Cases of Sleep Disorders

News Article
Hey Sleepyhead - Sleep Disorder Cases
Thursday, 11 l 03 l 2010 ; Source: Mind Your Body, The Straits Times
By Geraldine Ling
CASE 1: TEACHER PLAGUED BY SLEEP ATTACKS
Mr Matthew Quek suffers from two sleep disorders, obstructive sleep apnoea (OSA) and narcolepsy. However, the 33-year-old teacher and singer, who got married just five months ago, does not let his conditions affect his zest for life. Mr Quek had an inkling of his disorders three years ago when he suddenly fell asleep while driving home from school. He almost hit another car, but for the loud horn from the other driver which jolted him awake. A few weeks later, his parents, while staying overnight with him in Sentosa, discovered he had stopped breathing momentarily while he was asleep. They urged him to see a doctor but he wanted to monitor his condition before doing so. As the months passed, he grew increasingly tired during the day. He would nod off when he was not on his feet – such as while marking his students’ homework or driving. Even though he slept at least six hours nightly, he was tired. He said: “I felt like a walking zombie each time I woke up.” It was time to seek help. Two doctors he approached said his sleep problems were caused by mild sleep apnoea due to narrowed airways. Sleep apnoea is a general term for a disorder which occurs when people experience breathing pauses during sleep. He was treated with continuous positive airway pressure (CPAP) therapy, where a mask, connected to an air pressure delivery device, is worn during sleep to prevent the airways from closing. However, his problem of excessive daytime sleepiness persisted. He also experienced nightmares, paralysis and limb movements during sleep. At times, while having a nightmare, he would accidentally hit his wife, Mrs Quek An-Dian, 29, also a teacher. “I was shocked but concerned,” Mrs Quek said. She would wake him up to soothe his nerves. Frustrated, Mr Quek sought a third opinion from Dr Ignatius Mark, an ear, nose and throat surgeon who was recommended by a friend. Sleep tests then found that his sleep apnoea was the more serious type, OSA, where his breathing pauses during sleep were due to multiple blockages in his upper airways. Mr Quek’s CPAP device was upgraded to one that was more suitable for him. Sleep now came more easily, but he would still suddenly nod off during the day. The sleep paralysis, limb movements and nightmares continued, prompting Dr Mark to suspect another sleep disorder. Mr Quek was immediately referred to Dr Lim Li Ling, a consultant neurologist and president of the Singapore Sleep Society. A magnetic resonance imaging (MRI) scan showed he also had narcolepsy, a lifelong neurological disorder that causes its sufferers to suddenly fall asleep during the day. “It was a relief to be able to put a name to my condition. Finally, the enemy was revealed and I can fight it,” Mr Quek said. Today, in addition to CPAP therapy, he also takes medicine to sleep better at night. Mr Quek also exercises regularly by using the cross-trainer for 40 minutes daily. Thankfully, the sleep attacks do not occur when he is teaching. “When I’m teaching or moving around, I am alert as my adrenaline keeps pumping,” he said. However, daytime sleepiness is something he still struggles with especially when he is not on his feet. Taking short rests during his free time helps energise him. Music, he added, has helped to keep him sane amid all the stress and uncertainty. Besides helping out in his church’s music ministry, Mr Quek has also released four albums, the latest being My Romance, a collaboration with local jazz artiste Jeremy Monteiro. His wife, parents, friends, colleagues and faith have provided him with tremendous support. He said: “Love is the antidote for many maladies.”
CASE 2: PEOPLE THOUGHT SHE WAS LAZY
Some teachers had thought that Maisy Tan, 18, was lazy, when, in fact, she has a sleep disorder called narcolepsy. She was first diagnosed with the condition eight years ago when she was in Primary 4. She had found that her limbs would give way without warning, causing her to fall flat on her face. Bruises covered her body. She also felt extremely sleepy during the day and found it hard to concentrate in school, despite sleeping at least nine hours each night. Her results suffered and she went from being one of the top students to being last in her class. Teachers began to think she was lazy and would discriminate against her even as she progressed onto secondary school, she said. Some classmates started to call her “alien”, she said. Her repeated explanations about her condition did not help much as the teachers did not understand the severity of narcolepsy, she said. It was frustrating, she added. Nonetheless, Maisy continued to persevere in her studies and was able to score 26 points for her best five subjects in her O-level examination. Although she was posted to a nursing course at a polytechnic, the institution decided it could not cater to her medical condition. Some other polytechnics she called up made the same decision, she said. “I felt I had nowhere to go at the time,” she said. However, she did not give up and managed to secure a place at the Institute of Technical Education (ITE) where she is now studying food and beverage operations. She still faces the occasional discrimination or lack of understanding, but most of her ITE teachers, who know about her condition, will try to help. For instance, instead of asking her to do only deskbound assignments, they will give her hands-on tasks like cleaning up the student restaurant or polishing cutlery. This is because she tends to fall asleep if she is not on her feet. She will graduate on April 12, one day before her 19th birthday. When asked about her birthday wish, she said: “I just want to live my life without being discriminated against.”