A NJ-focused sleep care program takes bold leaps in diagnosing and treating many long misunderstood ailments
When Carol Ash, MD came to Meridian Health in 2009, she worked closely with the healthcare system to help transform society’s vision of how sleep medicine is perceived.
“For a very long time, sleep was something that healthcare generally ignored,” noted Dr. Ash, who currently serves as Meridian’s director of sleep medicine. “To most doctors, sleep and its complications were a mystery. But over the past ten years, sleep research has become so vast and the value and importance of sleep has been better underscored. No different than food or oxygen, sleep is a basic necessity, and without it there can be disease…even premature death. That, and symptoms of insomnia and broken sleep can be indicators of another more serious health issue. There are more than 80 different sleep disorders chronically plaguing our patients.”
So, in the midst of national healthcare reform, Meridian set out to investigate the fragmentation within the delivery of sleep care.
“At Meridian, each of our hospitals had its own sleep center, but there was not a standard, organized approach to the delivery of that care,” Ash said. “We recognized the need to transform that—moving toward a multi-disciplinary sleep clinic that would be truly organized around patient needs.”
A dedicated treatment team was formed, consisting of a range of sleep specialists who were familiar with dozens of both common and rare sleep ailments—and Meridian’s streamlined Sleep Medicine program was born.
“Sleep Apnea has become a popular diagnosis, for example, but what a lot of general practitioners do not realize is that there are a range of underlying causes for that sleep disorder that need to be addressed,” said Ash. “Meds and a CPAP [continuous positive airway pressure] machine is not always the answer. If the patient is overweight, they may need to work with a professional to address diet issues…others may require dental devices. Lack of sleep could even be attributed to a larger neurological or cardiovascular issue. Meridian’s multidisciplinary approach puts all of those resources at the patient’s disposal. Instead of having to figure out all of the different specialties for themselves, an entire team with a full complement of specialists was organized around sleep patients and their medical conditions.”
For Dr. Ash—who explained that she was inspired to become a doctor because of her parents’ influence— that focus on individual care is all a part of a compassionate approach to medicine.
“My parents lived in England throughout World War I I—I was born in England but raised in New Jersey—and as a child they instilled some very strong values about never quitting and being able to overcome absolutely anything,” Ash said. “Their war experience and the atrocities they witnessed helped them to gain a sense of compassion…an ability to care deeply for the plight of others. It prompted me to follow a career in medicine because as a doctor I felt I could make a difference for people from all walks of life. Even as a kid, I knew it was a difficult path, but I also knew that it was one worth pursuing.”
Dr. Ash ultimately pursued general medicine and then pulmonary critical care before focusing on a specialty in sleep medicine.
“I decided to pursue general internal medicine because I believed it gave me an opportunity to help the most people in need,” she explained. “But I realized that in internal medicine I wouldn’t know everything I needed to help the most vulnerable people, and didn’t want to depend on someone else to tell me what to do.”
She became involved in the study of sleep medicine in 1992 at a time when there were only about 20 doctors in New Jersey with that focus, and only about five sleep programs at the state’s larger universities.
“Sleep was an afterthought then,” Ash said. “But because of my pulmonary background, I was drawn to it. For me it was a fascinating world with many different disorders that went well beyond Sleep Apnea.”
A graduate of Seton Hall University, Ash earned her medical degree from the University of Medicine and Dentistry of New Jersey in 1989 and did a residency in internal medicine and fellowships in pulmonary and critical care medicine before becoming a sleep medicine specialist. In addition to serving as Meridian’s director of sleep medicine, she is often featured as an expert in many publications and interviewed on television and radio, including the Today Show and Good Morning America.
“The media has been a great opportunity for me to reach a greater audience and spread awareness about different sleep disorders and treatments,” she said. “Most patients who are having problems with their sleep are usually seen by a general internist who may or may not have had any sleep training. And treating restless sleep with a sleeping pill is no different than giving a pain pill without first figuring out the cause. Sleep is a complex process, and when you have a problem, a sleep specialist is the best individual to dissect all of the different symptoms and come up with a diagnosis. That specialist has the tools to peer deeply into someone’s rest. And here at Meridian, there is a really great group of physicians and a strong group of specialists available to facilitate the services that patients need.”