Obesity, aging drive huge growth in sleep disorders

Garry Heeney is among thousands of people who need a CPAP machine to treat obstructive sleep apnoea (OSA).

Garry Heeney is among thousands of people who need a CPAP machine to treat obstructive sleep apnoea (OSA).

Christchurch Hospital is grappling with soaring demand for its Sleep Service as thousands more people struggle with insomnia and sleep apnoea. 

Driven by obesity, an aging population and tighter health and safety regulations, patients treated for sleep apnoea at the hospital's Sleep Service increased from 800 in 2008 to 4500 last year.

Insomnia and obstructive sleep apnoea (OSA) are the main culprits putting pressure on sleep clinics around the country.

Graph showing the increase in referrals through the "Sleep Pathway" since 2008.

Graph showing the increase in referrals through the "Sleep Pathway" since 2008.

The publicly funded sleep service provides OSA treatment for those who meet strict criteria including having a "sleepy driver episode" while being a heavy machinery operator or professional driver and having severe congestive heart failure or uncontrollable hypertension.

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Those with the disorder repeatedly stop breathing while asleep and are startled awake by a choking reflex. 

Symptoms can include daytime sleepiness, snoring and obesity, but many sufferers are unaware they have the disorder. 

Garry Heeney did not have the tell-tale signs for sleep apnoea. The 58-year-old drain layer did not snore or feel tired during the day. 

But about a year ago he was asked by his employer to wear a wristband with a device monitoring his activity and fatigue levels in a 24-hour period. 

According to the device he had slept for only three to four hours.

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Heeney was unconvinced it was a problem, but was motivated to "get it sorted" so he could continue working.

"I've got to work, got to pay the bills .. and I love my job, keeping busy."

A broken wrist meant he needed a break from drain laying and he was given an opportunity to drive heavy machinery.

Commercial drivers with suspected OSA must be referred for a sleep study under New Zealand Transport Agency guidelines. The condition has to be adequately treated before a required medical certificate can be granted. 

An overnight oxygen test confirmed Heeney's airways had blocked over 30 times and he was diagnosed with severe OSA.

At the sleep service he was given a continuous positive airway pressure (CPAP) machine with a full face mask but, struggling with a sense of claustrophobia, returned it the next day. 

He then agreed to go to a private provider, Sleep Well Clinic, who started him on another CPAP trial. 

Sleep Well founder Alex Bartle told Heeney he was one of about 10 per cent of OSA patients who did not snore. 

Bartle made it clear the machine would take pressure off his heart and give him a longer life – a huge motivator for the father and grandfather. 

"I want to see our grandchildren grow up."

The $2000 package included included ongoing telephone support at any time, to help him get used to the machine. 

After two weeks the airway blockages had reduced to three times and he was told this was equivalent to 15kgs of weight off his heart. 

"You feel more energetic and refreshed."

Clinical director for the Christchurch Hospital sleep service Michael Hlavac said the clinic was treating two to three times the number of patients it did before the earthquakes.

While an increase in OSA could not be directly attributed to the earthquakes, the disorder was related to lifestyle change, which was common in Canterbury after 2011.

"People were doing things like exercising less and drinking more during that time." 

A proportion of people developed insomnia after periods of poor sleep and the disorder now affects 15-20 per cent of the population, Hlavac said. 

The private sector had experienced an increase in demand for treatment for insomnia as there was no specialist public service for treating the disorder, Bartle said. 

 - Stuff


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