The Sleep Medicine Center

Testing is performed over one or two nights at our state-of-the-art CaroMont Health Sleep Medicine Center in one of our eight sleep diagnostic bedrooms. A polysomnogram test is performed throughout the night in a private room equipped with sophisticated devices for monitoring sleep patterns, breathing, heart activity and body movements. During testing, every effort is made to maintain comfort and regular sleep routines. Once a diagnosis is made, a follow-up appointment will be scheduled to discuss treatment. We offer timely scheduling and CPAP and BiPAP Support.

Excessive snoring can be more than a nuisance. It is often a sign of sleep apnea, a serious medical disorder which affects more than 10 million Americans. People with sleep apnea stop breathing periodically while they are sleeping. These episodes occur repeatedly and can last up to 90 seconds. In most cases, this is caused by closure or obstruction of the upper airway (obstructive sleep apnea). It can also be caused by the brain’s failure to send the proper signal to the respiratory muscles (central sleep apnea). Central sleep apnea can be the result of neurological or other medical problems. The effects can be short and long-term, including excessive daytime sleepiness, fatigue, personality changes, morning headaches, hypertension, cardiovascular disease, depression and even death.

Because it occurs during sleep, apnea can easily go undetected. Often, it is a bed partner who first notices the warning signs that include:

• Loud irregular snoring, snorting or gasping for breath.
• Pauses in breathing that can last 10-90 seconds.
• Restless sleep or sudden body movements before breathing again.
• Excessive sweating during sleep.

Sleep apnea is treatable once it is properly diagnosed. The type of treatment depends on severity and symptoms. Treatments include weight-loss, mouth-piece devices, surgery or CPAP therapy.

More than 70 million Americans have experienced insomnia in the past year. Insomnia is the inability to fall or stay asleep. It can be transient, lasting a few days or weeks, or it can be chronic, lasting for months to years. While any degree of insomnia can lead to problems, by far the most serious form is chronic insomnia, which is due to medical, neurological or psychiatric problems and may require a thorough evaluation.

Stress can often be a contributing factor. Other factors are poor sleep habits, extended use of medications or drugs and excessive intake of alcohol. Polysomnograms are usually not required in the evaluation of insomnia; however, they may be helpful in specific cases.

Unpleasant sensations in the legs described as creeping, crawling, tingling or pulling are common symptoms in restless leg syndrome (RLS). These sensations may be felt from the thigh to the ankle, in one or both legs, and can occur when lying down or sitting for long periods. Symptoms worsen during relaxation, making falling asleep difficult. Daytime sleepiness can result, as sleep quality is impaired by neurological activity of these movements.

In some RLS cases, periodic limb movement disorder (PLMD) is present, where involuntary jerking or bending leg movements during sleep can occur as hundreds of movements per night. PLMD inhibits restful sleep, which can lead to chronic sleep deprivation. A sleep study may be performed to diagnose and treat RLS and PLMD. Treatments include medication, physical therapies and sleep hygiene.

A neurological disorder and life-long illness, narcolepsy is characterized by sudden and uncontrollable sleep attacks and persistent daytime sleepiness. Because the attacks can occur anywhere, at anytime, they can be very dangerous, even life-threatening. Symptoms include:

• Excessive daytime sleepiness.
• Uncontrollable sleep attacks.
• Cataplexy – a sudden loss of muscle tone.
• Automatic behaviors – performing tasks without consciously thinking.
• Sleep paralysis – inability to move upon waking up.
• Hypnagogic hallucinations – intense, vivid dreams.

Proper diagnosis of narcolepsy requires an overnight sleep test and a daytime latency test with a follow-up evaluation. Treatment involves a combination of medication, educational support and personal care.

Toddlers to adolescents can suffer from apnea, insomnia and parasomnias. Parasomnias are unusual behaviors during sleep such as sleepwalking, bed-wetting and night terrors. Symptoms of childhood sleep disorders can be entirely different from adults. In children, apnea can cause daytime hyperactivity, school difficulties, irritability and even failure to grow physically. Sleep problems in children can be solved with simple behavioral interventions without medications or surgery.