Sleep Disorders Center

Our contemporary Sleep Disorders Center is the only facility in Charlotte County that is accredited by the American Academy of Sleep Medicine. We treat 83 of the most common sleep disorders.

Epworth Sleepiness Scale (ESS)

The Epworth Sleepiness Scale (ESS) is a tool used to assess a patient’s general level of sleepiness and determine if sleep disorders could be the cause of his or her problems. This questionnaire is the standard assessment tool for symptoms of sleepiness.

Click here to answer a quick questionnaire to see if you may have sleep-related issues. Scoring: 10+ Indicates Sleepiness that should be evaluated. Give our office a call at (941) 613-1777 to schedule a consultation.

The most common sleep disorders our team helps diagnose, treat, and manage include:

Sleep Apnea

Sleep apnea means that you frequently stop breathing for 10 seconds or longer during sleep. It can be mild to severe, based on the number of times an hour that you stop breathing or have slowed breathing.

Blocked or narrowed airways in your nose, mouth, or throat can cause sleep apnea. Your airway can become blocked when your throat muscles and tongue relax during sleep.

You can treat sleep apnea at home by making lifestyle changes. You also can use a PAP breathing machine that keeps tissues in the throat from blocking your airway. Or your doctor may suggest that you use a breathing device while you sleep. It helps keep your airway open. This could be a device that you put in your mouth. In some cases, surgery may be needed to remove enlarged tissues in the throat.

Narcolepsy

Everybody gets a little sleepy once in a while, during a long car ride or other times when you want to be alert. But some people cannot control their sleepiness. It is no fun to be in the middle of your workday or driving your car down the street and have an overwhelming desire to sleep. This condition is called narcolepsy.

Doctors do not know what causes narcolepsy. Your doctor may ask you to keep a sleep diary for a couple of weeks. It will help you and your doctor decide on treatment.

It often helps to take limited naps during the day. And these things might help you sleep better at night: create a good place to sleep, do things that help your mood before you go to bed, and keep a consistent sleep schedule.

Your doctor may recommend medicine to help you stay awake during the day or sleep at night

Restless Leg Syndrome

Restless legs syndrome is a common nervous system problem. People with this syndrome feel a creeping, achy, or unpleasant feeling in the legs and an overpowering urge to move them. It often occurs in the evening and at night and can lead to sleep problems and tiredness.

Your doctor may suggest doing a study of your sleep patterns to figure out what is happening when you try to sleep. Many people get relief from symptoms when they get regular exercise, eat well, and avoid caffeine, alcohol, and tobacco.

Periodic Limb Movement Disorder (PLMD)

Periodic Limb Movement Disorder (PLMD) is a condition in which a person’s legs, and sometimes arms, move repetitively and uncontrollably while he or she is asleep. These episodes of limb movement can disrupt the person’s sleep, causing insomnia or daytime sleepiness. Periodic Limb Movement symptoms are only thought to be a disorder (PLMD) when insomnia or daytime sleepiness cannot be explained by any other problem, such as Restless Legs Syndrome. Recently, it has been found that these movements are often linked to subtle breathing problems.

Rapid Eye Movement Sleep Behavior Disorder (RBD)

Because REM sleep is characterized by paralysis, the person does not move around while they are asleep. With Rapid Eye Movement Sleep Behavior Disorder (RBD), however, that paralysis is weakened. As a result, sleepers with RBD can act out their dreams, and risk injuring themselves and/or their bed partners.

RBD-related behaviors range in severity from loud talking, swearing, laughing and shouting to reaching, grabbing, leaping out of bed, and crawling. Walking is uncommon, however.

The person usually remembers dreams that are associated with RBD episodes, including nightmares in which the patient tries to defend him or herself from an attacker. The International Classification of Sleep Disorders (ICSD) lists RBD as a REM-Related Parasomnia.

Snoring

Snoring is a noise that you may make while breathing during sleep. You snore when the flow of air from your mouth or nose to your lungs makes the tissues of your throat vibrate while you sleep. This usually is caused by a blockage or narrowing in your nose, mouth, or throat (airway).

Snoring can be soft, loud, raspy, harsh, hoarse, or fluttering. Your bed partner may notice that you sleep with your mouth open and that you are restless while sleeping. If snoring interferes with your or your bed partner’s sleep, either or both of you may feel tired during the day.

