Losing Sleep
GMC's new center emphasizes the importance of diagnosing sleep disorders

LAWRENCEVILLE -On the ground floor of Gwinnett Medical Center, tucked in a corner amid the sterile, white walls and nurses walking about in bright blue uniforms, lies what could be a four-star hotel.

Careful, though, you might miss it. Even a hospital employee can get confused.

"Do you know where the sleep clinic is?," someone asks.

"Oh, that's up on the second floor, darlin", the nurse says. A colleague corrects her. "It's right here," he says, pointing to a nondescript door with a frosted window.

With the ring of a bell, a heavy wood door opens.

Outfitted with comfy mattresses, hardwood floors, stone-tiled bathrooms and flat screen TVs, the newly renovated Center for Sleep Disorders at GMC boasts amenities found at a high-end resort. But one glance at the control room - straight out of Steven Spielberg's "Minority Report" - which anchors the four-bed facility, it's evident serious business goes down here.

After all, sleep - or lack thereof - is serious. Just ask Beth Greeson, a sleep expert at the lab.

"Sleep is as important as the air we breathe and the water we drink," she says on a recent tour.

Health risks

With the 40-hour work week becoming a nice memory and everything else that comes with life in the 21st century, it's no mystery Americans don't get enough sleep. Worse yet, nearly four percent of men and two percent of women are literally being robbed of their dreams due to sleep disorders, according to Dr. Greg Mauldin, a doctor at the clinic. Based on 2006 Census numbers, that is 30,284 men and 15,142 women in Gwinnett County, many of whom carry sleep-deprived bodies around like badges of honor on behalf of the corporate gods.

"Some people believe it's much higher than that, but even using those numbers that's still a significant amount of the population affected," Mauldin says.

The accredited lab specializes in diagnosing a variety of sleep disorders, including excessive daytime sleepiness, snoring, insomnia, sleep apnea, narcolepsy and restless leg syndrome. The average age of patients is between 45 and 55 years old. Open now for two weeks in upgraded digs, the clinic lacks all the anxiety-causing sterileness of a hospital. This is, of course, the point: Soundproofed and sleek, GMC officials say they wanted the new lab to feel like a hotel. Instead of a bellman, patients are greeted by a highly trained sleep professional with a keen sense of southern hospitality.

Besides insomnia, the most common disorder treated at the clinic is the condition called sleep apnea. This occurs when the muscles that protect and open the airway collapse during sleep. As a result, the person stops breathing, oxygen saturation declines and the heart rate accelerates. The brain, sensing this change, awakens the individual. After a few minutes of normal breathing, these events repeat throughout the night.

"Their sleep is fragmented because they are waking themselves up all night long and don't get to advance into the deeper stages of sleep that it takes to feel fresh the next day," Mauldin says. "So they are really missing out on good, deep, restorative sleep that it takes to feel better."

The most restorative phase of sleep is called REM, or rapid eye movement. During this stage, muscles become completely relaxed, blood pressure drops and breathing slows. This phase is important for memory consolidation. Based on studies, a normal night's sleep is considered between seven and nine hours per night, with two REM phases interspersed. There is a fine line, Mauldin warns.

"Studies have shown that if you sleep significantly less than seven hours you have an increased risk of dying an early death, and also if you sleep significantly more than nine hours you also have an increased risk of death," Mauldin says.

That's not the only danger. The fatigue spawned from events such as sleep apnea make people lethal to themselves and others. According to figures released by the National Highway Traffic Safety Administration, drowsy motorists cause more than 100,000 crashes annually, resulting in 40,000 injuries and 1,550 deaths.

Time for help?

Each patient's situation is unique, Mauldin says, but there are common denominators for which consulting a doctor are necessary. The most critical symptom is waking up feeling unrefreshed and feeling excessively sleepy during the day, he says. If the person's sleep condition is serious enough, they are referred to the lab. Prior to sleeping at the clinic overnight, patients go through an in-depth consultation in which they answer questions about their sleep habits and the affects of their condition on their daily life. Finally, an appointment is made for an overnight stay. Currently, the clinic - which sees four people per night, six days a week - is booked solid for three weeks.

The day of the study, patients check in at the clinic about 7:30 p.m. They can shower and relax in bed while watching TV. About an hour later, a lab technician hooks the subject up to more than 18 electrodes and other devices which monitor brain activity, heart rate, respiratory quality and muscle tone. An infrared camera in the room allows the technician to observe the patient throughout the night. The next morning, the data is broken down and scored by a doctor. Some patients who may have sleep apnea go through a "split study." The first half monitors the person's vital signs for airway obstruction. If prolonged blockage occurs, the apnea is diagnosed. The second half is a therapeutic measure as patents are fitted with a CPAP (continuous positive air pressure) mask, which keeps the soft tissue in the back of the throat from blocking the airway. If an at-home CPAP is required, GMC refers patients to homecare providers.

It's not easy, though, to treat everyone, says Terry Beck, a lab technician.

"If you have it really bad - upper moderate to severe airway obstruction - we will see enough activity the first half of the night to warrant coming in and treating it," he says. "But for a lot of people, it's just really tough to do a split study because a lot of them don't have the events."

While episodes like that require further visits to the lab and confound sleep professionals, one thing is clear: Sleep means life.

"There's a lot that we don't know about sleep, but we do know it is necessary and mandatory," Mauldin says. "There's no substitute for it and if you don't get enough, something bad is going to happen to you."