Medical research helps patients get a good night’s rest
Back in 1789, Benjamin Franklin famously wrote: “There are only two things that are certain, death and taxes”. Another item that could be added to that list is our need for sleep. We cannot live without it, and lack of it—or problems during it—can cause or contribute to a wide range of medical problems.
In the USA—where the most up-to-date statistics are available—public health and safety is threatened by the rising prevalence of Obstructive Sleep Apnoea (OSA) and other sleep disorders. According to the American Academy of Sleep Medicine, it is now estimated that approximately 26 percent of the US population suffers from OSA or other sleep-related problems.
In Thailand, Dr. Jakrin Loplumlert is the country’s top expert in the field of sleep science, and he says that the trend in Thailand is following that seen in the USA. He studied in Thailand at both Mahidol and Chula Universities’ medical faculties, and went on to further study in Cleveland, Ohio, where he left with a Research/Sleep Medicine Fellowship/Observership from the University Hospitals Case Medical Centre, in 2014. He then returned to Thailand, and has since then led the sleep science team in the Neuroscience Centre at Bangkok Hospital.
According to Dr. Jakrin there are a number of common sleep problems—such as sleep related breathing disorders, snoring, insomnia, inadequate sleep, narcolepsy, sleepwalking, etc.—of which the most commonly occurring is Obstructive Sleep Apnoea.
“OSA is found more within the male population,” he noted, “showing clinical manifestations such as snoring, waking up to go to the toilet, waking up gasping, waking up unrefreshed, morning headaches, daytime confusion, memory problems, or Excessive Day Time Sleepiness (EDTS).”
He went on to explain that OSA sufferers often exhibit a variety of more extreme medical problems as a result of their condition. It can cause or contribute to hypertension, coronary artery disease, cardiac arrhythmia, stroke, kidney disease, diabetes, or mood disorders such as depression or irritability, to name the most common ailments. To put it frankly, it’s a serious problem for the public health of a country, and urgently needs the help of experts such as Dr Jakrin.
Patients (Thai and foreign) from other hospitals in Thailand—and even other countries—are referred to Dr. Jakrin at Bangkok Hospital, and there the process begins. They first have a physical examination, followed by an overnight stay (with an optimum 8 hours of sleep time). Here, in a well-equipped hospital suite, a technician views them throughout the night by CCTV, continuously monitoring brain activity, heart rate, digestive system, et al. After exhaustive analysis of the data, the proper treatment is decided upon. Treatment options include: supplying the patient with an oral appliance; drug treatment with melatonin or a medicine with a similar effect; Ear, Nose, or Throat (ENT) surgery; or Continuous Positive Airway Pressure (CPAP) treatment, which is recommended in 90 percent of the cases. The latter is a procedure that utilizes a CPAP machine to provide mild air pressure to keep breathing passages open. It features a disposable full-face or nasal mask that fits over the face during sleep (some patients find the full-face mask a little too claustrophobic and opt for the smaller nasal mask).
For the treatment to work, the CPAP machine should be used every time a patient sleeps at home, as well as while traveling, or during naps. Getting used to using a CPAP machine can take time and requires patience. The doctor may need to adjust the pressure settings for a particular patient, and he or she will have to work closely with the sleep doctor to find the most comfortable mask that works best for them.
Some patients notice immediate improvements after starting CPAP treatment, such as better sleep quality, reduction or elimination of snoring, and less daytime sleepiness. But equally important are the long-term benefits that cannot immediately be recognized, such as helping to prevent or control high blood pressure, lowering the risk of stroke, and improvement of memory and other cognitive functions.
The majority of patients quickly become used to using a CPAP machine and mask, and the success rate in curing OSA and its related medical problems is high. If you suffer from snoring or other sleeping disorders it might be a good idea to make an appointment to see your doctor. And if you are here in Thailand you might soon find yourself making the acquaintance of the amenable Dr. Jakrin Loplumlert. Till then…sweet dreams!
By Robin Westley Martin