William C. Dement, MD. Ph.D. An Expert in this field.


The following is my response to the request from Mr. Caruso via Sleep Quest. My name is William C. Dement, and I am a physician and professor, as well as Director of the Stanford Sleep Disorder Clinic. Since the 1950s, I have been actively involved in the creation of the field of Sleep Medicine, and have seen thousands of patient’s lives improved as a result of the proper treatment for their sleep disorder. Obstructive Sleep Apnea is a pervasive sleep disorder that causes the patient to stop breathing upwards of hundreds of times at night, and affecting people of every age and ethnicity. Estimates show that approximately 30 million people in the United States are affected with this disease and have not yet been tested or treated. Those who do not undergo testing or treatment run the risk of life threatening medical comorbidities such as heart disease, stroke, diabetes, obesity, mental or cognitive dysfunction and poor quality of life.

In the case of Mr. Caruso, in addition to his severe obstructive sleep Apnea that was diagnosed in 2006, he suffers from severe Shingles that has made it nearly impossible for him to use his Continuous Positive Airway Pressure (BiPAP) device. When used, this device blows air through a tube, which attaches to a nasal or face mask that delivers airflow into the patient’s nose and airway, creating a pneumatic splint that allows the patient to breathe regularly throughout the night. Due to his extreme Shingles condition, he has been unable to use his BiPAP device because of the headgear that holds the mask in place cannot touch his skin due to the blistering. Since he is unable to use the device, when he tries to go to sleep, he frequently awakens suddenly due to lack of oxygen to his brain or other vital organs. This gasping for breath is a common symptom of untreated Sleep Apnea. When this occurs, it causes fragmented sleep, leading to extreme fatigue throughout the day with low energy and poor concentration. In the past six months, Mr. Caruso has also broken 12 teeth as a result of Bruxism (teeth grinding while asleep) which also linked as direct result of his diagnosis of Severe Sleep Apnea. These dental issues have affected his ability to eat normally.

Mr. Caruso also suffers from Insomnia in that he is awake for 24 hour periods, 3 to 4 times a week resulting in chronic fatigue. He also struggles with the amount of pain medicines that he takes for his chronic blister pain. The opiates play a major role in suppressing his central nervous system, leading to yet another issue because he is unable to take the amount of medicine needed to eliminate the pain, forcing him to cope with the pain instead of medicating like a patient would who did not suffer from Severe Sleep Apnea. Due to these complicated issues, Mr. Caruso has been unable to work because he is unable to perform his normal duties.

CPAP or Bilevel device are the most common and effective treatment for patients with Obstructive Sleep Apnea. In Mr. Caruso’s case, he is working with his equipment provider to find solutions that will allow him to wear the device each and every night. It is imperative that he continue to use his treatment device to control his Apnea while he sleeps or his health condition will spiral deliriously out of control.

Yours truly,

William C. Dement, MD. Ph.D.