Wind Sprints: How do you sleep at night, Summit County? (editor column)
August 26, 2016
It's late Friday morning and I'm at Rocky Mountain Coffee Roasters in Frisco, sipping a double shot of espresso, when Dr. Jules Rosen points to the red mark across his right cheek — the one I'd been secretly wondering about since he sat down to talk — and explains that it's because of the oxygen mask he wears at night.
How do you sleep at night? Dr. Rosen sleeps just fine.
When he was sleep-tested not too long ago, the Breckenridge resident found out that his oxygen levels were a little low. So he decided to do something about it. Rosen recommends that anyone living at altitude should do him or herself a favor and sign up for a sleep study.
When Rosen talks, I listen.
Rosen is the 64-year-old chief medical officer for Mind Springs Health, a mental health nonprofit that serves 10 counties in the Western Slope area, including Summit. He is at the bleeding edge of a mental health crisis in the mountains. His outfit now receives 600 new patients each month. It's a daunting caseload that has Rosen and his colleagues scrambling for innovative solutions.
But before he was at the forefront of mental health treatment in the mountains, Rosen, like thousands of other tourists, came to Breckenridge in 2010 for a ski vacation with his buddy Dr. Peter Lemis, a cardiologist based out of Frisco. Rosen liked the area so much that he bought a second home here. That home eventually became his primary residence when he took a post with Mind Springs three years ago.
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Before Colorado, he was the chief of geriatric psychiatry and a professor of psychiatry at the University of Pittsburgh. He has over 75 publications in peer-reviewed journals. He has studied WWII prisoners of war and Holocaust survivors. The guy knows his stuff, especially when it comes to cognitive illnesses associated with aging.
However, he wasn't quite prepared for the challenges presented by mental health in the mountains, where the suicide rate is three times that of sea-level communities.
One of his first surprises in Summit was when he discovered that as many as 10 of his geriatric patients had been misdiagnosed with Alzheimer's. More than half of them were simply not getting enough oxygen as they slept and were suffering from cognitive impairments as a result.
That got Rosen's mind turning: Do low-oxygen, high-altitude environments have an impact on mental health?
Over the past few years, his friend Peter Lemis and Frisco-based cardiologist Dr. Warren Johnson have been attempting to jump-start a study of the long-term effects of living at altitude as it relates to heart health.
Surprisingly, science has little to say on the topic.
"Summit County is a unique place in the United States in that very few areas in the world have such a high altitude with a sizable population," Lemis told the Daily earlier this year. "A study like this has not been done at high altitude."
Lemis and Johnson postulate that the lower oxygen levels found at elevations between 8,000 and 10,500 feet could, over time, result in pulmonary hypertension and eventually heart failure. The idea is that low-oxygen environments can lead to a form of sleep apnea. Your body responds to low-oxygen levels during sleep by contracting its blood vessels and increasing the blood pressure to its lungs.
Like Rosen, both Lemis and Johnson use oxygen concentrators while they sleep.
Rosen's hypothesis within the study is that sleep apnea might be connected to depression, suicide and even attention deficit disorder. That, too, is a ground-breaking idea that hasn't really been studied.
Whether we're signed up for the good doctors' study or not, we're all part of a grand experiment. What is altitude doing to our bodies and our minds? What is it doing to our children? When's the last time you checked their oxygen levels during sleep?
We know people in our resort communities are suffering from mental illness, but we don't yet know all the reasons why. Is it because of substance abuse? Is it due to loneliness or economic disparities? With scientific trailblazers like Rosen, Lemis and Johnson hard at work, there's hope that we'll soon have a clearer picture.
It may just turn out that one of the most significant factors in mental illness in the mountains may be the one thing we can't change — the altitude.
I wonder if my health plan covers a sleep study?
More and more, resort communities are beginning to come to grips with mental illness. Summit County is no exception. That's why that sensitive topic will be the focus of our second installment of our monthly What's Brewing reader series.
You're invited to join the Summit Daily News in a discussion on mental health at 10 a.m. on Friday, Sept. 2 in the Fremont Room at the Summit County Community and Senior Center in Frisco. We'll have a spread of coffee and breakfast pastries from Blue Moon Bakery in Silverthorne. We hope to see you there.
Ben Trollinger is the editor of the Summit Daily News. Contact him at (970) 668-4618 or at firstname.lastname@example.org.
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