Sleep lab offers therapy to ensure a restful slumber

The Jakarta Post , Bandung | Wed, 02/20/2008 1:18 PM | Health

For some twenty years, "sleep therapy" has been constantly developed to overcome the various disturbances that interrupt human sleep patterns.

Over the past three years, it has also been developed in Indonesia, with doctors concerned about this problem studying the physiological and pathological behaviors or disturbances that occur when one sleeps.

Their findings indicate there is a strong relationship between what happens when one is asleep and what happens during waking hours.

"We may diagnose and analyze the function and working mechanism of body organs during sleep. Until now, the standard medical examination was made during someone's waking hours," said Teguh Widjaya, coordinator of the sleep laboratory of Immanuel Hospital in Bandung.

In order to record a sleep disturbance, a patient must stay in a sleep laboratory. The Immanuel sleep lab provides a bedroom as comfortable as that of a four-star hotel and allows patients to be accompanied by a friend or spouse.

At the sleep lab, a patient will go through a polysomnography examination. Under this examination, the stages of sleep and other physiological variables that occur during slumber are analyzed.

Leks, 55, opted to take his wife Ati, 51, along with him to the sleep lab.

"We let patients sleep as normally as possible, just the way they sleep at night in their own beds, so the recordings can be made as naturally as possible," Teguh said.

A polysomnography is one of the methods employed to diagnose sleep disturbances in addition to an anamnesis examination, a careful physical examination and other necessary auxiliary examinations.

During a polysomnography examination, at least 15 sensor panels connected to cables are placed on several parts of the patient's body -- on the crown of the head, temples, ears, nose, chest, hands and ankles. Information is sent through these cables to a computer.

"It is slightly disturbing but if you are very sleepy you will simply ignore all these devices. Usually we install this device when the patient begins to get sleepy," Teguh said.

The sensors pick up information, ranging from heartbeats, brain activity and muscle movements to other physiological variables, for example, if a hand suddenly moves during sleep or a twitch of the lips and other parts of the body.

"If the eyes move, this means the patient is sleeping soundly," Teguh said.

While the patient is asleep, information from the sensors is sent through the cables to a computer, which will make a recording in the form of a polysomnogram, appearing as graphic lines.

Teguh and his sleep lab team study polysomnograms to determine the causes of disturbances to a patient's sleep. They then try to find solutions.

Leks himself realized he often stopped breathing in his sleep, a phenomenon medically known as Obstructive Sleep Apnea Syndrome (OSAS).

OSAS is either caused by an organic disturbance, namely a large root of the tongue, or a physiological disturbance.

"If the cause is organic, we may suggest surgery so the patient won't be disturbed again. But if the cause is physiological, we would recommend the use of a ventilator with a certain amount of pressure to alleviate or remove the disturbance," Teguh said.

OSAS can cause sudden death during sleep; when breathing stops the flow of oxygen to the blood.

The OSAS patients that Teguh has examined had oxygen rates of around 60 percent of the normal level, which is 90 percent.

After learning the cause of his sleep disturbance, Leks said he wanted to find a solution.

"It turns out that snoring can cause serious problems and can be lethal. I really want to get rid of my snoring," Leks said.

The Immanuel Hospital sleep lab has a team of doctors with various specialized skills. After the sleep disturbance of a patient is detected, he or she is given therapy.

"If the cause is a mental disturbance, we recommend consultation and therapy with a psychiatrist."

The sleep lab in Bandung is the third laboratory of its kind to be established in Indonesia. The other two labs are located in Jakarta and have been operating for three years.

Since the Immanuel Hospital sleep lab was opened in October 2007, Teguh said, many patients have shown interest to undertake an examination there.

As well as patients from Bandung, others have come from Semarang, Tegal, Yogyakarta and other cities to seek treatment.

Until the end of February 2008, the treatment rooms at the Immanuel Hospital sleep lab, where a sleep disturbance examination package costs Rp 3 million, were all be booked.

Prospective patients, says a registration officer at the lab, must reserve a place a month before their examination.

This may indicate there are more and more people living with sleeping disorders, who long for a deep, good night's rest.

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