Questions and answers with Dr Philippe Grunstein, sleep specialist at NNUH
Dr Philippe Grunstein is one of the sleep specialists at NNUH.
What is the role of the sleep clinic at the NNUH?
Appointed in 2003, I contributed to the creation of our sleep unit in 2004-2005. Previously, patients from Norfolk had to travel to Cambridge. I started with Dr Twentyman and we successfully made the case to set up a proper sleep clinic which has now been running for 15 years.
We innovated by enabling patients to get their sleep patterns recorded at home in their own bed, rather than coming into hospital. We have a great team of 6 consultants involved in sleep medicine; Dr Sankaran, Dr Metcalfe, Dr Del Forno and Dr Idris in addition to Dr Twentyman and myself.
We could not do anything without our dedicated specialised nursing staff; Annie Stanley, Vicki Ershadi and Georgina Siggins.
The demand has grown fast over the years and currently we look after 2,500 patients with obstructive sleep apnoea who are treated with CPAP (continuous positive airway pressure).
We also look after patients with other sleep disorders such as insomnia, parasomnia and hypersomnia.
How prevalent is sleep apnoea?
5-6% of the male and female population between the ages of 45-65 in Norfolk suffer from obstructive sleep apnoea. Quite often these patients are overweight or obese. High blood pressure and type 2 diabetes are often present as well. Most of them have the same pattern; they snore very loudly every night, then they stop breathing up to 1 minute before breathing again, they wake up unrefreshed, during the day they often fall asleep inappropriately. Morning erectile impairment is often an associated issue in men and so is depression in women.
How dangerous is obstructive sleep apnoea?
The loud snoring by itself damages the hearing and the vessels of the neck, the drop in oxygen when they stop breathing damages multiple organs. Atrial fibrillation (irregular heartbeat), strokes, high blood pressure, ischaemic heart disease and type 2 diabetes are the inevitable complications of untreated obstructive sleep apnoea.
How can people seek help from the sleep clinic?
Alerted by their partner in bed, referred by their GP, when they come to our clinic we arrange for a nocturnal domiciliary polygraphy recording. Treated with a continuous positive airway pressure machine and weight loss they feel the benefit very quickly.
How does sleep change when people get older?
In the elderly good quality sleep is the best indicator of their health status. When their sleep is impaired the cause of it is very often chronic pain, side effect of multiple medications. To restore their good sleep by tackling the conditions that ruin it at night we improve all the time their quality of life and their life expectancy.