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core medical services
sleep care services
sleep study | narcolepsy | insomnia sleep apnea | CPAP | sleep PLMD Sleep Study Wayne Hospital Sleep Studies By Tom Hoffmann Sleep Study Technician A sleep study is a medical test performed while you sleep at night. This test is used to evaluate and diagnose a sleep disorder. Sleep Studies are safe and noninvasive procedures that provide valuable information to your physician. Sleep studies are a covered benefit under most insurance plans. Our staff will contact your insurance company and arrange payment. Sleep studies are done on an outpatient basis, so you will not be admitted to the hospital. You will have a private room with a television. The night will begin with some paperwork and health questionnaires that aid in your diagnosis and treatment. After the paperwork is completed, you will be asked to change into your sleep attire. Before the sleep study begins, the Sleep Technician will apply several monitors to your body that record information while you sleep. The setup includes nine electrodes that will be glued to your scalp. These electrodes record brain waves and show when you are awake and sleep. You do not need to cut or shave your hair for this procedure. The glue is dissolved with water and is easy to clean out in the morning. Also, you will have four electrodes taped to your chin and the temple area to record chin and eye movements. There will also be a breathing sensor taped to the area between the nose and upper lip to monitor your breathing. This sensor does not block your airways so you will be able to breathe normally. Since we monitor your heart throughout the night, we attach adhesive electrodes to your shoulders and one to the side of your chest. Two electrodes are taped to each leg to record all leg movements. Also, you will have a cloth belt placed around your chest and abdomen to monitor your breathing. These belts are not restrictive and fit over your clothing. Finally, a band-aid type probe is wrapped around a finger to record the amount of oxygen in your blood. This setup is painless and you may watch television or read during the procedure. Before the sleep study begins, the Sleep Technician will provide you with information regarding common sleep disorders and treatments. A common treatment that may be used during your visit is Continuous Positive Airway Pressure (OPAP). The Sleep Technician will introduce you to this equipment and answer all your questions. The sleep study will begin around 10:00 to 11:00 P.M. and will last until 5:30 to 7:00 A.M. During the sleep study, the door to your room will be closed and the lights and television turned off. We do not allow cellular phones or pagers as this might disrupt your sleep. Your room is monitored with a video camera and a telecom to allow communication between yourself and the Technician. Although you have many electrodes attached to your body, you will be able to get out of bed and use the restroom or get a drink. Once the sleep study ends, the Technician will disconnect all the wires and you will be given the opportunity to take a shower. The results of your sleep study will be available during your follow up visit with your physician. A sleep study can now be conducted at Wayne Hospital. Simply call 937-547-5665 for more information. ^ back to top Narcolepsy What is narcolepsy? Narcolepsy is a sleep disorder that is characterized by excessive daytime sleepiness and sudden sleep attacks. This disorder is a chronic, life long illness that requires medical attention and treatment in most cases. Who gets narcolepsy? Over 200,000 people in the United States have narcolepsy but many go undiagnosed. Men and women of all ages can be troubled by this disorder with symptoms usually presenting in adolescence or as a young adult. What are the symptoms? People with narcolepsy may experience overwhelming sleepiness and uncontrollable sleep attacks during mundane situations, such as; reading, watching television, driving, sitting in a meeting, or in a classroom. Narcoleptics also experience fragmented or disrupted sleep during the night that causes frequent awakenings. Some other key symptoms of narcolepsy are:
What is the cause and treatment? This disorder has no known cause but may be hereditary. Although there is no cure for Narcolepsy, it can be managed through good sleep hygiene habits and medication. There are many narcoleptics that lead normal lives with the right treatment and medical supervision. Where can I find more information on narcolepsy? American Sleep Disorders Association 6301 Bandel Road #101 Rochester, MN 55901 www.asda.org Narcolepsy Network 277 Fairfield Road #310 B Fairfield, NJ 07004 973-276-0115 www.narcolepsynetwork.org National Sleep Foundation 729 Fifteenth Street NW Fourth Floor Washington, DC 20005 www.sleepfoundation.org ^ back to top Insomnia Insomnia is the difficulty or inability to fall to sleep or maintain sleep. There are varying levels of insomnia that range from transient to short-term to chronic. Transient insomnia lasts up to a few days and is associated with stress or excitement. An upcoming meeting, event, or travel may cause this anxiety and type of insomnia. Once the situation has passed, then the insomnia usually subsides. Short-term insomnia lasts longer by a few weeks and may also be attributed to ongoing anxiety or stress. Again, once this stress is relieved so is the insomnia and sleep returns to normal. The most severe type is chronic insomnia, which lasts from months to years. This sleep disorder can cause daytime fatigue, irritability, or impair daily function. Who gets insomnia? Transient and short-term insomnia may affect everyone at some point in his or her life. It has been estimated that over 35 million Americans complain of chronic insomnia. Insomnia can affect men and women of all ages. What is the cause and treatment? Insomnia is a result of another underlying problem or disorder. This underlying problem must first be managed and treated for there to be an improvement or elimination of insomnia. These factors include:
