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Nurses, such as Wendy Moore, RN, who work in the field of sleep disorders spend much of their time educating patients about sleep cycles. Here, Moore, the lead nurse in the Mayo Sleep Disorders Center in Rochester, Minn., meets with James Bishop to review CPAP therapy.

Lee Myers, RN, FNP, APRN, is an expert in an area of medicine that often is overlooked, although most people spend almost a third of their lives engaged in this activity. Myers is a nurse practitioner at the Sleep Disorders Center of Central Texas in Austin.

Myers admits that he stumbled onto this area of nursing when other jobs were unavailable, and never expected sleep medicine to have such radical impact on patients. His patients include people like a woman in her 70s who became limp in her legs when she played with her grandchildren because they made her laugh. She was suffering from cataplexy, a condition common in narcoleptic patients. Then there was the 36-year-old man who was falling asleep while driving and during work meetings because he had sleep apnea. The treatments for these two patients were relatively simple, and Myers watched their lives flip from unbearable to normal in a matter of weeks.

Even though dramatic improvements are common with sleep disorder patients, many sleep conditions remain undiagnosed. According to a 2003 poll of more than 1,500 adults conducted by the National Sleep Foundation, two-thirds of adults reported sleep problems, but only one in eight said their problems had been diagnosed.

Nurses agree that in many cases, patients consider their other health problems more important than their issues with sleep. Yet sleep disorders such as sleep apnea, restless legs syndrome, and insomnia left untreated can aggravate other health problems.

Poor sleep can affect the immune system and blood pressure levels and increase susceptibility to headaches and depression. Most nurses who work in sleep centers said that sleep apnea is the most common condition they treat and also the most rewarding.

Return to normalcy

“The patients come to you in such misery, and getting them started on treatment can be life-changing,” Myers said. People with sleep apnea usually have something obstructing their airflow in the nose or mouth and, as a result, may experience heavy snoring and periods where they don’t breathe momentarily. The inability to breathe usually causes someone to wake up, which can interrupt deep sleep, and is why these people can be excessively tired during the day.

With most sleep apnea cases, physicians ask their patients to spend a night in a sleep lab where technicians run tests to monitor electrical activity in the brain, eye movement, muscle activity, heart rate, and other things while the patient sleeps. If lab results reveal that the patient has sleep apnea, then the patients usually are prescribed nasal CPAP, or continuous positive airway pressure. The patient wears a mask over the nose during sleep to maintain this higher air pressure.

In the case of the sleep apnea patient in his 30s, Myers learned that the man had such severe apnea that he would wake up several times a night and couldn’t get back to sleep. “We started him on CPAP therapy a month ago, and now he’s raving about how his life has changed,” Myers said. “He had spent the last 10 years operating at 50%.”

The National Sleep Foundation estimates that about 18 million Americans have sleep apnea, and people who are most likely to have it include those who snore loudly and are also overweight, have high blood pressure, or who have a physical abnormality in the nose, throat, or other part of the upper airway.

For Myers, one of the most rewarding parts of his job is educating patients about their conditions and treatments.

Another problem Myers treats is restless legs syndrome, a condition in which people have the urge to move their legs to relieve discomfort, which can manifest in the form of a tingling, cramping, or burning sensation in the legs. People usually feel RLS when they are sitting down late in the day or at night or trying to fall asleep at night.