Cone Hospital review [August, 1986]

              revi e w ®
THE MOSES H. CONE MEMORIAL HOSPITAL
GREENSBORO, NORTH CAROLINA
Sleep Disorders Center
Opens at Moses Cone Hospital
Craig Muri, a registered polysomnographic technologist, monitors patients sleep patterns during
sleep disorders studies.
The Sleep Disorders Center at The Moses H.
Cone Memorial Hospital, which opened in May,
is helping physicians with the detection, diagnosis
and treatment of sleep problems. As many as ten
percent of the general adult population, and up
to 40 percent of people over age 60, suffer from
some form of sleep disorder.
Snoring, daytime sleepiness, unexplained
fatigue or depression, morning headaches or irregular breathing during sleep may be symptoms
of a serious and potentially fatal problem—a sleep
disorder.
There are an estimated 30 million habitual
snorers in the United States. Usually, snoring is
no cause for alarm, but when accompanied by
excessive daytime sleepiness, headaches or impotence, snoring may indicate a more serious
sleep disorder.
Insomnia, the inability to sleep, may be caused by a variety of psychological or physiological
problems such as anxiety, noise, pain or a reaction to foods.
Often confused with insomnia, nocturnal
myoclonus—or nighttime movement—can be
caused by an underlying medical problem. At
times, movement is so pronounced that the patient sleeps only intermittently, often causing extreme daytime fatigue.
Snoring, high blood pressure, excessive
daytime sleepiness or fatigue may be symptoms
of sleep apnea syndrome. Victims of this disorder
stop breathing while they sleep—up to several
hundred times a night. Thus, major organs are
deprived of oxygen and can be seriously damaged over time. Blood pressure can soar between
each breath, and the heart may beat irregularly
or even stop. A single apnea episode may last
up to 90 seconds and is manifested in three ways:
(1) obstructive upper airway apnea is characterized by a very loud snoring and is intensified by
chronic nasal congestion, enlarged tonsils, obesity or physical problems present at birth; (2) central apnea occurs when the diaphragm and
stomach muscles cease to work, oxygen levels
drop, causing the sleeper to become short of
breath, and consequently, to awaken repeatedly; (3) mixed apnea is a combination of both.
Falling asleep suddenly and unexpectedly,
cataplectic attacks and weakness upon waking
or unexplained fatigue or depression may indicate
narcolepsy, a distortion in the sleep/wake cycle.
This dangerous disorder affects over 200,000
Americans, often causing them to fall asleep so
rapidly they seem to faint.
Thomas W. deBeck, M.D., a neurologist who
specializes in sleep disorders medicine, and
Clinton D. Young, M.D., a pulmonologist, are the
medical co-directors at the Moses Cone Hospital
Sleep Disorders Center. Dr. deBeck recently
came to Greensboro from the Community
Hospital of Roanoke Valley, where he has
directed the Sleep Disorders Center since 1970.
Dr. Young, the medical director of Respiratory
Services at Moses Cone Hospital and the current
president of the North Carolina Thoracic Society, has done sleep studies at Moses Cone Hospital
for the past two years. "With the expanding
laboratory, we are now able to do a much more
sophisticated form of testing," he said. Dr.
deBeck studied at the Sleep Disorders Center at
Stanford University, the foremost sleep disorders
center in the country. Dr. Young will be attending the physicians' course there in the near
future.
Craig A. Muri, a registered polysomnographic
technologist, is the sleep center coordinator. He
trained and became registered in electroencephalography at Western Wisconsin
Technical Institute and studied to become a
polysomnographic technologist at the Stanford
University Sleep Disorders Center.
Lonnie Bunn, Associate Director of Support
Services, has administrative responsibility for the
Sleep Disorders Center.
Patients, who are referred for sleep disorders
study, sleep overnight in the Sleep Disorders
Center. "The patient has a private bedroom with
a television set. We encourage them to follow
their regular sleep routine, going to bed at the
usual time and rising at their normal hour," Muri
said. During the time patients are sleeping in the
Sleep Disorders Center, Muri stays in an adjoining room where the patient's sleep patterns are
constantly monitored.
The typical studies performed in The Sleep
Disorders Center are the nocturnal polysom-
nogram (NPSG) and the daytime multiple sleep
latency test (MSLT). The NPSG records the
following parameters: EEG, EOG, EKG, Chin
EMG, Anterior Tibialis EMG, 02 saturation,
nasal/oral airflow and respiratory effort. This test
is useful in detecting sleep apnea.
The MSLT is a measure of physiological
sleepiness. It helps to distinguish patients with
narcolepsy from those with sleep apnea. The
sleep recordings are evaluated by a sleep
disorders physician. Results, diagnosis and
recommendations are sent to the referring
physician.
Treatment varies according to diagnosis, and
most treatments are available at The Moses H.
Cone Memorial Hospital on request of the referring physician. Treatment of sleep disorders includes medication, Nasal CPAP, surgery, sleep
hygiene education and psychological or
psychiatric therapy.
The center, now located on the fourth floor,
will be relocated to new and larger quarters by
fall, 1986. If you would like additional information on The Sleep Disorders Center, please call
379-4406.
review
®
August, 1986
INSIDE:
Jean Caudle Award 2
Dial-A-Dietitian 2
Wellness Opportunities 3
Graduations 2 & 4
Purchasing Automated 5
Picnic 6
REVIEW
Moses Cone Hospital
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Greensboro, N.C.
MCH Nurse
Represents
State at
Ellis Island
Swearing in
Ceremony
Independence Day celebrations hold
significance for all of us who enjoy this special
nation. This year, Susan Bell, a nurse on Division 5700, celebrated by taking the oath of
citizenship on Ellis Island as the nation also
celebrated the unveiling by President Ronald
Reagan of the newly restored 100-year-old Statue
of Liberty.
Bell and her husband, Robert, were selected
by Governor James G. Martin to represent the
State of North Carolina at the naturalization
ceremony on July 3. Two representatives from
each of the 50 states and four territories were
sworn in by Chief Justice Warren Burger. Special
legislation was passed to make this particular
ceremony possible. The long and impressive
honor guest list included Attorney General Edwin Meese, three senators from New York, Chief
Judges Constance Baker Motley and Jack B.
Weinstein, five New York Congressmen, immigration officials, 14 U.S. District Court judges and
more.
A photograph, which appeared in the July 4
issue of the High Point Enterprise, pictured Bell
seated, during the ceremony, beside Mikhail
Baryshnikov, artistic director of the American
Ballet Theatre in New York, although our local
celebrity was unidentified by the newspaper.
The Bell's son Hamish, 19, became a citizen
of the United States in a ceremony held at the
Guilford Battleground Park on July 4. Their son
Logan, 5, was born in this country and, consequently, was already a citizen. They have a
daughter, Kristy, who is married and lives inn
Australia.
Carolyn Ford, Editor
The Bells received letters of congratulations
from President Ronald Reagan, Governor James
Martin, Congressman Howard Coble and Mayor
John Forbis.
Susan Hislop Bell was born in New Zealand,
she was educated there, graduating third in her
class from the Dannevirke School of Nursing.
Following graduation, she worked at the Hastings
Memorial Hospital in various specialized clinics,
including the selective position of an Emergency
Nurse Surgeon, a position without counterpart
in the U.S.A. A registered nurse in New Zealand,
the difference in the programs qualified her as
a licensed practical nurse here. Bell has been
employed at Moses Cone Hospital for the past
five years. She plans to enroll in in the physician assistant program at Bowman Gray School
of Medicine, Winston-Salem.
See New Citizen, page 6