For Referring Physicians

Sleep apnea is a disorder that commonly affects more than 12 million people in the United States. It takes its name from the Greek word apnea, which means "without breath". People with sleep apnea stop breathing repeatedly during their sleep.

To diagnose the condition, we offer a highly specialized test called a Nocturnal Polysomnogram (sleep study) which evaluates a patient’s sleep patterns, respiratory events, and cardiac rhythms during an overnight stay at our office supervised by a sleep technician. Insomnia, excessive daytime sleepiness, and restless leg syndrome are common disorders which we also diagnose and treat.

Following are conditions that have been known to be related to Sleep Apnea:

When considering a referral always start with consultation rather than sleep study.

Like any other disease entity, History and Physical is the cornerstone of sleep evaluation. For example, if the patient is unlikely to have sleep apnea, doing a sleep study can actually create a more confusing picture.

Many sleep disorders have more than one issue that need to be treated. For example it is not unusual for patients with obstructive sleep apnea to have sleep related anxiety and poor sleep habits. There may also be marital issues that may have evolved. All these issues need to be addressed for successful outcome.

Excessive daytime sleepiness. This includes various causes of sleepiness, which includes insufficient sleep syndrome, poor sleep hygiene, narcolepsy and obstructive sleep apnea.

Insomnia. usually this is a clinical diagnosis and polysomnography is not indicated.

Any kind of movement disorder during sleep. This includes various forms of parasomnias, REM-related behavioral disorder and seizure disorder.

Evaluation for causes of excessive fatigue. Sometimes sleepiness and fatigue are terms used interchangeably. Another cause of fatigue is seen in patients with fibromyalgia. These patients tend to have a peculiar EEG pattern, known as alpha delta pattern. This has been associated with unrefreshing sleep and some have suggested that these may be a form of upper airways resistance syndrome.

Sleep study involves measurement of various physiological changes that occur with sleep.

To stage sleep, we look at EEG pattern, muscle tone and eye movements. This will tell us whether the patient is in light sleep, deep sleep or REM.

Other physiologic patterns we evaluate are breathing sound, airflow, chest and abdominal movement and oxygen saturation. These parameters are gathered to assess for breathing during sleep.

Other measurements we evaluate are EKG as well as body position. Depending upon the indication for the study, various physiologic parameters can be enhanced for a more focused study.