Where can I find more information on insomnia? American Sleep Disorders Association 6301 Bandel Road #101 Rochester, MN 55901 www.asda.org Narcolepsy Network 277 Fairfield Road #310 B Fairfield, NJ 07004 973-276-0115 www.narcolepsynetwork.org National Sleep Foundation 729 Fifteenth Street NW Fourth Floor Washington, DC 20005 www.sleepfoundation.org ^ back to top Sleep Apnea Sleep apnea is the cessation of breathing during sleep. During an apnea there is no airflow into or out of the lungs. Apneas can last from 10 seconds to more than 30 seconds and can occur hundreds of times throughout the night. This interruption of airflow prevents much needed oxygen from entering the bloodstream via the lungs and prevents the release of carbon dioxide, the body's waste product. When oxygen levels in the blood decline and carbon dioxide levels rise, the brain is stimulated. The brain then signals the heart and the muscles in charge of respiration to work harder. As a result, there is an increased stress placed upon the body during each apnea. Sleep quality is also affected by the repetitive brain stimulations. These stimulations disrupt the sleep cycle by interrupting the deeper stages of sleep or by causing a complete awakening. Apnea is a serious condition that can contribute to numerous other health problems such as hypertension, stroke, heart attack, impotency, and excessive daytime sleepiness. There are three different types of sleep apnea, central, obstructive, and mixed. A central apnea (GSA) occurs when the brain fails to send a signal or stimulate the respiratory muscles. As a result of this brain malfunction, the respiratory muscles do not initiate inspiration and airflow to the lungs ceases. An obstructive apnea (OSA) is the most common sleep breathing disorder that is treated in the sleep lab. Once a person falls to sleep, the muscles throughout the body relax, including airway muscles. An OSA occurs when the airway has been obstructed and airflow has been partially to completely restricted. This obstruction can be caused by excessive tissue, enlarged tonsils, adenoids, or uvula or by the collapse of the airway due to muscle relaxation. Finally, a mixed apnea (MSA) contains both of these apneas together. There is a central apnea that usually occurs first and then the obstructive component that follows. Who gets sleep apnea? Sleep apnea can affect men and women of all ages. Although uncommon, children can also be afflicted by sleep apnea. The incidence of GSA increases with age. OSA is primarily seen in 35–50 year old men. However, the incidence of OSA increases once women reach menopause. Approximately, every 1 in 100 people in America suffer from obstructive sleep apnea. Other predisposing factors include people who are overweight, those with anatomical malformations, and certain medications. Overweight individuals increase their risk for developing OSA because of the excessive adipose or fatty tissue that surrounds the airway. This excessive tissue places extra weight on the airways, thus causing airway collapse once asleep. Anatomical malformations such as enlarged tonsils, adenoids, uvula, etc. may restrict airflow. Medications such as sleeping pills or other sedatives also increase the risk for sleep apnea by decreasing airway muscle tone. What are the symptoms? Those suffering from sleep apnea may experience different symptoms unique to their type of apnea. Symptoms that are common to all types include:
How do I find out if I have sleep apnea? Diagnosis of sleep apnea requires an evaluation by your Physician and a visit to the sleep laboratory. The sleep study used to diagnose sleep apnea is the Polysomnogram. This test involves spending one to two nights in the sleep lab while having several different aspects of your sleep recorded and analyzed. Generally, the first night is used to establish and document the severity of your sleep apnea. The second night is needed to initiate and evaluate treatment. What are the treatment options for sleep apnea? There are some general guidelines to follow for individuals with sleep apnea:
Other sources for more information about sleep apnea? American Sleep Disorders Association 6301 Bandel Road #101 Rochester, MN 55901 www.asda.org National Sleep Foundation 729 Fifteenth Street NW Fourth Floor Washington, DC 20005 www.sleepfoundation.org ^ back to top CPAP What is CPAP? Continuous Positive Airway Pressure or CPAP is the choice of treatment for many people who suffer from obstructive sleep apnea (OSA). A CPAP device includes a small lightweight machine, tubing, nose mask, and headgear. Who needs CPAP? OPAP is used to treat breathing disorders during sleep. People with central, mixed, and the more common obstructive sleep apnea may all benefit from CPAP therapy. How does CPAP work? During sleep, muscles in the airway relax allowing collapse and any excessive tissue in the throat, such as tonsils, adenoids, tongue, or the uvula to block the airway. This system gently delivers machine-generated air into the airway through a nasal mask. This air is positive pressure and acts as a splint to keep the airway open, thus eliminating obstructions. This provides immediate relief to OSA sufferers by providing uninterrupted breathing and sleep. Another mode of treatment is called Bilevel therapy. This also involves positive pressure but at a different settings on inspiration and expiration. There is a higher pressure on inspiration which prevents obstructions and facilitates airflow into the lungs. On expiration there is a lower pressure that allows passive, easy expiration while maintaining a patent airway. What are the side effects or complications of CPAP?