You may be able to help reduce your snoring by making changes in your activities and in the way you sleep.

Types of Sleep Studies

Overnight, Attended Sleep Study

Overnight, attended sleep studies—known as nocturnal polysomnograms (PSG)—are conducted in a sleep lab where you’re monitored (or attended) all night by a trained sleep technologist. A sleep study may be recommended to diagnose or rule out a sleep disorder such as Obstructive Sleep Apnea, narcolepsy, or Periodic Limb Movement Disorder. You may also undergo a sleep study if you have already been diagnosed with a sleep disorder so that a treatment plan can be created or adjusted.

During the study, we assess your sleep stages by recording brainwaves, eye movements, and muscle tone. We also carefully examine your breathing throughout the night by measuring your airflow, breathing effort, snoring, and oxygen saturation. Leg movements and heart rate are also monitored to provide a comprehensive evaluation of your sleep.

Collecting all this data requires the sleep technologist to apply numerous sensors before you go to sleep. The set up procedure is quite complex and usually takes about 60 minutes. The hook up includes applying sensors on the scalp, face, throat, chest, finger, and legs.

There are three common types of overnight attended sleep studies:

  • Diagnostic Evaluation: This study measures your sleep without any intervention. It is typically used to diagnose or rule out a disorder.
  • Titration: During a titration, the technologist adjusts the setting on the PAP machine to determine how much air pressure is needed to normalize your breathing.
  • Split Night Study:  A split night study is a combination of a diagnostic and titration study. The first half is used to diagnose sleep apnea and then midway through the night PAP is started. The sleep tech spends the rest of the night adjusting the pressure until breathing has been normalized.

Home Sleep Test

A Home Sleep Test (HST) is a simplified version of an overnight, attended sleep study that focuses on nocturnal breathing. HSTs are only used to diagnose or rule out obstructive sleep apnea (OSA). Because the emphasis is on breathing, it is possible to use fewer sensors.

Not all patients are good candidates for a home test and not all insurance carriers will cover the cost of the study. If you need a sleep study, your doctor will make a recommendation based on your specific situation whether you should have your test done in the lab or at home.

If you have been scheduled for a home sleep study, you will need to pick up the equipment from our Port Charlotte office. You will be given instructions on how to properly place the sensors and start the study. That night, before bed, you will need to secure sensors as instructed. These sensors will record information about your airflow, snoring, breathing effort, heart rate, and oxygen levels throughout the night.

In the morning, you will remove the sensors and recording device, place everything in the bag that was given to you at pick up, and return the equipment to the Sleep Disorders Center so we can download and analyze the data.

Daytime, Attended Sleep Study

It can be very helpful to monitor a person during the day because it allows us to gain more insight about his or her daytime sleepiness. A daytime study is almost always preceded by an overnight sleep study. The daytime study uses many of the same sensors on the scalp and face we use for a nighttime study, but does not usually include the sensors used to monitor breathing.

There are two different tests we conduct during the day:

  • Multiple Sleep Latency Test (MSLT): This test is the most common way to objectively quantify sleepiness and is a key test in diagnosing narcolepsy. The MSLT is comprised of 4-5 trials or “naps” spaced throughout the day. During the test, you are asked to relax and try to fall asleep.
    There are two key pieces of information we gather from this study—the mean sleep latency, which is the average time it took you to fall asleep for all your naps, and the number of REM periods. Whether or not REM sleep was identified is evaluated because it is atypical for a normal sleeper to have REM sleep during such a brief sleep period. Documenting REM in two or more of the trials can be a positive indication of narcoplesy when used in combination with a clinical history.
  • Maintenance of Wakefulness Test (MWT): The MWT is also a series of trials throughout the day, but instead of measuring your ability to fall asleep, it measures your ability to stay awake for a defined period of time under sleep-inducing circumstances. The test is based on the idea that, in some cases, your ability to stay awake may be more important than your ability to fall asleep. The MWT may be better suited for extremely tired individuals because it is not confined by the floor effect that limits the MSLT.
    This test is commonly used to document the effective treatment of a sleep disorder for the Department of Motor Vehicles or for an employer.

Sources: Healthwise, National Sleep Foundation, Stanford Health Care

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