Diagnosing Sleep Disorders
In many cases, sleep disorders are caused by a combination of factors. Effective, lasting treatment begins with thorough identification of the underlying cause(s) of the sleep problem. Physicians in the Sleep Disorders Program excel at finding the exact cause through a comprehensive evaluation. We talk to patients and ask the right questions to determine the exact cause for their sleep disorder.
Sleep Disorder Symptoms
One of the most common symptoms of a sleep disorder is snoring. If you snore, you should be evaluated for potentially serious airway obstruction, especially if you have a cardiovascular disease like high blood pressure. You should also get medical attention if your partner sees you stop breathing during sleep.
Other symptoms that could point to a sleep disorder are:
- Excessive daytime irritability or grogginess
- Feeling tired after 10 to 12 hours of sleep
- Several near-miss car crashes
- Excessive leg movement, or tossing and turning at night.
Hard-to-Diagnose Sleep Disorders
Our staff is highly skilled in evaluating hard-to-diagnose sleep disorders and offering options for difficult-to-treat cases. Many people who have been treated at other sleep centers discover the difference of receiving comprehensive care at the Sleep Disorders Program. A sleep problem may be completely overlooked unless a physician is trained in diagnosing sleep disorders. Because the program is part of an academic medical center, our sleep medicine specialists have access to the latest technology and research to fully evaluate a wide range of sleep disorders.
If your physician determines a sleep study is necessary to help with diagnosis, you will spend the entire night in a private room in the sleep center. After arriving at the center around 8 p.m., you will meet the sleep technologist who will conduct your test.
The technologist will thoroughly explain your study and then fit you with leads or devices that are part of your evaluation. The whole fitting process takes about 30 to 45 minutes. You are then free to relax, read a bit or watch TV until you fall asleep.
The technologist monitors you all night from the center’s control room. If you are having an apnea study and your monitors show apnea events, you will be awakened around 2 a.m. and fitted with a continuous positive airway pressure (CPAP) mask.
This simple device uses air pressure to keep the throat open. The technologist will start the CPAP pressure at a low setting, and then gradually increase the level until monitors indicate you are achieving deep sleep with no breathing gaps.
Mask fitting is recommended for people currently using a CPAP (continuous positive airway pressure) mask but are having difficulties due to leaks, a mask that no longer fits properly or the desire for a new mask option. Additional mask options include:
- Activa nasal mask
- Nasal Aire
- Vista nasal masks
- Nasal pillows
- Ultra Mirage nasal mask
Auto PAP Titration
The Auto Set machine is a CPAP machine that has the ability to increase or decrease CPAP pressure based on the state of the person's upper airway. Auto Pap is recommended for people currently using CPAP with the following symptoms:
- Observed snoring
- Excessive daytime sleepiness
- Observed apneas
Actigraphy assesses leg movements during the night. It is used to assist with the treatment of Periodic Leg Movements (PLM). Actigraphy is recommended for patients currently on medication for restless leg or PLMs who are still having symptoms such as:
- Irritating or unusual feeling in the legs at bedtime or during the day
- Legs kicking at night
- Continue to have excessive daytime sleepiness
CPAP / BIPAP Evaluation
Our sleep technicians assess CPAP and BiPAP machines and masks to ensure the proper pressure is set. This service is available for those who would like verification of their machine’s settings or are having problems adjusting to the CPAP machine.
Overnight Pulse Oximetry
Pulse oximetry is a test that determines the oxygen saturation in the blood. This overnight test is recommended for patients who may require oxygen during the night or have night time breathing disorders.
For some workers, like long-distance truck drivers, sleep disorders can pose a serious safety threat. The Sleep Disorders Program offers performance vigilance testing to evaluate individuals for sleep-related occupational risk.
Psychological Evaluation for Sleep Disorders
People experiencing certain sleep disorders, such as insomnia, often have learned behaviors and thought patterns that prevent them from falling or staying asleep. Difficulty with falling asleep can lead to anxiety and expectations that sleep will continue to be difficult. The anxiety, in turn, can further impede sleep.
After meeting with a sleep specialist, some patients may be referred to the Sleep Disorders Program team psychologist for an evaluation. Referrals are often made when insomnia is the primary complaint. The insomnia may be related to other disorders that affect sleep such as restless legs syndrome, periodic limb movement disorder, sleep apnea or other disorders. People often develop ways to cope with their sleep problem(s) that may, in fact, make their problem worse. Through an individual evaluation, the psychologist can determine the behaviors that may hinder sleep and recommend behavior changes.