“I don’t remember the last time I woke up refreshed and raring to go. Its been over 15 to 20 years ago.”
Chappy Krauthoff was optimistic that would change as he prepared to undergo the second phase of a sleep study being performed at Clark Fork Valley Hospital in Plains. Wednesday night he hoped to fall asleep and Thursday he hoped to wake up refreshed and raring to go.
Krauthoff had already completed the first phase of the exercise. In late March he spent a night in the hospital’s sleep lab, wired up so Respiratory Therapist Chris Malone, could definitively map every second of Chappy’s sleep behavior.
And the results were astonishing. Chappy was waking up (having events in technical terms) as much as 47 times an hour. This is typical of individuals who experience obstructive sleep apnea. And surprisingly, it’s a condition that is not uncommon.
Malone said 3-4 percent of all adults over age 40 have the condition and probably many more have yet to be diagnosed. It’s estimated that 20 million Americans experience some level of sleep apnea.
Obstructive sleep apnea is not just another simple medical condition. Malone said the condition can lead to increased risk of heart attacks and strokes, high blood pressure, weight problems and a general feeling of being worn out.
Malone explained that the underlying factor is the body’s inability to adequately oxygenate while sleeping. He said as the body relaxes, going into deep sleep, muscles and soft tissue in the throat relax so that the airway becomes restricted. That induces the most common symptom of sleep apnea, increased snoring. As the airway continues to constrict, it closes off, rousing the body from its deep sleep to an awake state as it fights for more oxygen. That is what’s termed an “incident” and it happens in seconds.
Chappy explains that the result leaves you tired and never feeling like you’ve had a complete night’s rest. For him, it meant he had to give up driving at night, he would need frequent afternoon naps and he just didn’t have any energy. Highly caffeinated coffee gives him no relief.
Malone explained that for individuals like Chappy, who experience OSA, the body is waking up numerous times a night but rarely to the point that the individual remembers. Instead, the mind plays tricks, believing there was a full night of restful sleep when just the opposite was occurring and the body knows the difference.
Ironically, Chappy came by the recommendation for a sleep study partly by accident.
He and his wife work closely with Clark Fork Valley Hospital and when Gail took a quiz to see if she might be a candidate for the study, she didn’t fit all the criteria. So Chappy said he would answer the questions, he found he needed to contact the hospital right away.
Chappy’s first sleep study showed that out of a typical eight hour night, he was getting only about 16 to 20 minutes of deep sleep.
In preparing an individual for a sleep study, Malone places numerous electrodes on the body to give a complete log of activity. Two belts around the chest and abdomen record the rise and fall of the chest.
By following the resultant waves on his computer screen, Malone can determine when sleep occurs, the different levels of sleep and when deep sleep is achieved. He can also tell when the patient is snoring and if an apneac episode occurs. The monitoring is done telemetrically from a room across the hall in the hospital.
For some patients, the activity, the monitoring and the “excitement” results in an inability to fall asleep. In that case, explains Malone, a sleeping aid can be administered.
After the sleep period, which generally lasts six hours, the log of activity is sent to a technician who painstakingly reviews the data and provides a detailed report of activity. That report is forwarded to a sleep specialist who makes a recommendation as to treatment, if any.
In Krathoff’s case, his second sleep session included the donning of a Controlled Positive Airway Pressure mask, or CPAP, to maintain the pressure in the airway. The device gently increases the air pressure in his airways, to keep the soft tissue from closing off the airway. It’s a trial run, of sorts, to see if Chappy would respond to a different sleep regimen. Malone made different adjustments to test which pressures were most effective so the machine could be programmed specifically for Chappy.
And it appeared to have worked.
Thursday morning, Chappy said he felt much better, although admittedly with an audience he had trouble getting to sleep and had to take a sleeping aid so that Malone could accurately monitor the difference.
Gail said he was much improved. He had better color, was more refreshed and had more energy.
Chappy said he took a long exercise walk in the afternoon and where he would normally return home and take a nap, he stayed up for the rest of the evening.
Chappy said sleeping with the device was much easier than he expected. Once he realized the limitations of rolling around, he settled in and enjoyed a good rest.
Malone said he was impressed with the improvements seen in Chappy’s sleep pattern. “We resolved his breathing problems with the cpap,” said Malone. “His sleep time improved, he had no pauses and he didn’t snore.”
Although he hasn’t returned yet for the final fitting, Chappy said he recommends the study for anyone who feels they might need help in sleeping. He said his stress level has been reduced as well, because now he knows there is something he can do to correct his condition of always being tired.
Malone, who works at other hospitals as well, said the activity at the Clark Fork Valley Hospital lab is much busier than he expected and he sees and monitors several studies per month. This week he was in Kalispell, then Whitefish and back to Plains for more studies.
“There are so many benefits to the study,” observed Malone. “In addition to the untold health benefits, people find they are more productive, they are no longer tired all the time and they have better concentration on tasks. The benefits are tremendous.”
On top of that, he said, it’s rewarding to make a difference in people’s health and their general well being.
And Chappy Krauthoff is a walking billboard for that.