Dying for a good night's sleep

Winter 2014

The year was 1988. Jerry Lee was only 30 years old and he couldn’t stay awake to save his life.

“I couldn’t sit down to watch TV without falling asleep,” he says. “But I did a lot of physical outdoor work and thought I was falling asleep because I was tired.”

As time went on, it became clear that the extreme fatigue was a product of more than physical exertion.  His wife noticed that Lee wasn’t sleeping well. While Lee couldn’t remember doing so, she saw him jolt awake several times throughout the night.

Assessment at then-St. Thomas Hospital suggested that Lee had sleep apnea, but to confirm the diagnosis he was sent for overnight observation at the newly opened Sleep Clinic at London Health Sciences Centre – marking the start of his long journey of care with Respirologist, Dr. Charles George.

“They hook you up with over 20 wires and glue electrodes onto your body,” he says of his experience staying overnight in the sleep clinic.  But in just one night, the results were clear. “Dr. George told me that I had one of the worst cases of sleep apnea he’d ever seen.”

In fact, the tests showed that Lee’s breathing stopped every 50 seconds. 

Sleep apnea is a sleep disorder characterized by pauses in breathing that can occur several times every minute. Many people with sleep apnea are not even aware that they are having difficulty breathing.  The number one factor contributing to the development of sleep apnea is excess weight, which puts pressure on the airway, though anyone with a small upper airway may suffer from the condition as well. 

Dr. George is quick to point out that the impact of poor sleeping goes beyond just the immediate issue of breathing.  “You really have to look at sleep as having far-reaching effects on overall health. Quality of sleep can have a dramatic effect on quality of life,” he says.

“The heart becomes strained when there is apnea,” explains Dr. George.  “When we stop breathing, the body still continues to use the oxygen it has – it just isn’t being replenished. That leads to  oxygen deprivation, known as hypoxia, which places strain on the cardiovascular system as blood vessels constrict, resulting in a significant deterioration of one’s  health condition. Patients face increased risk of high blood pressure, stroke, atrial fibrillation, congestive heart failure and ultimately, death.”

Because of the far-reaching implications of sleep quality, the field of sleep apnea and treatment has become multi-disciplinary, often involving ear, nose and throat specialists, dentists, maxillofacial surgeons (i.e. surgeons who work on the head, neck, face, jaws and mouth) and psychologists.

In Lee’s case, the first course of treatment was outfitting him with a continuous positive airway pressure device or CPAP machine. The machine keeps the airway open by delivering a stream of compressed air through a facemask. After just one night of sleep with the CPAP machine Lee felt well-rested.

Unfortunately, over the coming years, Lee’s condition deteriorated. Lee discovered he was diabetic and struggled with weight gain associated with insulin injections.  Then a bout of illness caused him to gain even more weight and the CPAP machine no longer provided relief. He tried a Bi-PAP machine, which delivers different levels of pressurized air depending on whether Lee was breathing in or out, but even that machine failed over time.

Lee’s sleep apnea caused such extreme daytime sleepiness that he had to give up driving so that he would not pose a danger on the road.

In 2011, at 53 years old, his heart began to show signs of failure due the stress of oxygen deprivation. Lee could barely walk and had to be on oxygen continually.

Dr. George advised Lee that the only way to save his life was to lose weight. Bariatric surgery – or weight loss surgery - was the best course of action, but before Lee’s body could sustain the strain of being put under anesthetic, he had to be stabilized. A tracheostomy - a tube inserted in his trachea - allowed him to breathe freely once more and his body became strong enough to undergo surgery within the year.

The bariatric surgery was a success and resulted in substantial weight loss.

Today, Lee is well rested and on the road to better health. Not only is he walking, he’s able to exercise, he no longer needs insulin to manage his diabetes, and while he still sleeps with a CPAP machine, the amount of pressure needed to keep his airway open has been reduced substantially.  

In regards to his new lease on life, Lee credits the help he received from Dr. George, who has tracked Lee’s overall health-care journey for more than 25 years.

“I’d recommend Dr. George to anybody,” he says. “If it hadn’t been for the care I received, I wouldn’t be alive today – I know that.”

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In 1988, Jerry Lee became one of LHSC Sleep and Apnea Assessment Unit's first patients.
Jerry Lee's sleep apnea machine.
Doctor George, top right, checks in on a sleep study.
In the Sleep and Apnea Assessment Unit Control Room, technicians can monitor three patients at once.
One of the nine private patient rooms available in the Sleep and Apnea Assessment Unit's new space in Victoria Hospital.
Today, Jerry Lee is in much better health - able to exercise and get a good night's sleep with the help of his CPAP machine