If you are having trouble with sleep and snoring then please read on.....
Sleep disorders and sleep apnea are important health issues and are greatly underdiagnosed and under treated. Poor sleep affects the function of every part of the body including our brain, heart and lung function. Sleep apnea means that there is an obstruction to the flow of air when breathing in. This causes a disturbance in the quality of sleep and may lead to a drop in the blood oxygen level which strains the heart, lungs and the rest of the body.
We are now offering home sleep study testing to diagnose sleep apnea. This allows the study to be done in the comforts of your home. You will be given a small device which looks like a headband. This headband monitors several key issues of sleep including if you stop breathing, if there is a drop in your oxygen level while sleeping or if there are any abnormalities in the amount of time spent in the deeper stages of sleep. Some people sleep for enough hours but still awaken tired. This occurs because they are not spending enough time in the restful stages of sleep.
The device should be brought back the next day after using it and the data is then uploaded onto our computer. The information is then evaluated and a complete sleep study report is generated. This report is also verified by our board-certified sleep medicine physician.
Once the study is received you will be called for a follow-up appointment to discuss your results and to formulate a customize treatment plan.
Dr. Liberatore, and Dr. Okun will be the first to provide a comprehensive evaluation regarding your sleep problem. They will take a complete history and perform a thorough head and neck exam,which will detect any source of obstruction on the nose or the throat that can be treated surgically. They will arrange for the sleep testing after their examinations and they will formulate a treatment plan that will include either a home or in lab sleep evaluation, or a consultation with one of our other team members.
We have selected the finest professionals in sleep medicine to customize each patients care. A team is what is needed to maximize the success of achieving a great night’s sleep and to address the multiple needs of each patient. Our team includes a Sleep Medicine Physician, a Dentist and Psychotherapist. Each of these professionals target and treat a different aspect of the many kinds of sleep disorders.
The Options of Treatment:
Surgery
Sometimes this is the best option when a patient has polyps, a floppy pallet, large tonsils and adenoids. After a head and neck exam the benefits versus risks will be discussed with each individual patient, as to the best surgical option, including Pillar Implants, pallet, Balloon Sinuplasty, nasal surgery, tonsillectomy and adenoidectomy.
CPAP
Is the Gold Standard Treatment or therapy for sleep apnea. CPAP uses mild air pressure to keep your airways open. Usually a mask is worn at night during sleep, providing Continuous Positive Airway Pressure to open the air passageway so that breathing can occur and blood can be oxygenated aiding in healing and restorative REM sleep.
Oral Appliance
Our in-house Board Certified Dentist can provide this form of treatment for mild to moderate sleep apnea and for patients who are CPAP intolerant. It looks like a retainer, which supports the lower jaw so the airway is held open while sleeping.
Cognitive Behavior Therapy
Our in-house Board Certified Sleep Physician can advise patients on a form of therapy that includes good sleep hygiene and eliminating the habits that can contribute to sleep disorders. Other strategies can help limit anxiety and psychological barriers to good sleep, all done under the guidance of our team Psychologists.
Medications
There are options for providing good quality sleep, helping with insomnia, acid-reflux and Restless Leg Syndrome.
Lifestyle Improvement through Nutrition & Exercise
So many sleep conditions have to do with nutrition and exercise, we advise and consult on this form of natural therapy, especially considering the direct link between diabetes, obesity and sleep apnea.
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An Overnight Sleep Study - Polysomnography
We Treat These Diagnoses
Types of Studies Performed
Download Dr. Liberatore's Publication PDF
An Overnight Sleep Study - Polysomnography
A thorough nasal, sinus, throat and neck exam will be performed by our doctors prior to the sleep study in most cases. This is very important because it will allow us to determine if there are any obstructive causes of sleep apnea that need to be addressed first. During the initial consultation, our doctors will then evaluate each patient for a potential sleep disorder such as Sleep Apnea or Insomnia. Sleep disorders effect over 70 million people in the US and many patients go undiagnosed leading to more serious health issues. A simple questionnaire will determine whether or not you will need a Polysomnography or an overnight sleep study. If so, you will be referred to our full service sleep laboratory. Dr. Liberatore is the co-founder of REM Sleep Disorders Center, conveniently located near to our practice.
Once Dr. Liberatore or Dr. Okun recommends an overnight sleep study, patients can expect a thorough and professional testing procedure. Even though patients are being evaluated overnight, they will still be able to attain a restful night’s sleep. The study will determine follow up treatment, and ultimately if there is an obstruction of breathing during sleep, preventing oxygen to saturate the blood prohibiting restoration and overall healing.
A sleep disorder is any condition that impairs sleeping well at night, to the extent that it disturbs daytime functioning. This is often manifested as excessive daytime sleepiness. The most common sleep disorders are sleep apnea and insomnia. Sleep disorders disrupts and disturbs a person’s overall quality of life, it can affect anyone and most are completely unaware. Many of those who are aware, do not seek the help that they need.
