Cook Islands is addressing the underdiagnosed issue of sleep apnoea through a new sleep clinic initiative, with the aim of improving public health and reducing related health complications.

Sleep apnoea is “under diagnosed” in the Cook Islands, according to Te Marae Ora chief medical officer, Dr Koko Lwin.

Sleep apnoea is characterised by repeated interruptions in breathing during sleep, leading to disrupted rest and a range of health complications, including cardiovascular issues and reduced quality of life.

This week, Te Marae Ora launched its sleep apnoea “Sleep Clinic” initiative introduced by Dr Lwin.

“Sleep apnoea is an underestimated health issue in Rarotonga,” said Dr Lwin.

Te Marae Ora has procured two “ApnoeaLink” devices to diagnose sleep apnoea. One machine is at the Rarotonga Hospital medical clinic and the other at the Tupapa Primary Health Care Clinic.

“We are doing trial run screening with these devices on our own staff for pilot testing,” said Dr Lwin.

Early next year, sleep apnoea specialists from Australia will be bringing with them 20 – 30 continuous positive airway pressure (CPAP) machines – a common treatment for obstructive sleep apnoea that uses a hose connected to a mask to deliver constant and steady air pressure to help patients breathe while they sleep.

Dr Lwin knows of two patients who have returned from New Zealand with a CPAP machine.

Dr Te Ariki Faireka suffers from sleep apnoea. He shared his personal journey with this condition shedding light on the importance of awareness and treatment.

“We have to destigmatise this health issue, our people are too embarrassed to acknowledge that they need to use the CPAP machine,” said Dr Faireka.

His sleep apnoea started when he was young.

When he was in boarding school at Auckland Grammer, he was bullied because of his snoring.

“I couldn’t control it, every time I fell asleep, I would snore,” he said.

He said the boys in his dorm room would pull him off his top bunk bed.

“It wasn’t fun growing up at that time, I knew I had an issue then but I didn’t really do much about it until later.”

Fortunately, while working in Hokianga in a fellowship programme he had the opportunity to have a test done since one of his tutors was a sleep specialist.

“I was diagnosed with severe sleep apnoea. Every night I would stop breathing a few hundred times, I would wake up, that’s a reflex.”

He purchased his own CPAP machine that he still uses today.

Dr Faireka said there are self-assessment tests online for people who want to know if they have sleep apnoea.

“We need to assess the problem properly and it will help our NCD (non-communicable-diseases) cases,” Dr Faireka said.

Dr Lwin was motivated to focus on the sleep clinic project when he attended the Pasifika Medical Association conference last year at Te Are Karioi Nui.

On Monday, Te Marae Ora, in collaboration with the Pacific Community (SPC) and the Cook Islands Nursing Council, also launched the Bachelor of Nursing Internship document, Postgraduate Midwifery Internship, Postgraduate Midwifery Internship guiding documents and the Baby Friendly Hospital Initiative (BFHI).

Te Marae Ora acknowledged visiting specialist in midwifery and breastfeeding, Karen Palmer, RN, RM, IBCLC, for her work in the development of the Baby Friendly Hospital Initiative and Policy with chief nursing officer, Nga Maea.

Palmer said BFHI is a World Health and UNICEF initiative to ensure all maternity facilities around the world promote, protect and support breastfeeding.

It lays down a set of standards for maternity units to follow.

“Perhaps the biggest ‘win’ to come out of the BFHI development process has been the commencement of the Community Midwifery Postnatal Service,” Palmer said.

“This service has been running for three months on Rarotonga and is very popular. It has already shown a lift in breastfeeding numbers at six weeks and reduced rehospitalisation for problems.”

Correction: Karen Palmer, not Dr Karen Hammad as incorrectly stated in Tuesday’s article, was present at the launch of the TMO policies on Monday. Dr Hammad is a nursing tutor from SPC who was in Rarotonga a few months ago to support Te Marae Ora’s nursing transition work.