Home' Southern Health News : August 2014 Contents 14 / AUGUST 2014 / SOUTHERN HEALTH NEWS
A good night's sleep no longer a dream for Sue
BY TRACEY HUTTON
Sue Thomson hasn’t had a good night’s sleep in 18 months. Working afternoon shifts from 3pm until 11.30pm left her restless
and lying awake for hours on end.
“I was a very light sleeper; I found it difficult to
get to sleep and wouldn’t get much sleep in a
night,” Sue said.
“During the day, I was always tired and lethargic.”
After visiting her local GP in March, Sue was
referred to the Adelaide Institute of Sleep
Health (AISH) at the Repatriation General
Hospital, where she was diagnosed with two
sleep disorders: Obstructive Sleep Apnoea
(OSA) (where breathing reduces or stops due to
repeated obstruction in the airway during sleep)
and insomnia (a condition in which a person
finds it difficult to fall or stay asleep).
When Sue heard researchers were undertaking a
study – called COMISA – to determine whether
a combination of two treatments would improve
sleep and quality of life for patients suffering
from both OSA and insomnia, she jumped at the
chance to be involved.
“I didn’t know I had these conditions, I just knew
that I snored very badly and was desperate for a
good night’s sleep,” Sue said.
The trial, involving AISH Sleep and Respiratory
Physician Dr Ching Li Chai-Coetzer, is testing
whether adding Cognitive Behaviour Therapy
(CBT) to Continuous Positive Airway Pressure
(CPAP) treatment will improve sleep quality,
CPAP adherence, quality of life and overall
health for patients with the two sleep disorders.
“CBT is an effective therapy for insomnia. It is
used to treat a variety of emotional, behavioural
and psychiatric conditions and is designed to
help patients identify dysfunctional thoughts
and behaviours, and replace them with healthier
skills and habits,” Dr Chai-Coetzer said.
“However, its effectiveness in patients with both
insomnia and OSA is uncertain.
“And although CPAP therapy (a mask and pump
that is worn overnight to prevent obstructions
to the airway) is a highly effective treatment
for sleep apnoea, a significant proportion of
patients find it difficult to tolerate the treatment
and may not adhere to it over the long term.
“If OSA remains untreated, it can lead to
health problems, including excessive daytime
sleepiness, an increased risk of motor vehicle or
work-related accidents, and an increased risk of
developing high blood pressure, heart attacks
“By adding CBT to usual therapy for OSA,
we hope to improve the patient’s insomnia
symptoms, increase their adherence to CPAP and
minimise the risk of long term health problems.”
Researchers are aiming to recruit 140 patients
to the study, with half being randomised into
a group which will receive four sessions of CBT
with a trained psychologist prior to starting CPAP.
The other half will receive standard treatment
for their OSA, including CPAP and weight loss,
sleep posture and lifestyle advice.
Study investigators have received $580,386 in
project grant funding from the National Health
and Medical Research Council (NHMRC) to
undertake the trial.
Dr Chai-Coetzer, who has also received a
$255,000 postdoctoral early career fellowship
from the NHMRC for this research, said OSA and
insomnia were the most common conditions seen
and treated at AISH, and they often co-existed.
She said some of the biggest risk factors for the
conditions were obesity, an ageing population
and other medical or psychiatric conditions such
After four months in the trial, Sue said her
sleeping habits have improved dramatically and
she is getting about “eight hours a night”.
Participants are required to be in the trial for
six months and will receive CPAP to use free of
charge during their involvement in the study, with
some also receiving four sessions of Cognitive
Behaviour Therapy for their insomnia.
Those interested in joining the trial should be
aged 18-75, have symptoms of OSA (for example,
snoring and day time tiredness) and insomnia.
A link to online screening forms for the trial can
be found at: http://www.adelaidesleephealth.
Dr Ching Li Chai-Coetzer performs a sleep study with
patient Sue Thomson.
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