 Nuiel Atchley - Respiratory-Sleep Study Director |
Respiratory and Sleep
Disorders Clinic
The Sleep Disorders Clinic consists of a sleep laboratory and sleep
clinic, which is involved in the evaluation and treatment of a variety
of sleep disorders, including Obstructive Sleep Apnea (OSA), Narcolepsy,
Restless Leg Syndrome, and Insomnia.
Obstructive Sleep apnea is a sleep disorder that only occurs when you
are asleep. If you quit breathing when you are asleep, then you have
sleep apnea. These spells of "breath-holding" usually last at least ten
seconds in duration. They may occur without you even knowing about them.
A diagnostic polysomnogram (an overnight sleep study) is necessary to
diagnose OSA. You may tend to feel low on energy and even drowsy during
the day. Other problems you may have are morning headaches, poor memory
and concentration, irritability and loss of sex drive. In addition, your
spouse may complain that you snore loudly. Some people will even awaken
themselves by snoring.
Why does sleep apnea occur?
1. Excessive Tissue - When you are asleep the tongue and other muscles
in the throat relax. This floppy tissue can decrease the size of your
airway. As a result, your airway closes and airflow stops periodically
during sleep.
2. Weight - During sleep, excessive weight around the neck and chest can
create a narrowing of the airway due to the weight of muscles relaxing
on the throat and chest. If you have a large neck or are clinically
overweight you may suffer from sleep apnea. 
Sleep apnea is a potentially life-threatening disorder and will only get
worse if left untreated. If this sounds like something that may affect
you, please do not hesitate to discuss it with your physician today.
Your physician may recommend testing in the sleep laboratory either
overnight and/or during the daytime. Once your disorder is diagnosed, a
treatment plan will be designed specifically for you.
Patients with a suspected sleep disorder should be referred to the
pulmonary sleep clinic, which is devoted to the management of sleep
disorders. The sleep clinic is staffed with providers who have expertise
in the management of sleep disorders. A sleep study will be performed in
the sleep lab on patients with appropriate indications, and treatment
recommendations will then be made by the sleep clinic.
Treatment Options include use of a CPAP (continuous positive airway
pressure) mask while sleeping, use of an oral appliance (mouthpiece), or
surgery.
Narcolepsy is a disorder that causes a person to have difficulty staying
awake. Narcolepsy can cause a person to suddenly fall asleep during the
day. These "sleep attacks" occur even after getting enough sleep at
night. The unusual sleep pattern that people with narcolepsy have can
affect their schooling, work, and social life.
Effects of Narcolepsy
People with narcolepsy often fall asleep without warning at
inappropriate times. Sleep attacks don't just happen during quiet times,
such as when reading or watching TV. These attacks can occur during
driving, eating, or other activities and can cause:
- Accidents and injuries
- Problems at work or at school
- Social problems
- Impaired memory, thinking, or ability to concentrate
- Depression
If your doctor suspects you have narcolepsy, he or she will likely
suggest you see a sleep specialist who may recommend special sleep tests.
The sleep specialist will confirm a diagnosis of narcolepsy, diagnose
another sleep disorder, or rule out a specific sleep disorder as the
cause of your symptoms, based on:
- The results of your sleep tests
- Your symptoms
- Your sleep habits as recorded in a sleep diary
Narcolepsy is easier to diagnose if you have more symptoms than just
daytime sleepiness and sleep attacks.
Sleep Tests
Sleep tests are usually done at a sleep disorders center. For some sleep
tests, you may need to sleep overnight at the center. Other sleep tests
can be done during the day. The tests most often used to diagnose
narcolepsy are:
- Polysomnogram (PSG)
- Multiple sleep latency test (MSLT)
Polysomnogram
For this study, you sleep overnight at a sleep center. While you are
sleeping, the staff at the center use various devices to measure your
brain activity, breathing, and movements. The signs of narcolepsy this
test can reveal include:
- Falling asleep quickly
- Entering rapid eye movement (REM) sleep soon after falling
asleep
- Waking up often during the night
Multiple Sleep Latency Test
This test is usually done during the day after an overnight PSG. Also
called a nap study, the MSLT measures how easy it is for you to fall
asleep during the day. You are asked to take short naps about every 2
hours. The test records eye movements, muscle tone, and brain activity
with small devices attached to the head. The signs of narcolepsy this
test can reveal are quickly falling asleep during the day (after a full
night's sleep) and entering REM sleep soon after falling asleep.
Living With Narcolepsy
Narcolepsy is a lifelong condition. Although there is no cure for this
condition, symptoms often improve with ongoing treatment. Most people
with narcolepsy can live near-normal lives. The condition can be
dangerous if sleep attacks or sudden loss of muscle tone occur while
driving or using machinery. Even when these episodes occur at other
times, they can cause injury or impair performance in school and on the
job.
What is Restless Leg Syndrome?
Restless leg syndrome (RLS) is a neurological disorder characterized by
unpleasant sensations in the legs and an uncontrollable urge to move
when at rest in an effort to relieve these feelings. RLS sensations are
often described by people as burning, creeping, tugging, or like insects
crawling inside the legs
The most distinctive or unusual aspect of the condition is that lying
down and trying to relax activates the symptoms. As a result, most
people with RLS have difficulty falling asleep and staying asleep. Left
untreated, the condition causes exhaustion and daytime fatigue. Many
people with RLS report that their job, personal relations, and
activities of daily living are strongly affected as a result of their
exhaustion. They are often unable to concentrate, have impaired memory,
or fail to accomplish daily tasks.
How is restless legs syndrome diagnosed?
Currently, there is no single diagnostic test for RLS. The disorder is
diagnosed clinically by evaluating the patient's history and symptoms.
Despite a clear description of clinical features, the condition is often
misdiagnosed or underdiagnosed.
Unfortunately, there is no single diagnostic test for RLS. Physicians
must rely largely on patients' descriptions of symptoms and information
from their medical history, including past medical problems, family
history, and current medications. Patients may be asked about frequency,
duration, and intensity of symptoms as well as their tendency toward
daytime sleep patterns and sleepiness, disturbance of sleep, or daytime
function. In some cases, sleep studies such as polysomnography (a test
that records the patient's brain waves, heartbeat, and breathing during
an entire night) are undertaken to identify the presence of PLMD.
Sleep Testing is available Sunday night through Friday.
EEG is available Monday through Friday.
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