Sleep Disorders News
Graymark Healthcare to Focus on Treatment of Sleep Disorders with Completed Sale of Independent Pharmacy Business Assets to Walgreens
OKLAHOMA CITY, Dec. 7, 2010 /PRNewswire-FirstCall/ — Graymark Healthcare, Inc. (Nasdaq: GRMH) has closed the previously announced sale of substantially all the assets of its ApothecaryRx’s retail pharmacy business to Walgreens Co. (NYSE: WAG, Nasdaq: WAG). ApothecaryRx operated 18 pharmacies across five states.
The transaction allows Graymark to focus on its core business of providing comprehensive care for sleep disorders, primarily obstructive sleep apnea, including diagnosis, therapy, and ongoing clinical and product support.
“Millions of Americans suffer from obstructive sleep apnea, and many aren’t aware they have a problem or that treatment is available in their communities,” said Stanton Nelson, chairman and CEO of Graymark Healthcare. “As a pure-play sleep disorders company focused primarily on obstructive sleep apnea, we believe Graymark is better able to help people sleep better.”
Graymark launched the nation’s first comprehensive care model for patients with obstructive sleep apnea in 2009 and has grown into one of the nation’s largest aggregators of sleep therapy providers.
“Given our substantially improved balance sheet as a result of this sale, we are ideally positioned to execute on our plans to grow through the acquisition of treatment centers, as well as through developing alliances with hospitals and other health care providers,” added Nelson. “The rapidly growing sleep apnea marketplace offers us an opportunity for significant growth and margin expansion.”
The sale to Walgreens was comprised of substantially all of the assets of ApothecaryRx for $25.5 million, plus approximately $3.8 million for inventory. Graymark expects to realize net proceeds of approximately $33 million from the completed divestiture, including collection of retained accounts receivable, and proceeds from the liquidation of remaining ApothecaryRx assets.
The Healthcare Investment Banking Group of Morgan Joseph LLC served as the financial advisor to Graymark in this transaction, with Greenberg Traurig LLP and Commercial Law Group, P.C. serving as Graymark’s legal advisors.
About Graymark Healthcare
Graymark Healthcare, Inc. is the nation’s second largest provider of sleep medicine diagnosis and treatment. Graymark owns and operates diagnostic sleep centers that treat a wide range of sleep disorders, and operates a medical equipment supply company that provides disposable and durable medical equipment. For more information, please visit www.graymarkhealthcare.com.
This press release may contain forward-looking statements that are based on the company’s current expectations, forecasts and assumptions. Forward-looking statements involve risks and uncertainties that could cause actual outcomes and results to differ materially from the company’s expectations, forecasts and assumptions. These risks and uncertainties include risks and uncertainties not in the control of the company, including, without limitation, the current economic climate and other risks and uncertainties, including those enumerated and described in the company’s filings with the Securities and Exchange Commission, which are available on the SEC’s Web site (www.sec.gov). Unless otherwise required by law, the company disclaims any intention or obligation to update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.
Weird Things That Happen When We Fall Asleep: REM Behavior Disorder
Recently, on the NPR show “This American Life,” comedian Mike Birbiglia talked about how he nearly killed himself while he slept—more than once. It seems that he has a disorder called REM Behavior Disorder, which makes a person act out his dreams. Normally the body is paralyzed (or nearly so) during sleep so this sort of thing doesn’t happen. But, in people with REM Behavior Disorder, the “sleep paralysis” mechanism fails.
As a comedian, Birbiglia makes jokes about climbing high onto a bookcase in his sleep——in his dream he was on a podium receiving an Olympic medal for vacuuming—and then falling off of it. Another time, he jumped through a second-story hotel window in his underwear “to escape a missile.” Since he survived, we can marvel (and, perhaps, laugh) at this escapade, but I’m guessing these events weren’t funny at the time—he ended up bruised and needing emergency medical attention.
REM Behavior Disorder is one of several uncommon sleep disorders–it affects about half of 1% of the population. Maybe it’s the rareness of these “extreme” sleep behaviors that makes them so interesting. Or maybe it’s just that these sleep-related experiences are so bizarre. They’re certainly not the usual series of events we anticipate when lying down for a good night’s sleep. In any case, here’s a brief roundup of some interesting—and, often, frightening—sleep disorders.
REM Behavior Disorder
The name REM Behavior Disorder comes from the stage of sleep when the eyes move rapidly (Rapid Eye Movement), and dreaming occurs. In most people, the brain is extremely active during REM sleep, but the body is paralyzed, except for some occasional muscle twitches. And, of course, the muscles needed to keep you alive—the breathing muscles and the heart – are still active and so are your eyes. While the body is quiet, the brain is racing along. Although most of us are blissfully unaware, deep sleep is actually a time of active brain activity.
REM Behavior Disorder was first described in cats and was only recently reported in humans—the first human case was described in 1986. Scientists don’t know why the bodies of people with REM Behavior Disorder aren’t paralyzed as they should be during REM sleep. Experts believe the acting out of dreams is a problem with neurotransmitters (chemicals in the brain), but different studies point to different neurotransmitters. It may be that different neurotransmitters are to blame in different people.
REM Behavior Disorder may be accompanied by a number of brain diseases including Parkinson’s disease, dementia, and multiple system atrophy (a degenerative brain disease). In nearly half of cases, REM Behavior Disorder may be related to alcohol withdrawal or withdrawal from a sedative or antidepressant medication. But it can occur for no apparent reason in otherwise healthy people.
