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Rooms inside the Center for Sleep Medicine are designed to provide a "homey" environment, making patients comfortable in order to study a more authentic night's sleep.

Research relating sleep disorders to a host of other health problems has accelerated the growth of treatment centers and added yet another reason for concern over the national obesity epidemic.

Weight gain goes hand in hand with not only an increased risk for hypertension and diabetes, but also with obstructive sleep apnea, said Dr. Geoffrey Hartwig, a neurologist at the Center for Sleep Medicine, affiliated with Hattiesburg Clinic. Sleep apnea, a disorder faced by more than 18 million Americans, disturbs sleep with brief halts in breathing and is a common complaint for overweight patients.

"In Mississippi, we are facing an even bigger dose of the problem than the rest of the nation because of our obesity issue," Hartwig pointed out.

Adding to the rising profile of sleep disorder treatment, he said, "Specialties that didn't think they had a problem in that regard are learning they really do."

Among recently explored links, a study reported in the Dec. 1 issue of Journal SLEEP reinforced a new awareness that daytime sleepiness caused by sleep apnea may put patients more at risk for cardiovascular problems.

From psychiatry to nephrology, many other medical specialties deal with conditions that can worsen when combined with sleep disorders, Hartwig said. Ophthalmologists are concerned that certain types of glaucoma can be affected by sleep apnea, while pediatricians are finding that some children diagnosed with attention-deficit/hyperactivity disorder (ADHD) may actually be suffering from sleep disorders instead.

"It's a mushrooming area," said Hartwig, whose lab has grown from two beds to six since opening in 1985 and can now run as many as 42 sleep studies per week.

The lab moved from Hattiesburg Clinic into a separate free-standing facility in May. Its medical staff also includes psychologist John Harsh, PhD, who, like Hartwig, is certified by the American Board of Sleep Medicine.

Demand for sleep studies and treatment has grown exponentially in recent years, said pulmonologist Dr. William Frazier, medical director at the Baptist Medical Center's Sleep Disorders Center of Mississippi in Jackson. The center performed a mere 80 sleep studies the year Frazier arrived in 1989; by 2006, that figure had reached 1,600.

"When I became board-certified, my certificate was only number 350 in the world," he said. "Now there are thousands. That's how much it has grown in a 20-year period."

Today, while narcolepsy and restless leg syndrome are common cases, sleep apnea accounts for some 85 percent of cases at Baptist Center, Frazier said. Positive airway pressure devices remain the standard course of treatment for sleep apnea, he said, but research continues searching for medications that could substitute for the awkward masks.

Meanwhile, second-generation hypnotic sedatives have already begun to improve treatment options for insomnia.

"So often the cure was worse than the disease," Frazier said. "But that's changed with the new generation of medications."

Around Mississippi, there are currently 16 full-service sleep disorders centers accredited by the American Academy of Sleep Medicine, along with four practices accredited as specialty laboratories for sleep-related breathing disorders.

All factors indicate the accelerating demand is a trend that's here to stay for the state's healthcare community.

"The incidence of sleep apnea is growing, and that's directly tied to lifestyle and it's not going away," Frazier said. "The need for sleep services in Mississippi will continue to grow right along with the waistline of our population. We need to be ready to handle the increase in volume."




March 2007

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