If you’ve had sleep problems – having trouble falling or staying asleep, tossing and turning or just plain staying awake for hours on end – you’ve got plenty of company. An estimated one in three adults in the United States say they don’t get enough sleep. The problems that follow go well beyond early-morning bleary eyes and fatigue. The sleep-deprived are at high risk for a host of chronic health problems, ranging from heart and kidney disease to depression.
All of which goes a long way toward explaining the expansion of the UCHealth Sleep Medicine Clinic – Anschutz Medical Campus. The new space on the third floor of the UCHealth Leprino Building now houses both patient exam rooms and a new 10-bed lab for overnight sleep tests. Two more rooms are reserved for future research. The new overnight beds, housed in rooms that are designed to block out sleep-disrupting light and sound, add to the four that continue operations seven days a week at the UCHealth Sleep Lab – Central Park.
The expansion allowed UCHealth to better meet the patient demand for sleep studies, said Dr. Katherine Green, medical director of the University of Colorado Sleep Center and associate professor of Otolaryngology – Head and Neck Surgery with the University of Colorado School of Medicine.
“Immediately after we opened the Leprino lab, we doubled our overnight testing volume,” Green said. “Our wait times for overnight testing were cut by about 50%.”
The expansion also produced a large increase in the number of testing devices for home sleep studies. That improves access for patients who can’t feasibly do an overnight test, such as those living in rural areas, Green added.
Green said the lab expansion followed a soaring volume of clinic visits.
“From a clinic volume perspective, we continue to see exponential year-to-year growth,” Green said. “And I think we are just scratching the surface as to what that volume potential is.”
Waking up to major problems caused by chronic sleep issues
A big reason for her belief is the prevalence of sleep apnea, both obstructive (OSA) and central (CSA). The two disorders disrupt breathing in different ways. In OSA, the more common of the two, the tongue or other soft tissue blocks the airway during sleep. In CSA, signals from the brain to muscles that control breathing are disrupted.
Millions of people have been diagnosed with sleep apnea, but the numbers are a small fraction of the total who suffer from it, Green stated.
“One of the fascinating things to me about sleep and particularly sleep apnea is that approximately 80% of those in the United States who have it are undiagnosed,” she said. “In the public health sector, we are realizing the impacts of poor sleep quality across so many facets of medicine and well-being. So, I think the potential for our volume to grow is there to a very significant degree.”
That growth offers UCHealth opportunities not only for more sleep studies and treatment, but also for screening, education, outreach and research, Green added. She noted, for example, that the Sleep Center is collaborating with anesthesiologists to more systematically screen patients for OSA before elective surgeries at UCHealth University of Colorado Hospital.
“We are now formalizing the process of getting people home sleep tests and formal evaluations before they undergo general anesthesia because we know sleep issues can have a negative impact on their surgical outcomes,” Green said.
New sleep lab: A multidisciplinary approach to sleep issues
Green noted that all faculty of the Sleep Medicine Clinic are fellowship-trained in sleep medicine, but clinic faculty also have background training in neurology, pulmonary and critical care medicine, psychiatry, hospitalist medicine and otolaryngology. “The clinic highlights and celebrates the diverse training backgrounds and medical fields that are a part of the specialty of sleep medicine,” she said.
The clinic’s broad reach is critically important to providing care for patients with sleep problems, Green said.
“Sleep is something that touches so many disciplines,” she said. For instance, a sleep evaluation may uncover a heart arrhythmia or a hormonal abnormality that requires a referral to another specialist.
“We are oftentimes identifying these problems and then helping patients find the right space for care,” Green said.
In addition, Green and Dr. Amy Schell, the clinic’s ear, nose and throat (ENT) specialists, are both trained in sleep surgery, particularly to treat OSA. Their work includes implanting the Inspire device for OSA. Surgeries like these supplement more common treatments for sleep apnea, such as continuous positive airway pressure (CPAP) machines. The Sleep Medicine Clinic was also the first in the city to offer the newer remedē system, an implantable device that treats CSA.
Building a foundation for additional Sleep Clinic growth
As is often the case, the growth of the clinic has also generated challenges. One is the need for more sleep technicians to handle the increased capacity. The technicians monitor eye movement, breathing, heart rate and oxygen levels during the overnight tests and synthesize the data after the tests are over.
Green said her priority as medical director is to maintain the quality of patient care as the volume scales upward. To that end, the clinic has started a training program for sleep technicians.
“We have an associate’s pathway, where employees start as trainees and are able to do the necessary education and clinical hours to then take their certification testing to become technicians,” Green said.
Overall, she called the expansion a successful effort to meet “the unique needs and concerns” that are part of building a larger facility for more overnight sleep tests.
“I think we went above and beyond with the design in Leprino to make the rooms feel more like hotel rooms than hospital rooms,” Green said.