The benefits of CPAP therapy are immediate but many times require a life-long commitment. CPAP is a treatment for apnea but not a cure. Apnea sufferers may try different treatment options, such as oral devices, medications, surgery, or weight loss but will probably not be cured by these options either. These other treatments may improve the severity of the breathing disorder but CPAP has shown to be most effective. CPAP compliance, as with any other treatment, is the key to success for treatment of sleep apnea. It is imperative that people on CPAP use it every time they sleep. Because CPAP immediately eliminates apneas and obstructions, there is an improvement in sleep quality and oxygen levels in the blood. Once this happens, the symptoms associated with sleep apnea may subside. A person may feel rejuvenated, with an increased energy level, may not feel as fatigued throughout the day, and experience improved job/task performance. Treating sleep apnea may also decrease the risk for hypertension, heart attack, and stroke. CPAP may also benefit sleep partners, since they won’t be bothered by snoring anymore! An evaluation, sleep study, and prescription are needed by a Physician to get started on CPAP therapy. Once all of this has been completed, the Physician will order the CPAP through a homecare company. The company provides the CPAP system and a Nurse or Respiratory Therapist completes the initial set up and education. Follow up with the Physician and the homecare company is needed to assess the progress and success of treatment. For more information about CPAP or other services offered by the Wayne Hospital Sleep Lab, call 937-547-5665. Other sources for information about sleep apnea and CPAP therapy? American Sleep Disorders Association 6301 Bandel Road #101 Rochester, MN 55901 www.asda.org National Sleep Foundation 729 Fifteenth Street NW Fourth Floor Washington, DC 20005 www.sleepfoundation.org ^ back to top Sleep PLMD Periodic Limb Movement Disorder or PLMD is a movement disorder that occurs during sleep and is characterized by periodic, repetitive mild to violent leg, foot, ankle, hip, or arm jerks. These movements usually occur as often as every 4 to 90 seconds in a consistent regular pattern. PLMD affects the quality of sleep becausa of frequent arousals due to the limb movements. Although some people are not aware of the movements or sleep arousals, the sleep cycle is continually interrupted. PLMD usually presents upon sleep onset and may subside by the early morning around 4 a.m. Some people that suffer from PLMD may also suffer from Restless Leg Syndrome (RLS). RLS is characterized by an uncomfortable creeping, crawling, or tingling sensation in the legs or arms. These sensations usually accompany an urge or need to move the afflicted limb for relief. RLS generally presents in the evenings prior to bedtime. Who gets PLMD? PLMD occurs in men and women of all ages but the incidence increases with age. There is evidence that PLMD is hereditary. What are the symptoms? Symptoms of PLMD vary depending upon the severity of movements and occurrence. People that realize movements throughout the night describe limb jerking, difficulty falling to sleep, maintaining sleep, and poor sleep quality. Others that don’t notice the movements describe excessive daytime sleepiness and fatigue. These sufferers may be told by their be partners that they kick throughout the night. How can I find out if I have PLMD? Diagnosis of PLMD includes an evaluation by your Physician and a visit to the sleep lab for testing. The sleep study used to test for PLMD is the Polysomnogram (PSG). The PSG is a procedure that involves staying overnight in the sleep lab while having several different aspects of your sleep recorded and analyzed. An interview with your sleep partner might also be necessary to see if you frequently jerk or move throughout the night. What is the cause and treatment? PLMD has no known cause but can be related to the following:
Where can I find more information about PLMD? American Sleep Disorders Association 6301 Bandel Road #101 Rochester, MN 55901 www.asda.org National Sleep Foundation 729 Fifteenth Street NW Fourth Floor Washington, DC 20005 www.sleepfoundation.org ^ back to top |
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