Helping patients get a good night’s sleep

As November rolls around, we all get ready to fall back one hour. This year daylight savings time ends on November 5, usually when that happens there are a few days of adjustments and we are tired for a bit.

But what if you are always feeling tired during the day, having trouble keeping our eyes open and paying attention to what others are saying?

That was exactly what was happening to Carole Nelles. She thought she was sleeping through the night, but then wondered how can she be so tired still? One day her daughter came home to visit and noticed she was snoring terribly loudly, so loud ‘it shook the walls’ and told her to see a doctor.

And that is exactly what she did. Her doctor referred to Markham Stouffville Hospital’s (MSH) Sleep Disorders Clinic at within the hospital’s Centre for Respiratory Health. At the clinic Nelles underwent a sleep study also known as an overnight polysomnogram —which monitors brain waves, eye movements and muscle movements, as well as breathing and oxygen levels, to determine sleep stages, heart rhythm, leg kicking and breathing problems.

And when she received the results were shocking. Carole had stopped breathing 88 times during the night. She was diagnosed with sleep apnea, a sleep disorder that involves pauses in breathing lasting from a few seconds to a few minutes.

She was sent to the clinic’s respiratory care services to get a CPAP (continuous positive airway pressure) device that would help her breathe throughout the night. She started using the machine and went back six weeks later for a test. Her results had changed drastically, the number of times she stopped breathing went from 88 to 2.1. Ever since using a CPAP machine Nelles, finds the lower numbers are typical results. Her CPAP machine will tell her how many hours she slept and how many times she stopped breathing.

“I slept right through the night. The energy I had was unbelievable. And when I wake up, I could get right to my work day,” says Nelles. “It is a total lifestyle change.”

She found she could accomplish more things during the day and consequently, she was eating healthier too. She had the energy to prepare her meals, and make wiser choices.

The Sleep Disorder Clinic at MSH offers diagnostic and treatment service for adult patients with symptoms that could include nighttime snoring and gasps, limb movements during sleep, inability to fall asleep or stay asleep, daytime excessive sleepiness and morning headaches.

“We have six respirologists, four of which are sleep trained, and the ones that are sleep trained will do sleep consults, interpret sleep studies and recommend therapy,” says clinic manager Liz Lalingo.

With sleep apnea, therapy varies depending on its severity; it could involve losing weight or requiring an oral appliance or positional sleep aid. “The real gold standard is CPAP therapy in the treatment of severe sleep apnea,” says Lalingo.


Chronic diseases such as heart disease, diabetes or stroke may have underlying sleep apnea. That’s why the sleep clinic works hand-in-hand with primary-care doctors and hospital departments. Cardiologists and neurologists often need to rule out sleep apnea; nocturnal high blood pressure, for example, can be exacerbated by sleep apnea.

For more information about Sleep Disorders clinic visit,

Photo: Carole Nelles sleeping with a CPAP device.


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