Photo: After 20 years of “sleep” at Waikato Hospital, Majurey is looking forward to a role that will help wake up awareness and prevention in the community.
It was 1998 when Waikato Hospital cardiac nurse Merrhis Majurey was asked the question many hardworking nurses would love to hear – would she like to go to sleep?
“I said yes and then found the meaning of the question – they wanted me to join the newly established Sleep Service!”
Over the next two decades she has seen a big change in awareness of sleep conditions and advances in their treatment, as well as personally gaining a Master of Science in Medicine (Sleep Medicine) through Sydney University and holding the role of charge physiologist in Waikato Hospital’s Sleep Laboratory.
“In the early days there wasn’t a lot of public knowledge about sleep. Sleep apnoea and the importance of good sleep were never mentioned on television or in newspapers like you see now,” she says.
“At the start, only a couple of GPs regularly referred patients to our service, and some health professionals didn’t even agree with it. Many were just unaware of sleep conditions.”
Patients were unaware too, and she recalls they often became angry when told to stop driving for a week while they were tested and diagnosed – “or they denied having an issue even when their partner described their sleeping habits.”
“It’s a lot easier now. There is a lot more public interest and awareness about sleep, and many of our patients know other people who are using CPAP (Continuous Positive Airway Pressure) therapy for sleeping disorders like sleep apnoea,” she says.
The treatment equipment has also advanced rapidly, from the earlier clunky, noisy CPAP machines. Majurey says international sleep technology now includes machines so small you can hold them in the palm of your hand and even solar-powered models for those who want to go hunting or camping.
The hospital-issued machines that patients take home and use long-term are compact and quiet, comfortable to wear and look nice. “Those things are very important. You are giving people something to use in their bedroom, so it needs to be unobtrusive and quieter if they are sharing the room with another person.
Majurey says partners and family are important in identifying and treating sleeping disorders.
“Often people are unaware of their own sleeping habits and might think a partner is exaggerating when they describe habits like heavy snoring, kicking around in bed, gasping for breath and so on. But we take the partner’s comments very seriously as they are the ones who can see what is really happening.”
And it is men who are most affected, with research indicating that around 9 percent of males and 4 percent of females may experience sleep disorders. Women may have some hormonal protection but it might also be that women are under-diagnosed.
Majurey is particularly interested in the social and psychological impacts of untreated sleep conditions.
“We see people who are grumpy, irritable, stressed, prone to get angry. They can’t stay awake long enough to play with their kids in the evening, some have impotency issues, and all of these sorts of things impact on their partners and families.
She believes sleeping disorders may be a factor in family violence. There are also physical impacts such as difficult-to-control hypertension and blood glucose levels. All these things have a personal, community and financial cost.
“Diagnosing and treating sleep disorders early can save a lot of heartbreak and money,” Majurey explains. “One accident caused by someone falling asleep at the wheel will involve so much financial cost in emergency response, medical treatment and rehabilitation that preventative education and early diagnosis becomes a very cheap option.”
Prevention is where the next step in Merrhis Majurey’s career takes her. She is leaving Waikato Hospital on 26 May 2017 for a role in the newly formed company Fit for Duty which will focus on education and screening staff in “at risk” workplaces for early detection of sleeping issues and obstructive sleep apnoea.
The truck and long-haul industries in particular have a vested interest in sleep screening, as their workforce is predominantly middle age to older men, often on shift work involving disrupted sleep patterns and long hours of sedentary work with potential weight gain. From research to date, the rate of sleep apnoea in commercial truck drivers appears to be as high as 25 to 45 percent.
Clinical director of Waikato Hospital Respiratory Medicine Janice Wong pays tribute to Majurey’s contribution. “Over the last two decades, Merrhis has been the constant name that you would think of if you need help from the Sleep Lab. More recently she has pioneered to use telehealth in Sleep Lab. She has a vast amount of knowledge and experience, and she will be hard to replace. On behalf of the respiratory department, I would like to thank Merrhis for her enormous contribution to the Sleep Service. It has been a great pleasure working with her as a colleague and knowing her as a friend.”
Footnote: Obstructive sleep apnoea (OSA) is a condition when people stop breathing while they are asleep. When someone with OSA is asleep, the tissues in their airways relax and can block the airways. When this happens, it causes them to momentarily stop breathing until the brain arouses them to a lighter stage of sleep or to wake so they can begin breathing again. This cycle can repeat hundreds of times a night, and often the sufferer is unaware of the problem. If a partner or family member is showing signs of sleep problems, it is important to discuss it and get advice from a health professional.