October 3, 2003

New sleep lab opens at Vanderbilt Marriott

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Terrell Smith sits in front of the mural in the fifth floor outdoor play area at Vanderbilt Children's Hospital. Her office window overlooks this area, which reminds her of what she's here to do. Dana Johnson

New sleep lab opens at Vanderbilt Marriott

Seeking a more “sleep-friendly” environment, sleep experts at Vanderbilt Medical Center are taking a novel approach for providing sleep studies.

In a first for Nashville and Middle Tennessee, Vanderbilt has opened the first hotel-based sleep center in the Marriott at Vanderbilt University. The state-of-the-art sleep laboratory utilizes regular hotel rooms, slightly converted to monitor sleeping patterns.

The new lab area encompasses one end of the 5th floor of the Marriott (4,000 square feet), and has six rooms set aside for sleep studies, with additional rooms for monitoring and program support.

The location of the new sleep center, which was more then two years in planning stages, was the idea of Drs. Robert L. MacDonald, professor and chair of the Neurology Department, and Dr. James R. Sheller, associate professor of Medicine in the Allergy/Pulmonary and Critical Care Medical Division.

“It mimics a more natural home setting, which will provide for an environment to help the patient sleep more like they would at home,” explained Dr. Beth Malow, associate professor of Neurology, director of the Vanderbilt Sleep Disorders Program and who is board-certified in Neurology, Sleep Medicine, and Clinical Neurophysiology.

Malow, who has headed the Sleep Disorders Program since June 2003, said the new center would seek accreditation within the year and would be providing a multidisciplinary approach to sleep medicine.

“Our program focuses on all sleep disorders,” she explained, “including sleep apnea and narcolepsy.”

The Sleep Disorders Program is a collaborative resource of multi-disciplinary specialists designed to provide comprehensive patient care for individuals having difficulty sleeping at night, having difficulty staying awake in the daytime, or experiencing unusual movements or behaviors in their sleep.

Such disorders as sleep apnea, narcolepsy, restless legs syndrome, sleep walking, possible nocturnal seizures or other sleep-related events, insomnia, and shift work disorders are evaluated and treated, as well as sleep difficulties associated with illnesses, such as Parkinson’s disease, stroke, epilepsy, and lung or heart disease.

Malow said up to 24 percent of all men, and 9 percent of all women suffer from obstructive sleep apnea (OSA). More than 90 percent of the patients seen at Vanderbilt’s Sleep Disorders Program have been diagnosed with OSA.

OSA is associated with excessive daytime sleepiness and neuropsychological dysfunction and directly affects a person’s quality of life. Other health conditions that have a causal relationship to OSA include high blood pressure, increased risk of heart disease and stroke, and a contributing factor to depression and other psychological conditions.

One of the most common and most effective treatments of OSA is the use of a continuous positive airway pressure (CPAP) device. Malow said once patients have been diagnosed with OSA, they are brought back to the sleep center and fitted with a CPAP machine and monitored one more night to adjust the machine’s pressure settings.

A 1999 study published in the journal CHEST, showed that after eight weeks of CPAP therapy patients showed improved vitality (75%), social functioning (90%), and mental health (96%).

“CPAP is 100 percent effective in patients that will wear the device,” Malow said. “By taking a multidisciplinary approach with our patients, we have a rigorous follow-up process to monitor our patients and do everything possible to have them wear the device.”

Physicians evaluate adult and pediatric patients in the Sleep Disorders Clinic, located in The Vanderbilt Clinic. If appropriate, overnight or daytime studies are performed in the Sleep Disorders Laboratory, located in the Vanderbilt Marriott. If indicated, patients may be referred to appropriate specialists in neurology, pulmonology, pediatrics, otolaryngology, psychiatry, or other disciplines for further evaluation and treatment.

The Sleep Disorders Program and Laboratory is administered within the Department of Neurology. The manager of the program is Sandy McMasters, who in addition to having expertise in program management, is a registered polysomnography technologist.

Deby Bean, also a registered polysomnography technologist, is the lead technologist overseeing the studies performed in the laboratory, and Cathy Carlson, a respiratory therapist, assists patients in getting adjusted to CPAP. In addition to Dr. Malow, two sleep staff center physicians from Pulmonary Medicine, Dr. James Sheller and Dr. Lisa Lancaster, evaluate patients in the sleep clinic and interpret sleep studies. Both are board-certified in Sleep Medicine.

Other physicians participating in the Sleep Disorders Program include: Dr. Muhammad Al Kaylani (neurology); Dr. Amir Arain (neurology); Dr. Andre Lagrange (neurology); Dr. Scott Boyd (maxillo-facial surgery); Dr. Mark Courey; (otolaryngology); Dr. Mohammad Fazili (pediatric pulmonary); and Dr. Ronald Salomon (psychiatry).

Patients can usually be accommodated within the sleep clinic or laboratory within four to six weeks. For patient appointments, or for more information about the program, call (615) 340-5216 or visit their Web site at www.mc.vanderbilt.edu/neurology/sleep.htm.

An open house will be held at the Sleep Disorders Laboratory Oct. 9 from 2-6 p.m. Round-trip shuttle service will be provided between 2-4:30 p.m., and will leave the main entrance of TVC every half-hour. All are invited to attend.