The Sleep Center at Pulmonary & Sleep Associates, is the area's most comprehensive sleep disorders center. The experience of our multidisciplinary staff is extensive and includes both pediatric and adult sleep medicine. Pulmonary & Sleep Associates is fully accredited by the American Academy of Sleep Medicine.

Pulmonary & Sleep Associates evaluates sleep disorders, including insomnia, snoring, sleep apnea, narcolepsy, and others. During a first visit to the center, a sleep specialist will conduct an evaluation. The specialist will take a comprehensive sleep history, and will perform a physical examination. If a sleep study is deemed necessary, the patient will be asked to make an appointment to return and spend the night in one of our private, comfortable, home-like bedrooms.

Sleep disorders rob more than 100 million Americans of a good night's sleep. More than 80 different sleep disorders limit quality of life and result in poor health. Some can even be life-threatening. During a sleep study, breathing, brainwaves, muscle activity and heart rhythms are monitored. After the study is complete, it is scored and summary data is compiled. The study is read and the data interpreted by one of the sleep specialists, who then makes a diagnosis and recommends treatment.

The most common types of sleep studies include:

• Polysomnography. This procedure records a variety of body functions during sleep, including electrical activity of the brain, eye movement, muscle activity, heart rate, breathing, air flow through the nose and mouth, and blood oxygen levels.

• Multiple sleep latency test. This test measures how long it takes you to fall asleep during naps taken over the course of a day.

• Multiple wake test (MWT). This test, which is also called maintenance of wakefulness test, measures your ability to stay awake during a designated wakeful time.

Sleep studies are done to diagnose sleep disorders, which typically include:

• Sleep disordered breathing or obstructive sleep apnea.

• Problems staying awake (from conditions such as narcolepsy).

• Problems with sleep-disruptive behaviors (such as sleepwalking, night terrors, or bed-wetting).

• Problems with daytime sleepiness or insomnia (from conditions such as sleep apnea or restless legs syndrome).

Sleep apnea is a condition that occurs when a person regularly stops breathing during sleep for 10 seconds or longer. It can be classified as mild, moderate, or severe, based on the number of times per hour breathing stops (apnea) or slows (hypopnea). Apnea episodes may occur from 5 to 50 times an hour.

A person with sleep apnea may snore loudly and have a restless sleep with difficulty breathing. The person may wake up with a headache and be very tired throughout the day.

Sleep apnea may improve with changes in sleep habits, such as resting position. Sometimes devices to help breathing during sleep are useful; occasionally surgery is tried.

Should I have a sleep study to diagnose obstructive sleep apnea?
The most common form of sleep apnea is obstructive sleep apnea (OSA). If undiagnosed and untreated, OSA can interfere with your quality of life. If you have OSA, you may be at risk for excessive daytime sleepiness and complications such as high blood pressure, high blood pressure in the lungs (pulmonary hypertension), depression, irregular heart rhythms, heart failure, coronary artery disease, and stroke.

Narcolepsy is a disabling sleep disorder that mixes the nervous system's messages about when to sleep and when to be awake. Narcolepsy usually starts during the teen years or early adulthood and continues throughout life.

Narcolepsy may cause:

• Sudden sleep attacks, which may occur at any time during any type of activity, such as eating dinner, driving the car, or carrying on a conversation. These sleep attacks can occur several times a day and may last from a few minutes to several hours.

• Sudden, brief periods of muscle weakness while a person is awake (cataplexy). The weakness may affect specific muscle groups or may affect the entire body. These periods of muscle weakness are often brought on by strong emotional reactions, such as laughing or crying.

• Hallucinations just before a sleep attack.

• Brief loss of the ability to move when a person is falling asleep or just waking up (sleep paralysis).

Medications may help prevent sleep attacks and episodes of muscle weakness, but narcolepsy rarely goes away completely.

Restless legs syndrome is a condition caused by uncomfortable sensations in the legs that produce an intense, often irresistible urge to move the legs. This can lead to sleep disturbance and severe fatigue that interferes with daily activities.

These sensations are described as "pins and needles," prickling, creeping, crawling, tingling, and sometimes painful. They most often occur in the evening when the person is attempting to relax or sleep. Moving the legs can temporarily relieve these sensations.

The cause of this syndrome is often not known. Certain drugs (such as antidepressants), pregnancy, or iron-deficiency or related anemia can trigger it.

Restless legs syndrome can be treated with drugs such as those that increase the brain chemical dopamine (levodopa or dopamine agonists), pain medications (opioids), or anticonvulsants (gabapentin) to control leg movements and assist with sleep.

Pediatric sleep services

At Pulmonary & Sleep Associates, our pediatric sleep services are designed to meet the unique needs of each individual child. Our team of trained specialists works closely with the child's primary physician to ensure appropriate evaluation and treatment.

Our testing facility is designed with state-of-the-art technology and allows for a wider variety of measurements that are typical in adult testing. Our facilities and equipment provide the "gold standard" in sleep disorder evaluation. In addition, a comfortable, non-threatening atmosphere helps to encourage natural sleep. Technicians continuously monitor each child - providing immediate physical and emotional bedside support.

The physical and emotional needs of children are very different from those of adults. This is especially true with sleep disorders. (Accommodations are made for a parent to spend the night in the sleep center with the child to make the child feel more at home.)

An important component of health and well-being is getting a good night's sleep. This is especially true for children. Without enough sleep, children may not develop and grow normally or reach their potential in school.

Approximately 20 percent of children suffer from some form of sleeping problem. From poor sleep habits to underlying medical conditions; the impact can be devastating to the child and their family.

Does your child exhibit any of the following behaviors?

• Snoring

• Mouth breathing

• Breathing pauses

• Frequent awakenings

• Restless sleep

• Sleep disturbances

• More than normal daytime sleepiness

• Leg twitching or kicking at night

• Difficulty waking up in the morning

• Behavioral problems in school

• Unfocused or impulsive behavior

According to the American Academy of Pediatrics, all children who snore should be screened for Obstructive Sleep Apnea, or OSA which has been linked to ADHD in some cases. OSA occurs when the airway is partially or completely blocked during sleep, during which time the body's oxygen levels can fall, and carbon dioxide levels can rise. This can result in poor brain oxygenation, fragmented sleep, frequent arousals, and may, if left untreated, be harmful to the heart and lungs. Statistics on snoring and OSA show that:

• 10% to 12% of children snore during sleep

• 20% to 30% of children and adolescents who snore have OSA

OSA is a serious condition that occurs in 1% to 3% of otherwise healthy preschool children. Pulmonary & Sleep Associates offers patients and their families the opportunity for sleep evaluation and treatment. A multidisciplinary team of specialists work together with each patient, their family and primary care physician to determine treatment.

For more information about adult and pediatric sleep disorders or for an evaluation, contact Pulmonary & Sleep Associates at 785-234-5480.