Community Tech Tip – WISH-ful Thinking

Ankur N. Patel, M.D., M.S., speaking with Russ from Camas, WA via teleconference. Watch for a future interview on our blog, The Buzz.

​by Russ Alman, Communications Director --

​My column this month is a bit personal to me, but I wanted to share this story so that perhaps I can help other seniors — and younger people too — address an important health issue that often goes undiagnosed or ignored.
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I have sleep apnea. And it’s actually pretty severe. Back in 2014, I was diagnosed at the Confluence Health Sleep Studies Center.
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Doing an in-clinic sleep study involves an overnight stay in a private suite, hooked up to a bunch of wires and monitors so that technicians can record how many obstructive apnea events occur per hour.

Me in the Confluence Sleep Lab in 2014. I thought it would be funny to text this selfie photo to my mom without an explanation. She was not amused… she thought I had a heart attack!

I don’t think I slept more than 45 minutes during the test. But they got the data they needed: I had an Apnea-Hypopnea Index (AHI) score of 30, which means that about every two minutes, my breathing was restricted or stopped by my airway collapsing. That is right on the border of being considered severe sleep apnea.

What does that mean in real-world terms? It means my body was being deprived of oxygen while I slept.

I was prescribed a Continuous Positive Airway Pressure) CPAP machine to pump pressurized air into my lungs while I slept. I really tried to comply and use it, but for me, it was a struggle. It was hard enough for me to breathe with my chronic allergies, but adding the CPAP made me feel like I was suffocating. After 18 months, I finally gave up and just figured I could deal with it.

As time has passed, however, my symptoms have gotten more severe, which is not uncommon as people age. I gained weight. It became harder to focus. Eventually, it got to the point where I was nodding off at work (even in front of other people!) and couldn’t sit down to watch a TV show for more than 30 minutes without blacking out. And while I used to be able to easily drive long distances, I could no longer stay alert for anything more than a 15 minute drive… it was getting downright dangerous!

Finally, earlier this year due to other health issues, I saw a pulmonologist to test my lung function. The good news, said my doctor, was that my lungs were functioning at full capacity, though I needed to be consistent about preventively treating my long-term asthma issues.

Then he read me the riot act. He said in no uncertain terms that I was slowly killing myself by not treating my sleep apnea. He was actually upset with me! He explained that he had been through the same experience and could empathize, but I absolutely needed to get my prescription updated and get back on the CPAP bandwagon.

That was the kick in the butt I needed. I had recently figured out through a combination of occasional antihistamine use at the right time of day and consistent nasal irrigation how to manage my stuffy sinuses, so I was highly motivated to get back on the CPAP.

(Sidenote: I am a HUGE fan of the NasalFresh irrigation system. It has been literally life changing for me. You can find it online at
nasalfreshmd.com.)

Just to prove to myself that I could do it, I pulled out my old dinosaur CPAP machine from the closet, bought new tubing and a new mask out of pocket... and got a good night’s sleep for the first time in years.

It’s now been almost two months and I haven’t missed a single night of CPAP therapy. I’m calmer, more focused and AWAKE. I have no problems making it through the day and staying alert, and my sleep pattern is normalizing. I now feel tired at night when I’m supposed to feel tired, and most nights when I go to bed I fall asleep immediately and stay that way through the night.

The one hiccup in restarting CPAP therapy has been getting a new prescription. Confluence Health’s sleep studies group is severely backlogged. Even after two months, I haven’t been able to even get an appointment scheduled.

I checked with my insurance company to see where outside the Wenatchee Valley area I could go to see a sleep medicine doctor. That’s when I discovered that I could see a sleep doctor entirely through telehealth.

It turns out that in many cases, sleep studies can now be done at home using portable equipment. That makes a lot more sense to me — sleeping in your own bed in a comfortable environment on your own schedule.

After doing some research on clinics that accepted my insurance, I contacted Wellness Institute for Sleep & Health (WISH) in Camas, Wash., about 20 minutes east of Vancouver. Within two weeks, I had an appointment with Dr. Ankur Patel through telehealth and a current prescription for a new CPAP and supplies.

It turns out that Dr. Patel worked at the Confluence clinic in Wenatchee but decided to start his own practice and focus on telehealth services. He and his wife moved to Camas a few years ago. Small world!

My initial telehealth appointment took about an hour. (I actually held the appointment in my office at the Community Center!) Dr. Patel was very friendly and professional and gave me suggestions to improve my therapy and compliance this time around.

Since I had a previous diagnosis and prescription, we decided to forgo doing a new sleep study for the time being and decide later whether I would benefit from retesting. We’ll discuss this and my progress at my follow-up appointment in late July.

My insurance has approved my prescription for a new, state-of-the-art CPAP, which I’ll be using by the time you read this. The new machines are smart enough to recognize when you’ve fallen asleep and automatically adjust to your breathing needs. They also include access through a smartphone app so that you can monitor your progress and share data with your doctor.

The reason I’m sharing this story with you is that there are many, many people — especially seniors — who have undiagnosed sleep apnea. In fact, there is an estimate that about a third of the world population is has undiagnosed obstructive sleep apnea, Dr. Patel told me in a recent conversation.

Even if they suspect they have it, access to sleep doctors and the thought of having to do a sleep test in a foreign environment are serious barriers to getting treatment.

I’ve mentioned in previous articles that telehealth can be a huge benefit. This is a case where telehealth has given me access to treatment months faster while providing me with better, faster, more personal access to my physician.