Our health care community is becoming increasingly aware of the many medical complications that are caused by poor sleep or lack of sleep. Many of the health issues we once thought were linked to other causes, such as poor diet or stress, we now find to be more directly related the common sleep problem. Poor sleep or lack of sleep can result in medical complications such as high blood pressure, cardiovascular disease, stroke, gastrointestinal reflux, and damage to the immune system.
Put very simply, we need sleep.
We Treat These Diagnoses
Obstructive Sleep Apnea, or OSA, is a sleep related breathing disorder that causes you to stop breathing during sleep. OSA occurs when the tissue in the back of the throat collapses and blocks the air from getting into the lungs. Blockage of the airway can happen a few times a night or several hundred times per night. This is a very common sleep disorder.
Insomnia is a chronic inability to fall asleep or remain asleep for an adequate length of time.
Hypersomnia, also known as Narcolepsy, is the term used to describe people who suffer from extreme sleepiness. It can cause a person to suddenly fall asleep. These “sleep attacks” can happen while eating, walking or driving.
Restless Leg Syndrome, or RLS is a neurological condition that is characterized by the irresistible urge to move the legs. RLS can also cause difficulty in falling or staying asleep which can be one of the primary complaints of the syndrome. Many of people who have RLS also have periodic limb movements of sleep (PLMS). In order for a person to be officially diagnosed with RLS, he or she must meet the following criteria:
- Your RLS symptoms start or become worse when you are resting. The longer you are resting, the greater the chance the symptoms will occur and the more severe they are likely to be.
- Your RLS symptoms get better when you move your legs. The relief can be complete or only partial but generally starts very soon after beginning an activity. Relief persists as long as the motor activity continues.
- Your RLS symptoms are worse in the evening especially when you are lying down. Activities that bother you at night do not bother you during the day.
Periodic Leg Movement Disorder manifests as jerks that occur every 20 to 30 seconds on and off throughout the night. This can cause partial awakenings that disrupt sleep. Sleep deprivation can seriously impact your work, relationships, and health.
Inadequate Sleep Hygiene is a form of insomnia that is also called “bad sleep habits.” It involves the things that you normally do every day. These habits keep your sleep from being refreshing. They can also keep you from feeling alert during the day.
Jet Lag/Shift Work Disorder can be caused by a person’s work conditions. Men and women who often travel long distances by airplane suffer from jet lag. A long trip quickly puts you in a place where you need to sleep and wake at a time that is different than what your internal body clock expects. Those who have work rotations, early morning or night shifts often suffer from shift work disorder. The work schedule requires you to work when your body wants to sleep. Then you have to try to sleep when your body expects to be awake. This causes you to have trouble sleeping and to be severely tired.
Delayed Sleep Phase Disorder or DSP can occur when busy work and social schedules can cause some to get in the habit of going to bed very late. Delayed Sleep Phase Disorder (DSP) is when you can only fall asleep a couple hours or more later than normal. This also causes you to have a hard time waking up early in the morning.
Other Diagnoses we treat include:
1. Primary Snoring
2. Sleepwalking
3. Sleep-related Seizures
4. Sleep Terrors
5. Parasomnia
Types of Studies Performed:
Polysomnogram: If there is a problem with your breathing during sleep, then a physician will recommend an overnight sleep study. This study is called a polysomnogram. Electrodes are attached to your head and body by a technician. These electrodes monitor and record brain waves (EEG), heart rate/rhythm (ECG), breathing patterns and blood oxygen saturation during sleep. They also record eye, arm and leg movement. This will reveal if you have OSA and the severity of the problem.
Comprehensive Sleep Evaluation & Follow Up: With OSA, patients may be asked to return to the sleep center for a second polysomnogram. This time, they will be given continuous positive airway pressure (CPAP) treatment as they sleep. This is called a CPAP study.
CPAP/BiPAP Titration: Continuous positive airway pressure (CPAP) is the treatment most often used to treat OSA. It is delivered through a mask worn over the nose or face. The air gently blows into the back of the throat. This keeps the airway open so you are able to keep breathing as you sleep. The amount of air pressure needed is different for each person
Split Night Study: Diagnostic and CPAP Titration
MSLT/Nap Study: The Multiple Sleep Latency Test (MSLT) is a nap study. It is used to see how quickly you fall asleep in quiet situations during the day. The MSLT is the standard way to measure your level or severity of daytime sleepiness. Excessive sleepiness is when you are sleepy at a time and place when you should be awake and alert. We will ask you to attempt to fall asleep at around 9am, 11am, 1pm, 3pm, and 5pm. We will measure the speed with which you fall asleep and the kind of sleep you go into. Sleep latency is a good indicator of the degree of your excessive daytime sleepiness, and the kind of sleep you obtain will give us a clue as to whether you may have narcolepsy.
