Patchwork sleep

STEVE LEWIS/Durango Herald

Compared to the mask and machine many are using for sleep disorders, and can be seen on the wall in the background, the Provent nasal patch is much lighter and less cumbersome. Rick O’Block, a director at Mercy Regional Medical Center, models the patch.

By Dale Rodebaugh Herald staff writer

It doesn’t work for everyone, but a new device holds promise for sufferers of sleep apnea who traditionally wear a mask at night to keep their air passages open.

Dr. Ed Razma at the Four Corners Sleep Disorders Center at Mercy Regional Medical Center is treating sleep apnea with the Provent nasal patch, a much less cumbersome device than the mask and machine many are using.

Provent consists of a pair of patches – one for each nostril – about the size of a Band-Aid with one-way valves. They provide the same “continuous positive airway pressure,” or CPAP, as the traditional mask but without the accompanying CPAP machine, which plugs into an electrical outlet.

A sleep study should precede use of either, Razma said, because an overnight stay in the sleep lab can reveal other disorders.

Among the 16 conditions measured as the patient sleeps are brain waves, oxygen level, abnormal movements, air flow through nose and mouth, chest movement, heart rhythms and snoring.

The restriction of air to the lungs because of the collapse of soft tissue in the back of the throat can have serious health consequences as well as produce daytime fatigue and drowsiness.

It’s estimated that about 28 million Americans have sleep apnea, which is characterized by snoring.

The CPAP machine generates pressure to keep air passages open while the patient sleeps, Razma said. The machine is adjusted to the lowest pressure needed to keep airways open.

But the mask is bothersome, and frustration may lead a patient to discard it after a time. The patches are lightweight and easy to apply.

The patch valves restrict the flow of air out, Razma said. As a consequence, air pressure works its way back into the throat to keep it open.

“Research shows that 50 percent of patients benefit from the Provent,” Razma said. “The other 50 percent showed no improvement.”

Sleep apnea, the repeated pauses in breathing – sometimes hundreds a night – can lead, if untreated, to high blood pressure, stroke and heart attacks.

The interruptions and awakenings are generally forgotten when morning comes, but the effects linger. Sleep interruptions can produce fatigue, drowsiness, lack of concentration and lessening of mental acuity during the day.

Sleep apnea affects more men than women. People who are more than 40 years old, overweight or have a nasal obstruction such as a deviated septum are more prone to suffer from sleep apnea.

“A 10 to 20 percent weight loss can improve a sleep apnea condition by 50 percent,” Razma said.

The Provent nasal patch is convenient for people who travel because they don’t have to lug the machine used with the mask. But the patches can be expensive for some, about $60 for a month’s supply because they are used only once.

Provents are not available over the counter, but require a doctor’s prescription.

Recent studies, including one at the University of Wisconsin, link sleep disruptions to increased risk for obesity and diabetes and cancer. The Wisconsin study tracked cancer rates in 1,500 people with sleep problems more than 22 years.

The problem, it’s posited, is that long-term reduction of blood oxygen can trigger the development of cancerous tumors. So stopping people from snoring could help fight tumor growth.

Researchers found that people with severe sleep disorders were 4.8 times more likely to develop cancer than those without such problems.

“The findings are intriguing but preliminary,” Razma said. “They need more research.”

But in a way they make sense because studies show that low oxygen levels stimulate the production of blood vessels which, in the case of cancer, nourishes cancerous cells, he said.

As a general observation, Razma said, new studies seem to link poor sleep with medical problems.

“It seems to show that we should maintain good sleep,” he said. “If we experience poor sleep, we should correct it.”

Dr. Gus Hallin, also at the Four Corners Sleep Disorders Center, said the study is bound to generate comment and further research.

“The findings need to be confirmed,” Hallin said. “But it’s a big study so it’s important.

“The results are plausible because it’s been clearly shown that sleep replenishes the immune system, which is a first line of defense against early cancer,” Hallin said.

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