At first, having trouble sleeping seems more like an inconvenience than a legitimate cause for concern. Yet it has been demonstrated repeatedly that lack of quality sleep can have major consequences. Among other problems, it can impair one's daytime judgment to the same degree as alcoholic intoxication.

There are a wide variety of sleep disorders ranging from harmless snoring (experienced by 80 percent of men and 60 percent of women) and teeth grinding, to the most serious condition known as apnea—a Greek word meaning "without breath." Sleep apnea, which is as common as adult diabetes, affects 12 million Americans and can, if left untreated, cause high blood pressure, heart attack, stroke, other cardiovascular disease, memory problems, excessive weight gain, impotency and recurring headaches.

In 1998 the Penobscot Bay Medical Center (PBMC) created a Sleep Disorders Center—familiarly known as the Sleep Lab—to diagnose and treat individuals who are affected by one or more types of sleep disorders. Dr. Andrew Filderman, director of pulmonary and critical care at PBMC, established and supervises the unit. Filderman, who is one of 16 Maine physicians board-certified in sleep medicine, is assisted by registered technologists Cindy Roth and Sarah Zurek.

Standing by the laboratory bedroom window, with a view
of the hospital lawn and the woods beyond, are Cindy Roth,
a registered polysomnographic technologist, and Andrew
Filderman, MD, DABSM, medical director of the Sleep Lab.
Dr. Filderman is also director of pulmonary and critical
care at PBMC. Not pictured is the Sleep Lab's other registered
technologist, Sarah Zurek.

The diagnostic procedure at the Sleep Lab—located in a quiet corner of the hospital—consists of high technology. Typically a study begins between 7 and 9 p.m. when the patient is placed on a special bed in a laboratory bedroom. The Sleep Lab technologist wires the patient for observation by placing a number of electrodes on top of the head to monitor brain waves; two at the eyes for the detection of rapid eye movement (REM) sleep; one between the mouth and nose for breathing, two on the chin for bruxism (teeth grinding); a microphone on the throat to record snoring; a strap on the chest and abdomen to check breathing effort; electrodes on each leg to record kicking; an oxygen saturation probe on one finger; electrodes for an electrocardiogram and a body position monitor.

Typically, a patient undergoing a diagnostic
procedure at the Sleep Disorders Center
at Penobscot Bay Medical Center is wired
with more than 20 electrodes during
his or her night's sleep there.
Most sleep problems and sleep disorders
can be diagnosed and are treatable in
safe and effective ways.

After falling asleep, the patient is under nightlong observation from an adjoining room and monitored by the technologist. The only circumstance in which the patient is awakened is when he or she experiences 30 or more apneas an hour. When that happens, the patient is fitted with a snug mask over the nose. The mask is hooked up to a small air compressor that applies room air under positive pressure through the nostrils until the apnea ceases and oxygen levels return to normal.

The Sleep Lab conducts from eight to ten diagnostic studies a week including, since 2003, daytime observations of patients suspected of suffering from narcolepsy. Because of the high prevalence of sleep disorder problems, there is currently a four-week waiting list for receiving treatment.

“A large number of Americans are excessively sleepy during the day. If properly treated, many of the sleep disorders underlying these symptoms can be improved,” says Dr. Filderman. “Unfortunately, the majority of people experiencing these disorders remain undiagnosed. Our challenge is to get the information out to the public so that they may discuss these issues with their primary physician and possibly have a diagnostic study if appropriate.” For further information on the Sleep Lab, call 596-8462.

Penobscot Bay Medical Center is a member of the Northeast Health family of services, which includes Kno-Wal-Lin Home Care and Hospice, the Knox Center and Quarry Hill Retirement Community. Through these organizations, and a staff of 95 outstanding physicians, Northeast Health is able to provide members of our community with a continuum of care from birth throughout their lives.