Sleep Health

A sleep study, or Polysomnogram (PSG), is an overnight recording of sleep patterns and behaviors associated with sleep. Sleep studies help determine what stages of sleep an individual achieves and whether any sleep-related abnormalities are present. Sensors are applied to your skin to record brain waves, eye movements, muscle tone, body movements, heart rate, breathing patterns and blood oxygen levels. The sensors are painless, and although there are connecting wires to the diagnostic instruments, you are free to get up and walk around as needed.

During the sleep study, every attempt is made to allow for a normal night’s sleep.

People typically sleep better or worse when away from home, but in either case this does not usually affect the quality of the sleep study. Our sleep centers are set up like bedrooms and are furnished with select comfort beds. Patients wear their own bedclothes, can bring their favorite pillow and toiletries to shower in the morning. A trained sleep technologist explains the procedure, operates the diagnostic equipment and is stationed all night in an adjacent control room. They monitor the sleep recording and ensure the sleep study participant is comfortable.

Following the sleep study, a sleep specialist interprets the recording. The findings are integrated with your sleep history to determine a diagnosis and make the appropriate treatment recommendations. A sleep study report is also sent to your primary care physician, who should review your results at a follow-up office visit.

A person diagnosed with Obstructive Sleep Apnea (OSA) may be referred to a sleep center for a sleep study with a Continuous Positive Airway Pressure (CPAP) machine. A CPAP is the most effective and widely used method of treating sleep apnea.

While asleep, a CPAP machine gently delivers air into a person's airway through a specially designed mask which fits over the nose or mouth, thereby creating enough pressure to keep the airway open and produce immediate relief from sleep apnea and snoring. Most people get used to the CPAP apparatus after a few minutes and have little difficulty sleeping with it in place. It is important to note that the CPAP does not breathe for the person, but instead allows the person to breathe at a normal rate.

At the beginning of a CPAP study, sensors are applied to your skin to monitor brain waves, eye movements, muscle tone, breathing patterns and blood oxygen levels. Before you fall asleep, the sleep technologist will place the CPAP mask and make sure it is a comfortable fit.

Individuals who experience excessive daytime sleepiness or who fall asleep at inappropriate times may be referred by their physician to a sleep center for a Multiple Sleep Latency Test or a Maintenance of Wakefulness Test.

The Multiple Sleep Latency Test (MSLT) is designed to measure how long it takes a person to fall asleep during the course of a day. The MSLT is conducted the day following an overnight PSG. The test consists of nap recordings. During these naps, a sleep technologist monitors the patient's sleep/wake patterns. The MSLT takes an entire day to administer, and is usually completed before 7:00 p.m.

The Maintenance of Wakefulness Test (MWT) is designed to measure how alert you are during the day. It shows whether or not you are able to stay awake for a defined period of time.

In addition to numerous devices, there are different surgeries that treat sleep apnea. Each has its own pros and cons. After talking with you and evaluating your airway using special diagnostic methods, your surgeon will recommend the most appropriate treatment for you.

• Nasal surgery: Obstruction of the airway passages in the nose may be caused by polyps, a deviated septum, enlarged adenoids, enlarged turbinates (e.g., bones, vessels and tissues within the nose), or a weak nasal valve. Nasal surgery alone rarely cures sleep apnea, but it can improve the results of medical treatments and help with snoring.
• Soft palate implants: Placing implants in the soft palate of the mouth is a minimally invasive procedure that can be done in the office. The implants make the palate less likely to relax against the back of the throat during sleep. This reduces the likelihood of snoring and can treat mild sleep apnea.
• UPPP (uvulopalatopharyngoplasty): In this surgery, the tonsils (if they are present) are removed, and excess tissue from the soft palate and throat may be repositioned or trimmed.
• Hyoid advancement: By moving the tiny hyoid bone in the neck slightly forward and up, surgeons can expand the airway and prevent the tongue from relaxing against the throat. 
• Tongue advancement: In this procedure, the surgeon moves one of the main muscles of the tongue and the bone it is attached to forward in the mouth. This limits the ability of the tongue to fall backward against the throat during sleep.
• Tongue base reduction: For some patients, the best treatment is one that reduces the size of the tongue base itself. This may be done with radiofrequency waves or with partial surgical removal.
• Hypoglossal nerve stimulator implant: This nerve stimulator helps restore muscle tone to the upper airway, keeping the airway open during sleep.
• Maxillomandibular advancement (MMA): This surgery involves moving both the upper and lower jaws forward to open the airway. The surgery is customized for each patient through virtual surgical planning. MMA is the second-most successful surgical procedure for treating sleep apnea, particularly if it is very severe.
• Tracheotomy: This surgery bypasses obstructions of the upper airway by creating an opening in the neck directly into the windpipe. While this is considered the most effective procedure for curing sleep apnea, it is not commonly performed and is typically an option of last resort for very severe cases.