Dr. Hermes Velasquez, board certified in sleep medicine, pulmonary medicine and critical care, just joined the Indian River Medical Center staff and now shares a suite of offices with Dr. Diego Maldonado, Dr. Mauricio Munoz, Dr. Annetta Alexander and Dr. Susan Murphy.
Velasquez earned his medical degree from the Universidad del Zulia Maracaibo in Venezuela, completed his residency and fellowship at University of Miami School of Medicine-Jackson Memorial Hospital and has been practicing in Hattiesburg, MS for the past 10 years.
In addition to his critical care skills, Velasquez, a self-described, “lung doctor,” treats asthma, COPD, emphysema, pulmonary hypertension, pulmonary fibrosis and sarcoidosis, and is skilled at interventional bronchoscopy procedures.
He also treats a myriad of sleep disorders.
Sleep disorders, according to the Centers for Disease Control and Prevention, affect more than a quarter of the U.S. population. The Cleveland Clinic reports that, “there are approximately 80 different types of sleep disorders,” and that, “about 70 million Americans suffer from them.”
Some of those 80 disorders are: snoring, insomnia, narcolepsy, REM sleep disorders, circadian rhythm sleep disorders, restless leg syndrome, sleepwalking and perhaps the most dangerous of the batch, obstructive and central sleep apnea.
“Not really much,” fundamental has changed in the treatment of sleep apnea in the past 20 years, according to Velasquez, but treatment devices have improved. The CPAP or continuous positive air pressure machine remains the gold standard for treating sleep apnea but Velasquez says the newer CPAPs are infinitely more patient-friendly than their predecessors.
For people who think they might have sleep apnea, there’s now one more good reason to get a diagnosis and, if needed, seek treatment. In a study published in the April 2015 issue of the medical journal of the American Academy of Neurology, the condition was linked to early memory loss and cognitive impairment in seniors.
The use of CPAP machines, the study says, appears to slow that decline. Researchers claim that people with sleep apnea who use CPAP machines were diagnosed with cognitive impairments about 10 years later than people who did not use CPAPs.
In obstructive sleep apnea, the tongue, tonsils and soft palate collapse and block the patients’ airways. In central sleep apnea, the brain fails to signal the appropriate muscles needed to breathe. In both cases, sleep is interrupted, sometimes hundreds of times in a single night. That leads to severe sleep fragmentation and dramatic reductions in blood oxygen levels.
That loss of blood oxygen damages the heart, the lungs and especially the brain.
Interrupted sleep can also leave the patient overly tired and mentally confused the next day.
CPAP machines are essentially pumps that blow a steady stream of air into the patient’s nose by way of a face mask. That keeps the patients’ airways open throughout the night and maintains higher blood oxygen levels.
Velasquez calls CPAPs, “the most effective, the most documented therapy out there” for sleep apnea.
Like many physicians, he seems unimpressed with both nasal surgery options and with a newer nerve stimulation/pacemaker device designed to keep airways open electronically.
Newer CPAPs, explains Velasquez, “are actually becoming more patient friendly. All of these algorithms they are putting into [new machines] regulate the pressure and the run time. They sense you. They sense the way you breathe so they work with you much better than the old machines.”
Today’s CPAPs, Velasquez continues, are also significantly less noisy, lighter and more portable than machines of ten years ago. Moreover, there are many more options as far as masks are concerned. “We now have so many types of masks,” Velasquez points out, “So many models and so many different varieties,” that it’s far easier to find one that best suits the patient’s respiratory patterns.
Recognizing sleep apnea may well be more difficult than treating it. “Not everybody who snores has sleep apnea, but most everybody who has sleep apnea does snore,” explains Velasquez.
One more advancement in diagnosing, if not treating, the condition is a take-home test.
Some patients can now be given a device no larger than an iphone that monitors their sleep and oxygen levels in the comfort of their own bed, something that was unheard of a decade ago. The data collected is transferred to the hospital’s diagnostic system and a treatment plan is formulated, if needed.
Not everyone, however, is a candidate for the take-home test, so IRMC also has its own in-house sleep study lab where patients check-in in the evening and check-out the next morning. A new IRMC satellite sleep center lab is also in the works, though as of press time it’s not clear where and when that might open.
In the meantime, IRMC now has one more physician on staff to treat sleep disorders, lung problems and other critical care issues.
Dr. Hermes Velasquez is with Indian River Medical Center. His office is at 1155 35th Lane, Suite 201, Vero Beach. The phone number is 772-794-5800.
