Advice and insights from a Clinical Sleep Navigator who is screening, educating, and inspiring her community to improve their overall health by focusing first on a good night of sleep
In this month’s EnsoData sleep story, we dive into the life of the woman running the sleep education program at Northwestern Medicine: Denise Alexander. Serving as a Clinical Sleep Navigator, Alexander identifies, screens, and educates patients in the hospital who are at risk for sleep apnea. Primarily, she works to pinpoint at-risk patients and help them traverse the complex process of completing a sleep study and getting set up with a treatment option to improve their overall health. The sleep navigator or sleep educator role is pivotal in the health system, so let’s dive in to see why.
The Personal Element: Becoming The Second Northwestern Sleep Navigator
Like other recent sleep stories, Alexander is committed to making a difference in sleep medicine because she has experienced the impact of obstructive sleep apnea (OSA) firsthand. By happenstance, Alexander’s respiratory therapist office was located in the same building as then sleep navigator, Andrea Ramberg, (yes the same one working here now).
While in her respiratory role, Alexander frequently referred patients she suspected had OSA to Ramberg for screening. Often, the two found themselves discussing sleep health and the effects of sleep on different demographics within the patient population.
“Andrea was a wealth of information and I soaked up everything she had to share,” said Alexander.
Their discussions eventually turned to Alexander’s husband and middle son. At the time, Alexander knew that both her husband and son were likely candidates for sleep apnea. Her son’s condition was physical, as he was born with a congenital disorder affecting his facial structure including his airway, palate, and neck.
Her husband displayed traditional OSA side effects, including daytime sleepiness and consistent snoring. Unfortunately, it quickly became clear from conversations with Ramberg that not all healthcare providers actively screen for sleep apnea, meaning Alexander herself had to advocate for her family to receive a sleep test.
When they finally were tested, both her son and her husband were diagnosed with sleep apnea, each diverging down their own treatment pathway. It was around this time that Andrea joined EnsoData, leaving a sleep navigator sized-hole in the Northwestern health system. Enter Denise Alexander.
“The sleep clinic staff welcomed me with open arms,” noted Alexander on her transition into sleep medicine. “We have an incredibly close-knit work family. The pulmonary, cardiac, neurology, and hospitalist groups I work closely with every day make my job possible. It is their support and trust that make the sleep navigator program the success that it is today.”
Alexander is humble, but her own unique skills also help drive the program forward. The work she does is responsible for not only helping Northwestern capture patients that otherwise might have been missed, but also contributing around 30% of the total in-lab volume for the clinic. The clinical sleep program also drives the health system’s DME operation. Alexander supports patients throughout the process. Not only is she responsible for screening 30% of all patients, but she also supports scheduling and setting up sleep studies, guiding folks with insurance verification and authorization challenges, and monitoring patient therapies and outcomes.
“We follow our patients from beginning to end and continue to serve them long after set-up. I believe this lends to the relatively high compliance rate amongst our patients,” said Alexander.
Not the Traditional Sleep Professional Pathway
One of the ways Alexander stands out among the many amazing people in sleep medicine is her pathway to get where she is today. Alexander doesn’t hold her CCSH (she’s studying for the exam this year) and she isn’t an RPSGT, either. But her experience with patients and her knowledge of the cardiopulmonary system as a respiratory therapist is what makes her perfect for the sleep navigation role.
Per Alexander, she relies on her “in-depth knowledge and understanding of the cardiopulmonary system, the mechanics of breathing, and the anatomic alterations of the lungs that are seen with different disorders of the lung.” She highlighted the link between poor sleep health and overall health, a topic discussed here by the National Sleep Foundation.
In short, patients who experience poor sleep are also linked to other comorbidities. This is especially true for those who struggle to sleep because of their OSA. This population is often struggling with other issues, including COPD, asthma, CHF, pulmonary hypertension, diabetes, atrial-fibrillation, and more.
“I am a respiratory therapist by background, but have always had an interest in sleep health. We know as health care providers that poor sleep can have a significant effect on overall health. I can educate patients not only on sleep apnea itself, but also many of the cardiopulmonary conditions they have and how they can be linked with each other.”
Alexander’s experience allows her to accurately gather and interpret data from both the bedside and EMR while recognizing and acknowledging the impact of a patient’s comorbidities.
OSA Screening, Patient Education, and Sleep DME Support Fuel Improved Community Health
The Northwestern Medicine health system values the health of their community, creating programs that go beyond the in-clinic setting to address patients where they are more easily reached. One example that Alexander shared is a partnership with Del Webb, a retirement community.
Alexander works with Del Webb to host sleep apnea screenings and educational sessions around HSAT and CPAP devices, among other areas of support, all from the community’s club house. Even in the face of pauses due to the pandemic, the program sessions have grown in size over the past year. Alexander’s work touches on corporate health events and other community activities, all to help screen potential patients and educate the community on the importance of sleep health.
In the future, Alexander aims to create a referral program for primary care, family medicine, and specialty groups to refer selected at-risk patients for further screening by a sleep navigator. This goal hits on a main theme our team has noticed over the first few months of 2022: sleep professionals’ roles are expanding as the greater healthcare world recognizes the importance of sleep on the overall health of a patient.
As our previous sleep story feature Sandy Smith likes to say: “sleep deserves a seat at the table,” so let’s make sure we’re not left off the dinner reservation. Thank you for taking the time to read along, and Denise, thank you for sharing your story. Until the next one.
Learn more about Sleep Navigation or read other EnsoData Sleep Stories on our Blog!
Are you ready to embrace the sleep navigator role within your health system? Take the next step in your journey with one of the following resources:
And if you’d like to read other sleep stories in our series, try out a few of the options below: