need to have your sleep pattern tested or treated. So we're discussing how sleep issues are addressed. From the plains of rural Northwest Kansas to you, this is Health in the Heartland presented by Norton County Hospital, where medical experts aim to empower health at any stage of life. Thanks for listening. I am Joey Wahler. Our guest Kayla Broeckelman, a Registered Respiratory Therapist and the Respiratory Therapy Director at Norton County Hospital. First, how exactly does sleep or lack thereof impact our health generally speaking?

Kayla Broeckelman, RRT (Guest): Yeah, so sleep plays a vital role in good health and the wellbeing throughout all of our lives. Getting enough quality of sleep at the right times can help protect our mental health, our physical health, and also our quality of life. If we're suffering from sleep deficiency, that's going to harm us over time and it's going to raise our risks for other chronic health problems like heart disease or even lung disease. So I always tell my patients the way you feel when you're awake is going to depend on how you're sleeping. So when you're sleeping, your body is really working to support all that healthy brain function, maintain your physical health. And then I also have parents that bring their kiddos in, and so I just remind them that sleep is also supporting their growth and development as well.

Host: Gotcha. Now if someone has trouble sleeping, the first step in addressing it is a sleep study. So what are some of the signs that someone may be in need of that?

Kayla: Yeah. So, a sleep study is a test that we are going to use to diagnose sleep disorders such as sleep apnea or even narcolepsy. If your provider is recommending a sleep study, it could be because you've been complaining of snoring or gasping at night. Maybe you're having trouble falling asleep and staying asleep. Some people suffer from that daytime drowsiness or irritability. And so sometimes even their spouse may say, heh these things are going on. So if you're complaining of those things, this is going to be super helpful to your provider because we're going to be monitoring your sleep stages, the cycles of your sleep, and that helps identify those sleep patterns and see if they're being disrupted and why.

Host: So you mentioned a provider there, meaning someone would be referred to you then, yes?

Kayla: Yes. So, in order to get that sleep study, your provider, so your physician, nurse practitioner whoever it is that you see maybe at your local clinic, that is who is going to order the test for us.

Host: Gotcha. And so take us through what a sleep study entails exactly.

Kayla: During a sleep study, first thing is, is like I said, you're going to visit with your provider. They're going to refer you to me. A lot of my patients are worried when we even talk about a sleep study that they're not going to fall asleep or sleep as well here in the hospital as they would at home.

This usually doesn't affect the test results though, because a full night's sleep isn't required to get those accurate test results. So during that sleep study, your technician is going to come in, they're going to get you all hooked up. You're going to, to several different monitors. Those monitors are going to record your brain activity. The oxygen level in your blood. It's also gonna keep track of your heart rate, your heart rhythms, your breathing, as well as any eye movements or leg movements during the study. Couple of different options for a sleep study, but most commonly your provider or your doctor are going to order what's called a split night test.

And during that split night test, the first half of the night is just to check the severity of your sleep apnea or to see if you even have it at all. And then there's a cutoff score or some guidelines that, that sleep tech is going to use to decide if we need to use the second half of the night to put you on C-PAP or oxygen. And titrate pressures of that C-PAP to offset any of the apnea they may have found during the first half of the night.

Host: Are there also sleep studies that are done at home?

Kayla: Yeah. So here at Norton County Hospital, we do offer both forms of the sleep study. So we have that in-house sleep study that we just talked about. And then we also do a take home sleep study. They're just a little different in the fact that we're actually gonna send you with some really easy to use portable equipment to do that test at home. Sleep studies at home are really only meant to be used as a screening tool though, if you're having the symptoms and home sleep studies really are not an option for patients with significant medical problems like heart failure, severe lung disease, and even some of those neuromuscular diseases.

The home sleep study is also only going to confirm any suspicions of sleep apnea. So if that test is positive, that's when we might still have you come in and do that more in depth study here in the hospital.

Host: In other words, the home version doesn't necessarily replace the in-house version. It's just a more convenient way to take that first step.

Kayla: Exactly. So if that test were to be positive when you come in for the sleep study here in the hospital, typically what they'll do is they'll just start you right to that C-PAP titration because they already know that there is a sleep apnea component. So now we need to fix that.

Host: Gotcha. So once those sleep study results are known, what are some of the next steps in assessing and then providing treatment for people?

Kayla: Yeah, that's a good question. So your sleep technologist that's going to be with you that night cannot actually give you any results the morning after the study. So we always ask our patients to please be patient with us with that process. So like we had kind of talked about on those in-home studies, there'll be a first and a second half of the night.

So with that cutoff score, if you're not started on C-PAP, bi-pap, oxygen, the night of your study, that doesn't mean you don't have sleep apnea. It just may mean that you may not have met the guidelines early enough in the night for any of those treatments to be started. So that's when that second half of the study, we may ask you to come back another night.

So after we have all the results back from the pulmonologist, typically you're going to get a call from your physician's office one to two weeks after the study with the results to either schedule that second half of the night, so do that titration study, or if you'd already had the titration study we may be discussing what your options would be to get you started on some therapy at home.