There are many medications that can help people with REM Behavior Disorder. However, since so few people are affected by the disorder, we don’t have large, high quality studies to tell us which medications are best. As a result, it can take some trial and error to find a medication that’s right for an individual with this condition. A sleep specialist can help.
It’s important to make the bedroom of people with REM Behavior Disorder as safe as possible until they can get their nighttime behavior under control. It may be a good idea to put the mattress directly on the floor, pad the corners of furniture in the room, remove anything fragile or dangerous from the room, and have bed partners sleep in another room.
Sleep paralysis
In a way, sleep paralysis is the opposite problem of REM Behavior Disorder: instead of acting out dreams while asleep, a person with sleep paralysis is awake but cannot move. It’s common, affecting up to 40% of the population. It can be associated with sleep deprivation, other sleep disorders, psychological stress, or certain medications. Fortunately, it lasts only a few seconds or minutes and usually requires no treatment. Still, it can be scary.
The teenager who sleeps for 10 days
Trying to wake Louisa during one of her episodes is difficult
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While most teenagers struggle to get out of bed in a morning, Louisa Ball might take 10 days to fully wake from her slumber, due to a very rare neurological disorder. So what’s it like living with Kleine-Levin Syndrome?
Louisa has slept through holidays, friends’ birthdays and half of her GCSEs.
In 2008, aged 14, she had been suffering from flu-like symptoms. She was at her school in Sussex when she started nodding off in class and behaving strangely.
“I didn’t know what I was doing, what I was saying, everyone thought ‘hey this isn’t right,'” she recalls.
“I was hallucinating and after that I don’t remember anything. All of a sudden it just went blank and I just slept for 10 days. I woke up and I was fine again.”
Her parents Rick and Lottie watched their daughter becoming fidgety and with unusual facial expressions as she sank into sleep. The first time was a frightening experience for them, although Louisa herself says she wasn’t scared by the episode, more puzzled.
“It was really weird, no one knew what was wrong, we just thought it wasn’t going to happen again. And then four weeks later it happened again.”
She was finally diagnosed with Kleine-Levin Syndrome (KLS). There is no known cause or cure but Louisa says it was good to know what it was and that it wasn’t life threatening.
The average time it takes to diagnose the condition is four years, because there is no test and so it requires a process of elimination of other disorders.
The disease was named after Willi Kleine, a neurologist from Frankfurt, and Max Levin, a psychiatrist from New York, who identified patients with similar symptoms in 1925 and 1936.
Louisa is unusual as KLS usually affects teenage boys, who can also exhibit hypersexuality and inappropriate behaviour.
As well as excessive sleeping, symptoms include behaviour changes, irritability, feeling in a dream-like state and binge eating, symptoms that can be mistaken for normal teenage behaviour. There are no drugs that have conclusively shown to alleviate symptoms.
‘No dreams’
People with the sleep disorder narcolepsy fall asleep immediately, but people with KLS might sleep more and more over a number of days before falling into sleep mode.
Louisa says she remembers very little when she wakes up from an episode: “It’s just blank – no dreams. Now I’ll remember a lot more that’s gone on. Before I wouldn’t remember anything at all. My dad thinks my brain is learning to cope with it more.”
So how do you deal with a disorder that takes over your life so much?
It nearly ruined Louisa’s career ambitions, because she slept through most of her GCSEs but her college allowed her to enrol and she is studying sport performance and excellence, with dreams of being a dancer.
At first, her school teachers didn’t understand, she says. “They’d give work to my brother for me to do and when I went back to school they expected me to have done it but I’d have slept for 10 days.”
Some people with KLS have complained they have lost their friends because they suddenly disappear for weeks on end but Louisa has a close knit group of girlfriends. Some even visit her when she’s sleeping, just to check she’s ok.
When she wakes up, it takes her a few days to fully come round, and her body is quite stiff so her dancing is affected for while.
“I’ve never really got upset about it but I sometimes do think ‘why me’, because I’ve always been a normal healthy person. But all of a sudden it happened and there’s no reason why it happened and that sometimes frustrates me.
“But I’ve got used to it now and learnt to live with it. I’m a special kid.”
The change in behaviour before and during a sleep episode is one of the most upsetting things for Louisa’s parents, who take it in turns to remain with her. Doctors have told the family it’s crucial to wake Louisa once a day to feed her and get her to the bathroom.
But Lottie admits it can take a while to get her to come round. “I’ve tried before to literally force her to wake up but she just starts swearing and gets so agitated and aggressive.”
After watching a video the family made of her while sleeping, Louisa says: “I look scary, it doesn’t look like me, it’s like I’m on drugs.”
Frustrated by the lack of information in the UK, Louisa was taken by her parents to the Hospital Pitié-Salpétrière in Paris, where researchers are looking into whether it is caused by a defective gene.
Many sufferers have abnormalities in their temporal lobe, the area of the brain involved in behaviour and memory. A scan of Louisa’s brain function revealed she does have abnormalities in her frontal lobe but there are no signs that this has affected her behaviour or memory.
The good news is the disease can also disappear just as suddenly as it came on. This normally happens after 10 to 15 years.
But Louisa is currently going through a good period. She was out doing Christmas shopping with her best friend this week and has not had an episode in 13 weeks. A few weeks ago she won yet another dance competition.
“It’s almost as if I’ve forgotten about it because I haven’t had one in so long.”
Louisa’s parents, however, are still watching her constantly for signs she could be heading into a sleep state.
“It’s weird – now I’ve left school I haven’t actually had an episode, they probably think I was faking it,” she jokes.