March 27, 2009

RVH sleep lab expansion serves regional need

In response to increasing regional demand, Renfrew Victoria Hospital has added two beds to its sleep laboratory.

Before the addition, patients often had to wait as long as five months to get an appointment in the three-bed unit. Now that the facility has been renovated and is in full operation, the five available beds have reduced the average wait to just three or four weeks.

“We wanted to make sure we had the capacity to meet this region’s needs,” explains RVH CEO Randy Penney. “We recognize that this is an important regional service, so we have planned this expansion with projected future demands in mind.”

Rachel Leclaire, registered respiratory therapist at RVH, says patients are very appreciative of the shorter wait times and the access to the specialized service in their local community.

“They don’t have to drive into the city and deal with the traffic, that’s a big factor for them,” she notes.

With the nearest sleep labs located in North Bay, Ottawa and Kingston, Leclaire notes that RVH serves a very large catchment area stretching from Deep River to Whitney, south to Cloyne and Perth, and over to Almonte and Arnprior.

Determining the cause of a sleep problem is the core business of the service.

Patients are monitored throughout the night for a variety of sleep issues and every aspect of their sleep is observed through more than 20 sensors. Most commonly, obstructive sleep apnea patients are studied to diagnose the need for a nasal CPAP (Continuous Positive Airway Pressure) machine to use at home.

Leclaire explains that the CPAP keeps the airways open at night by continuously adjusting the pressure of airflow to stop the symptoms.

The lab also sees a number of patients who are concerned about excessive daytime sleepiness. Disruptive snoring and restless leg syndrome are two other common problems that result in a referral to the sleep lab.

The RVH sleep disorder team scores each patient’s sleep study and then sends the data to Respirologist Dr. Judith Leech.

She has been medical director of the RVH sleep lab since it opened about 10 years ago. Trained in respirology at McGill University and sleep medicine at the University of Illinois, Dr. Leech is the former head of sleep medicine at The Ottawa Hospital. She is currently chair of the Ontario College of Physicians and Surgeons’ Task Force on Sleep Medicine.

“We are extremely fortunate to have someone of her expertise at the head of our program,” comments Penney. “Patients who visit our lab can be assured that they are in the care of a highly professional and knowledgeable team.”

Dr. Leech assesses each case and makes recommendations to the patient’s family doctor.

While some may need to use a CPAP machine at night, others may be required to take medications. In some cases, promoting basic sleep hygiene is all that is recommended as a result of the sleep test.

Leclaire offers some basic “sleep hygiene” tips to get people started:

• Leave work at work—extra stress is a very common factor in sleep loss or low sleep quality.
• Stick to a strict sleep schedule and be sure to unwind quietly at the end of each day—away from the computer or television.
• Eliminate caffeine in the evening and drink no more than three cups of coffee a day.
• When it’s bedtime, retreat to a quiet, dark, cool bedroom.

Following these guidelines will lessen what she calls “self-inflicted sleep deprivation.” But when the deprivation is beyond a person’s control, the sleep lab’s experts at RVH are available to help identify any potential medical problem.

Referrals to the sleep lab must be made through a family physician.

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(For more information contact Randy Penney, CEO, Renfrew Victoria Hospital, 613-432-4851, ext. 250.)