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Sleepless in Summit County

ALEX MILLER
summit daily news

FRISCO – For those who can fall asleep at the drop of a hat, anytime, anywhere, the notion of spending restless nights wide awake is tough to imagine. But for millions of Americans, sleep disorder is serious business – evidenced, in part, by the staggering number of prescription sleep aids written in what’s estimated to be a $5 billion market.

But whatever’s keeping you up at night, chances are it’s exacerbated by sleeping at high altitude. Many sleep problems have at their root something to do with breathing, and with less oxygen to work with at 8,000 or 10,000 feet, it’s no surprise sleep disorders can be worse in the mountains. According to Dr. Peter Riley, who specializes in pulmonary and sleep medicine for St. Anthony Central Hospital in Denver, more and more people are seeking professional help to improve their sleep.

“Oftentimes you can really help people,” Riley said. “It’s an under-recognized thing – people who have problems sleeping don’t talk about it, or they don’t think anything can be done about it.”

In the past year, St. Anthony has expanded its Sleep Disorders Center to include St. Anthony Summit Medical Center. That means High Country residents can take advantage of the sophisticated sleep studies the center provides right here in Frisco. In a sleep study, patients are connected to a variety of wires and gizmos that monitor breathing, heart rate, oxygen saturation, brain activity, eye movement and even facial muscle movements. The study is conducted in one of the private rooms at the Frisco hospital, and it’s meant to try to capture as best as possible a typical night’s sleep.

“It gathers tons of data meant to describe a person’s sleep architecture – the pattern of sleep across the night,” Riley said. Much of what they’re looking for, he said, is evidence of “sleep fragmentation” – how sleep gets interrupted in the night. And much of that has to do with breathing.

Sleep apnea is a condition where a person literally stops breathing, then resumes. Riley explains there are two basic kinds of sleep apnea: obstructive sleep apnea and central sleep apnea. In the first, the condition is related to something physical in the airway that obstructs breathing. That can be anything from an overly thick neck or large tonsils to a misaligned jaw or a back-sleeper whose muscles get too relaxed. This kind of apnea can be relatively simple to diagnosis and treat – sometimes with surgery but typically with a “CPAP” device. This is a shoebox-sized ventilator that includes a mask worn over the face and which provides “continuous positive airway pressure” – in other words, not just oxygen but pressure that assists in breathing.

More common for high-altitude sleepers is central sleep apnea, or “CSA.” Here, the lower amounts of oxygen and pressure cause people to hyperventilate – to breathe more often and faster – especially if they’re not acclimated. As Riley explains:

“When you hyperventilate, you get rid of more CO2. If the CO2 level goes down, your brain thinks there’s no reason to breathe. Then, when you’re not breathing, the CO2 level goes up and the brain says you need to breathe again.” That, he said, is what leads to repeated bouts of apnea and results in sleep fragmentation.

“It leads to a sleep-state misperception,” Riley said. “With so much stimulation of the brain going on, we don’t perceive it as restful sleep.”

Riley said data being collected from patients at the Frisco branch of the Sleep Disorders Center represents the highest-altitude sleep study information anywhere.

“It’s not a huge population, but it’s an important population,” Riley said. While studies have been conducted on high altitude and sleep in the past in Leadville and China – as well as some among high-altitude mountain climbers – Riley hopes the accumulation of years of data in Frisco will lead to better understanding and treatment of those who live at altitude year-round. For now, he said oxygen is a simple and often effective way to help those new to altitude sleep. Most of the time, those who visit Summit County will find that, after a week or so, they’re already sleeping better. For others, it’s an ongoing problem. One man at a seminar held by Riley this past winter said he’d taken the sleep medication Ambien every day for more than three years.

“There’s so much we don’t know,” Riley said.

For more information on the Sleep Study Center, go to http://www.summitmedicalcenter.org and click on “specialties” – or call (970) 668-6900.


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