Sleep has a huge impact on everyone! Poor sleep can result in :
There is a large socioeconomic impact from people suffering with sleep disorders.
Over 40 million Americans have chronic sleep disorders.
95% of these remain undiagnosed.
Annual direct cost of sleep related problems is estimated at $ 16 Billion.
There is an additional $ 50 - $100 Billion in indirect costs ( accidents, hospitalization and death ).
More than 100,000 motor vehicle accidents annually are sleep related
Disasters such as Three Mile Island, Chernobyl and the Exxon Valdez were officially attributed to judgment errors due to sleepiness and fatigue. *
* Statistics from the National Sleep Foundation and American Academy of Sleep Medicine
How are sleep disorders diagnosed?
First, the patient must tell their physician that they’re having a problem.
Many times, sleep disorders can go undiagnosed and untreated when patients don’t tell their doctor that they’re having a problem or if their physician doesn’t ask them about their sleep. Sometimes, sleep disorders symptoms are attributed to other medical illnesses or to medications.
Once it has been acknowledged that a person has a sleep problem, a complete history and physical and sleep specific history is performed. Not all sleep disorders require further information but some require that an overnight sleep study (polysomnogram) be performed to make an accurate diagnosis.
Rarely, a daytime nap study (Multiple Sleep Latency Test or MSLT) or daytime measure of wakefulness study (Maintenance of Wakefulness Test or MWT) is required to assist in making the diagnosis. If sleep apnea is the only sleep disorder that is suspected, then depending on your insurance companies coverage, a HST or Home Sleep Test may be ordered.
Home Sleep Tests (HST) only diagnose or screen for one sleep disorder, sleep apnea. If this is the test ordered by your physician, you will pick up the recorder around 4:00pm on the day the test is scheduled. We will demonstrate how to connect the sensors as well as provide you with written, illustrated instructions with a phone number to call should you require further assistance. You will be required to return the recorder the following morning by 11:00am. Your HST will be scored and analyzed and the sleep physician will read the test. You will be scheduled for a return sleep clinic appointment with your physician to review the HST results with a recommendation for treatment.
Some private insurers consider these tests to be experimental where others will only approve a home sleep test. A negative HST isn’t always conclusive and if symptoms persist, then an attended Sleep Study should be considered.
Overnight Sleep Studies or Polysomnograms
Overnight Sleep Studies are performed in our Fully Accreditated Sleep Disorders Center or in some cases, an at Home Sleep Test may be performed. Sleep studies that are performed in Sleep Disorders Centers are considered to be the “gold standard”.
A sleep study is a recording of various physiological measurements that include brain activity, breathing through your nose and mouth, eye movements, chin muscles, heart rhythm, respiratory effort (chest and stomach movements during breathing), leg muscles and blood oxygen levels.
A Registered Technologist will be present throughout the night continuously monitoring you.
The sensors or electrodes that are used to record this information are designed to be as comfortable as possible and are not painful. Your skin will be prepped prior to the application of the sensors to remove dead skin cells so that a good signal will be recorded. The sensors will feel somewhat strange initially but most people do not find them uncomfortable or an obstacle to falling asleep.
We recognize that your sleep in the sleep disorders center may be different than your sleep at home. Usually it will take you a bit longer to fall asleep but most people will sleep. This usually will not interfere with obtaining the necessary information from your sleep study in order to make a diagnosis.
The sleep disorder center bedrooms are designed to be as comfortable as possible and are not “clinical” looking. They look more like a hotel room with a television and private bathrooms.
When you are scheduled for a sleep study, you will be asked to arrive at 8:00pm or 8:30pm. A highly trained sleep technologist will greet you and show you to your room. They will explain everything that will happen during your stay and try to make you as comfortable as possible. There will be some paperwork to complete upon your arrival and you should bring the sleep questionnaires that were previously provided with you. The technologists stay awake all night while you sleep to make sure that you are safe and to monitor you throughout the night.
You should refrain from consuming anything with caffeine after 3:00pm on the day of your test and try to keep busy and not take any naps. Take all of your normal medications unless otherwise instructed by your sleep physician.
You will be able to roll over and change positions almost as easily as you would at home because the sensor wires will be gathered into a ponytail behind your head. You will not become tangled in the wires! You should feel free to sleep in your usual position although we may ask that you try to spend time sleeping on your back during the night. We like to record you sleeping while on your sides and on your back. Don’t worry if you don’t usually sleep in one of these positions. Most of us turn during the night and spend a little bit of time sleeping on our back and on our side(s), even if we think that we don’t!
If you need to use the bathroom during the night, it is not a problem! All you will need to do is say out loud that you need to go to the bathroom and the technologist will come in and “unplug” you so that you may get up and go! It is not a problem and you may get up as many times as you need to. There is a microphone in the ceiling of the sleep bedroom so that the technologist may hear your breathing / snoring during the night as well as if you call for assistance.
Your sleep study will be approximately 1000 pages in length! Its analysis and interpretation is part of a complex process. Many hours of work are required by specially trained sleep specialists to score and analyze the study. All of the data recorded will be reviewed in detail. After the test is scored and analyzed,
Dr. Maas or Dr. Monge, both are board certified in sleep medicine, will review the entire sleep study and will make a diagnosis from the data recorded, your comprehensive sleep history and physical as well as from the sleep questionnaires that you’ve completed. Then accordingly, they will make recommendations for treatment of your sleep disorder. If you have a sleep disorder, we should be able to diagnose it from all of this information.
You will be scheduled for a return sleep clinic appointment with your sleep physician to review your sleep study. Your sleep physician will review the results with you in detail and then will make recommendations at that time for the treatment of your sleep disorder.
We will ask that you continue to follow up with us so that we may monitor your progress with the prescribed course of treatment.
Our goal is to help you feel better and help prevent other medical problems that an untreated sleep disorder can lead to.
We Want You To Have Better Nights for Better Days!