Host: Okay, so to backtrack for a quick moment. When we talk about difficulty sleeping for whatever the reason may be, how common is it Kayla for people to not get enough sleep? How many people are, how many people aren't?

Kayla: You know, that's a really tough question to really truly answer. There's probably more people out there that are not sleeping well then you would think. I mean, I couldn't give you an exact number, but we have patients that come through all the time that are like, oh, I've just been so irritable. My anxiety is off the charts or whatever it may be.

They don't necessarily snore, so they don't consider themselves a candidate for a sleep study. But sometimes we have super young, healthy fit people come through the sleep lab and they have worse sleep apnea than somebody that's, you know, 60 years old and is overweight so to say. I mean, the patient population ranges.

Host: Now you mentioned anxiety as one reason that people don't get enough sleep or good enough quality sleep. For people that have that at the core of their sleep issues, is it still important to come in and get tested if only to rule out there being another condition, like sleep apnea. In other words, let's say it's just too much stress that's causing you not to sleep enough. I guess this would enable you to at least know that it's not something else, right?

Kayla: Exactly. So, I mean that's when maybe that home sleep study would come into play. Let's screen it. And let's see if your anxiety is coming back to a sleep apnea component. And if it's not, that's when that patient's going to further visit with their doctor about maybe some other medications or calming techniques to control their anxiety.

Host: How about some other things that may affect sleep quality like the right mattress or pillow. We see commercials buy this, buy that will improve your night's sleep. True?

Kayla: You know, that's a question I really don't have a good answer for. So, sleep studies sleep in general. There are different pillows out there that I know that they say these are great for side sleepers. These are great for back sleepers, but if you're going apneic at night, sometimes it's not so much just a positioning. There's, there's different forms of sleep apnea. So there's that obstructive sleep apnea, which is the most common type where you might hear those people, snoring and gasping for air at night. There's also central sleep apnea, which is something that's going on with your brain. So that's more of a neurological type of a sleep apnea.

So being that there's different kinds. I mean, I can't tell you that a pillow is going to fix your problems. That's what that sleep test is going to help us decide.

Host: Fair enough. How about something that I presume is more in your wheelhouse? Like the way diet impacts sleep, not just what we eat, but what we drink like caffeine.

Kayla: Absolutely. So, yeah. Patients that are struggling to fall asleep at night, sometimes yeah, it does have to do a lot with what they're eating, what they're drinking. Even when we have patients come in for sleep studies at night, we always tell them not to eat or drink any caffeine prior to the test. And that we want them to try not to nap in the afternoon. So, I mean, quality of sleep really depends on what you do during the day as well.

Host: We hear that age old adage people need six to eight hours of quality sleep to function properly, true? Or do some manage on less?

Kayla: I would say that is true to a degree. Everybody's going to require more or less sleep. Some people can function off of less sleep. But I would say six to eight hours of sleep is going to be the best for most adults. So that way their bodies can handle the day, so to say. Children and babies, they're going to spend a lot more time sleeping.

So we want those children to get plenty of naps during the day if they need it. But also they're going to need sometimes, you know, 10 hours of sleep, they're going to need more sleep at night than an adult would.

Host: So Kayla, sleep studies are just one of the numerous services offered in your department at Norton County Hospital. What are some of the others that are provided daily?

Kayla: Yeah, so our respiratory therapy department offers several outpatient diagnostic services as well as inpatient services. So taking care of our patients that are admitted here to the hospital. But just a few on the outpatient side to mention would be, we do pulmonary function testing. We do overnight oximetry testing. We can also draw arterial blood gas. We also help with the cardiac stress testing and place cardiac monitors. And then we also offer an outpatient bronchiolitis clinic for children ages two and under, and then we also offer COPD education to our chronic lung patients.

Host: All right. So lastly, in summation for those struggling to get good sleep, what's your main message to them in a nutshell?

Kayla: So my main message to them is going to be if you are not sleeping well, or even if you like I said, are struggling during the day I would highly recommend that you go in and you visit with your physician about those things. They're also going to screen you in their office. They're going to ask you some questions and if you have a certain cutoff score, when they ask you those questions, they're definitely going to recommend you a sleep study. So again, that sleep, it's really playing a big role in our overall health. And so if we're not getting enough quality sleep, we're not gonna support that mental and physical health. So, if you feel like you need a sleep study, please contact your provider and let's get you taken care of.

Host: Well, folks, we hope you now know more about sleep issues and how they're addressed. Kayla Broeckelman, thanks so much again.

Kayla: Yeah. Thank you.

Host: To learn more about Norton County Hospital's sleep studies and all their other services offered, please visit ntcohosp.com, that's ntcohosp.com. If you found this podcast helpful, please do share it on your social media.

And thanks again for listening to Health in the Heartland presented by Norton County Hospital. Take care of yourself and others. Be well. I'm Joey Wahler.