Sleep Services
Sleep Services provided at Lung and Sleep Center, P.C. include the outpatient evaluation for adult patients with any of the common complaints such as excessive daytime sleepiness/fatigue, unrefreshing sleep, and snoring. As well as the evaluation and treatment of sleep disorders, such as obstructive and central sleep apnea, Pickwickian syndrome, insomnia, restless legs syndrome, narcolepsy, circadian rhythm disorders (shift work & jet lag), parasomnias, bruxism, and the sleep manifestation of medical and psychiatric disorders. Both initial consultations and ongoing care through our CPAP clinic are provided. In addition to a comprehensive sleep history and physical examination, diagnostic testing is tailored to the needs of the patient and their specific sleep condition or problem.
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The Sleep Lab
Our sleep lab features a computerized sleep laboratory, where sleep studies are conducted by caring clinical staff. Hotel-quality accommodations at our four-bedroom sleep facility include a flat-screen television, fresh linens and private bathroom complete with showers. The sleep laboratory is open Monday through Friday, with sleep studies starting at 8 p.m. and finishing around 6 a.m., the following day. Dr. Desai is available on-call weekends and after hours on weekdays.
The following descriptions of services offered at Lung and Sleep Center, P.C. will help you know what to expect and make you feel comfortable for the night. Our four-bed sleep center is the most advanced and comprehensive available, meeting severe and complex conditions head-on. Staffed by registered polysomnographers and experienced sleep technicians, our facility provides hope for those who can’t get adequate sleep. Each person is gently eased into testing and made completely comfortable before the real work known as a “sleep study” begins.
Dr. Desai tailors his testing and evaluation after listening to each patient’s complaints and list of symptoms. He carefully considers unique medical history to obtain information needed for final and customized interpretations. The result is a custom course of treatment quickly recommended to the ordering physician.
Why Do I Need A Sleep Study?
The sleep study or polysomnogram is an important diagnostic test ordered by your primary physician or Dr. Desai to investigate your sleep complaints or diagnose one or more of the 83 different sleep disorders. Most commonly, sleep studies are done to evaluate patients who complain of excessive daytime sleepiness, unrestorative sleep, and for obstructive sleep apnea syndrome, central sleep apnea syndrome, movement disorders and neurological conditions such as narcolepsy. Studies are typically performed at night. For patients who work night shifts, studies may be scheduled during the day.
Arriving for your Sleep Study
On the appointed day, patients arrive at the clinic one to two hours before their usual bedtime. They are warmly greeted by a sleep technologist who will escort them to their study bedroom. Once settled, the sleep technologist will explain what will happen during the study and address any concerns. If this is your first visit to the sleep clinic, you may be asked to complete a sleep questionnaire. A informational DVD will be shown. This information is both helpful and important for the patient to be educated on what to expect.
The sleeping rooms are comfortable, relaxing, hotel-like bedrooms with regular (not hospital) queen-sized beds. Each room has its own attached bathroom with a shower and a television. Sleep technicians are not licensed to administer medications. Patients may administer their own medications or an attendant (spouse or friend) may need to be available.
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What To Expect During A Sleep Study?
During the sleep study, we attach electrodes to measure different electrical signals including brain waves, eye movements and chin muscle tone to tell us if you are asleep and what stages of sleep you transition through when you are asleep. We also measure electrical activity of the heart (ECG) and leg. A flow sensor is placed in your nostrils to measure airflow. Belts are placed around the rib cage and abdomen to measure breathing movements. A clip is placed on a finger to measure blood oxygen levels. Other measurements may be done as required. There are no needles involved and there is no pain. The electrodes are connected to a box by the bedside for relaying the signals to a central control room. The patient is easily disconnected to get up to use the restroom.
All patients are videotaped while asleep. This is helpful in the evaluation of patients with seizure disorders or epilepsy and those who have abnormal movements or behaviors during sleep.
Sleep studies are performed at the Lung and Sleep Center, P.C. utilizing the Viasys Sensor-medics System according to the strict guidelines established by the American Academy of Sleep Medicine. The sleep technologist will be recording and monitoring your sleep. If any problems arise during the study, the sleep technologist will address them promptly. If you need help or assistance, your sleep technologist is merely an intercom call away and will respond immediately to address any problems that arise during the study. Dr. Desai is available to the sleep technologists throughout the night for any questions.
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PAP Titration study
If you are here for a positive airway pressure trial (PAP or BIPAP), you will be set up as you were on your first night. In addition you will be fitted with a mask before recording sleep. It is critical for the mask to fit properly and be comfortable for the patient. With the mask and machine on, you may peacefully drift off to sleep. Pressure settings will be raised one level at a time until the setting is obtained that eliminates your apneas and snoring, and improves your sleep quality.
Patients generally complete the study around 5:30 to 6 a.m. If you need to be awakened earlier, please notify the technician.
What Happens Next?
Once the sleep studies are completed the patient will follow up with Dr. Desai or in sleep clinic to review the results. The results will be discussed with the patient and appropriate actions will be taken for the patient to receive their machine. This entire process takes seven days or less. Interpretations are sent to the physician who ordered the sleep study.
Multiple Sleep Latency Test (MSLT)
The Multiple Sleep Latency Test is a test to assess daytime sleepiness. The test is done in conjunction with a polysomnogram or sleep study.
The MSLT occurs in the daytime. Typically, the individual will have a sleep study the night before. They will be awoken at 6:00 in the morning. At two-hour intervals during the day, they will be asked to lie down in a dark room and try to go to sleep. Typical times for a Multiple Sleep Latency Test would include a nap at 8:00 AM, 10:00 AM, 12:00 noon, 2:00 PM and 4:00 PM. During this test, the individual will have electrodes assessing brain waves on their scalp. In addition, eye movements will be recorded by placing electrodes above or below your eyes, and muscle activity will be recorded by placing electrodes on the muscles of your chin. An EKG will also be recorded.
Based on how quickly the person falls asleep, the sleep specialist will be able to assess whether daytime sleepiness is present. This could be due to obstructive sleep apnea, narcolepsy or idiopathic hypersomnia. Medications may be prescribed to help the individual maintain alertness if, in fact, the study indicates they are sleepy.
Maintenance Of Wake Test (MWT)
The Maintenance of Wake test is a test to assess whether a person who has a sleep disorder is able to maintain alertness. This test is often used to assess whether truck drivers, school bus drivers or other individuals who drive hazardous equipment and have a sleep disorder, such as sleep apnea, can maintain alertness.
For an MWT, the individual may or may not have a sleep study the night before, this is determined on an individual bases. The MWT consists of four 40 minute trials, over the course of the day, such as 8:00, 10:00, 12:00 and 2:00, the person sits in a darkened room in street clothing and needs to stay awake. They are not able to watch TV, read or use a computer.
During this test, brain waves (EEG) are recorded by placing electrodes on the scalp. Eye movements are recorded by placing electrodes above and below your eyes. Muscle activity is recorded by placing electrodes on the muscles of the chin, and an EKG is recorded by placing electrodes on your chest.
This study will be reviewed by a sleep specialist, who will make any recommendations needed.
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