Mountain View, CA - May 4, 2012 - Radio and Internet ads for sleep clinics often feature a laundry list of symptoms associated with chronic sleep disorders: fatigue, irritability, inability to concentrate, memory loss, slow reaction, angry outbursts, and looking tired. Some ads focus on chronic snoring; others point out increased risk for heart disease, diabetes and early death.
What the ads don't mention is that sleep disorders are strongly associated with sexual dysfunction. Ads for erectile dysfunction almost never mention the problem is often accompanied by sleep disorders--yet the two conditions are strongly correlated.
That fact is central to why El Camino Hospital Los Gatos made the decision to open its new Sleep Disorders Program, despite the presence of several other sleep clinics in the Silicon Valley. It's also why patients have been pouring in from the moment the program opened its doors.
"One of the busiest urologists in our Men's Health Program urged us to open a sleep clinic," says Bido Baines, Executive Director, Urology Services and Men's Health Program at El Camino Hospital. "He was referring up to 300 patients a year to outside sleep clinics for diagnosis and treatment--and he said 50 percent of his erectile dysfunction patients were being diagnosed with sleep apnea. But he was frustrated because outside clinics either took six months to see the patient or were lax in providing follow-up. He urged us to create a center that would facilitate a seamless continuum of problem solving for patients."
Scientists aren't sure why sleep apnea and sexual dysfunction are linked in both men and women. In a study published last year in The Journal of Sexual Medicine, researchers reported significantly higher levels of sexual dysfunction in women and men aged 28 to 64 with obstructive sleep apnea (compared to individuals without sleep apnea.) This tracked with earlier studies, including a 2009 study of 401 men who were being evaluated for suspected sleep apnea that found that 70 percent of those diagnosed also had erectile dysfunction, compared with 34 percent in those without sleep apnea.
Dr. Edward Karpman, a board certified, fellowship trained urologist in the El Camino Hospital Men's Health Program, says, "Many of my patients come to me with a long list of health problems that none of their doctors has been able to link together; heart disease, obesity, depression, fatigue. So I ask, 'How's your sleep?' and find out they haven't had a really good night's sleep in years. I think trying to figure out the sleep angle is just as important as everything else."
Steve, a 58 year-old retired technology executive who is one of Dr. Karpman's patients, couldn't agree more.
"I was this close to giving up," says the South Bay resident, who asked that his full name not be used. "I wasn't sure how long I wanted to hang around. Life wasn't worth it."
Overweight, suffering from cardiovascular issues, erectile dysfunction, and a sleep disorder that had afflicted him since his early 40s, he was on antidepressants and rarely felt like getting up in the morning. His weight had ballooned and he woke up exhausted. He also suffered from osteoporosis that had erased 20 percent of his normal bone mass. His life changed the day he walked into the Men's Health Program at El Camino Hospital.
"It wasn't an issue of not being able to afford good medical care," Steve says. "I had the best private insurance available. The problem is that no one was looking at the big picture. I had a cardiologist over here. A primary care doctor over there; a sleep specialist 10 or 12 miles away and so on. None of them were talking to each other."
"No one had checked my testosterone level before," Steve says. "It turns out that it was incredibly low, which probably is at the heart of many of my health problems. But Dr. Karpman didn't stop there. He's like a bulldog--he wasn't going to let go until he found a way to improve my life."
Adjusting Steve's testosterone was only one part of the puzzle. Dr. Karpman worried that Steve's treatment for sleep apnea was ineffective. He insisted on a sleep evaluation, which confirmed his suspicions. A prescription for a new device has had "miraculous" results.
"Before that, I spent $5,000 on a stupid mask that I wore all those years for absolutely no benefit," Steve says. "I even had sinus surgery and it didn't solve the problem. But Dr. Karpman wasn't going to give up on me. When they took another look they found that I needed a different type of device--which solved the problem. If you don't get your sleep right, nothing works right. This has changed my life."
The "all in one place" approach to treatment makes a huge difference, according to Steve, who now sees a cardiologist right next door to Dr. Karpman, and a sleep specialist at the hospital. "At some point I began to give up, and think that life just wasn't going to get better," he says. But they're all working together--I can't tell you what a difference it makes." With the energy he gets from a good night's sleep and the benefit of restored hormonal balance, his weight has dropped from 310 to 248. His relationship with his wife "is like we're newlyweds again. You can't pay enough money for that. It's like starting all over again."
Although the hospital's sleep disorder program got its push from the Men's Health Program, it welcomes women, too. One of the first patients in the door was Joann Medina, an operating room nurse.
"I noticed that even though I would think I had gotten a good night's sleep, I'd feel really tired during the day," Medina says. "I went through many years of denying I had any sleep issues, but when I heard the hospital was opening a sleep center, I felt it was time to find out for sure."
Medina, who often vacationed and shared a hotel room with friends, was told by her roommates that she snored and moved around as if not having a restful sleep. It made her hesitant to travel, since she felt she was subjecting her companions to the problem.
"I feel good that I'm finally doing something about it," says Medina. "It's a very positive feeling, especially since I realize that my sleep apnea could have negative effects on other aspects of my health."
The process was straightforward, she says. After being admitted to the hospital, a sleep technician met her and walked her through the forms and questionnaires that are part of the evaluation process. Then they attached the leads to monitor her brain and other body functions, explaining in detail each step.
"The room itself was very comfortable and conducive to sleep," says Medina. "It felt like a safe environment to come to terms with my sleep problems. I thought it would feel strange to have someone looking at me sleep, but I actually was glad to know he was there in the control room, watching over me." In the morning they woke her up, unhooked her and she went off to work.
Although she hasn't been fully evaluated yet, she did learn she has sleep apnea, a not-surprising diagnosis given her friends' feedback. The next step will be recommendations about the appropriate treatment.
"As soon as I find out what my options are I can make an informed decision," she says. "I feel like I can ask all the questions I want to."
Sleep disruptions are a symptom, not a disease, and they can be caused by a variety of issues, from teeth grinding to night terrors. While the Sleep Program is equipped to diagnose the complete range of sleep disorders, sleep apnea is the most common diagnosis, affecting one in 15 people, or 18 million Americans. It may coexist with or be a precursor to other conditions, including Type 2 diabetes, heart disease, depression, high blood pressure, cardiac arrhythmias, dementia, stroke, obesity and endocrine issues.
If a primary care doctor or specialist suspects that a patient may have a sleep disorder, the only way to accurately diagnose the problem is by referring them for a sleep study. The process takes approximately 12 hours from start to finish, and includes patient evaluation, analysis of sleep study results, diagnosis of any sleep disorders and recommendations for follow up treatment, including surgery if necessary.
The El Camino Hospital Sleep Disorders Program will recommend treatment for a diagnosed sleep disorder, often giving patients a range of possible solutions such as a device that can be used at home to regulate breathing during sleep, or surgery. Unlike most other sleep programs, however, it will also refer patients to cardiologists, endocrinologists or other specialists to follow up on underlying causes.
"It's really a testament to El Camino Hospital that they listened to our concerns and opened this program," says Dr. Karpman. "It's one more way that we can provide our patients--both men and women--with comprehensive, 'big picture' care."
To learn more call 408-866-4070.
