According to the National Institutes of Health, 50 to 70 million Americans are affected by chronic sleep disorders and intermittent sleep problems that can significantly diminish health, alertness and safety. Untreated sleep disorders have been linked to hypertension, heart disease, stroke, depression, diabetes and other chronic diseases. Sleep problems can take many forms and can involve too little sleep, too much sleep or inadequate quality of sleep.
The Institute of Medicine recently estimated in its report, Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem, that “hundreds of billions of dollars a year are spent on direct medical costs related to sleep disorders such as doctor visits, hospital services, prescriptions, and over-the-counter medications.” Sleep problems and lack of sleep can affect everything from personal and work productivity to behavioral and relationship problems. Sleep problems can have serious consequences. According to the National Highway Traffic Safety Administration, drowsy driving claims more than 1,500 lives and causes at least 100,000 motor vehicle crashes each year.
Compounding the problem is the fact that most people know when to seek medical help for physical discomfort such as fever or pain—but sleep problems are often overlooked or ignored. In fact, the overwhelming majority of people with sleep disorders are undiagnosed and untreated.
Should Your Sleep Be Evaluated?
To determine whether you might benefit from a sleep evaluation, ask yourself the following questions:
- Do you regularly have difficulty getting to sleep or staying asleep?
- Do people tell you that you snore?
- Has anyone ever told you that you have pauses in breathing or that you gasp for breath when you sleep?
- Are your legs “active” at night? Do you experience tingling, creeping, itching, pulling, aching or other strange feelings in your legs while sitting or lying down that cause a strong urge to move, walk or kick your legs for relief?
- Are you so tired when you wake up in the morning that you cannot function normally during the day?
- Does sleepiness and fatigue persist for more than two to three weeks?
If you answered yes to any of these questions, then a complete sleep evaluation should be considered and discussed with your physician. Before your visit, it may be helpful to track your sleep patterns and medications.
Primary Care Physicians and Sleep Specialists
Depending on your insurance plan and other factors, your primary care physician may start your evaluation by running tests for specific medical disorders that are known to affect sleep. Your physician might even be able to diagnose a sleep problem based solely on your symptoms and recommend initial treatments. At some point, you may be referred to a sleep specialist for a more extensive assessment of your sleep complaints and for more specific treatments.
If this occurs, be sure to ask your physician to refer you to a certified sleep physician. Certification requires that a physician undergo formal training and pass an examination in sleep disorders to demonstrate a higher level of expertise.
After an initial consultation with your physician or a sleep specialist, you may be referred for a sleep study. The medical term for this study is “polysomnogram,” which is a noninvasive, pain-free procedure. During a polysomnogram, a sleep technologist records multiple biological functions during sleep, such as brain wave activity, eye movement, muscle tone, heart rhythm and breathing via electrodes and monitors placed on the head, chest and legs.
At Valley Sleep Center, our rooms are designed to resemble a comfortable bedroom setting, with décor, televisions and a private bathroom to help make you feel as relaxed as possible during your sleep study.
Preparing for Your Sleep Study
A list of specific instructions is typically provided to patients before their arrival at the testing facility, but you maywant to consider asking additional questions before your test, such as:
- What is my insurance coverage?
- What should I bring to my study? (Cloths, toiletries, medications, etc…)
- Are personal comfort items such as snacks, a pillow, slippers or robe allowed?
- Does it matter if I take a nap the day of the study?
- Should I refrain from eating or drinking anything like coffee, tea or other caffeinated products?
- Should I avoid stimulants, alcohol or sedatives?
- What about prescription and non-prescription medications, dietary or herbal supplements? How long before the sleep study should these be discontinued?
- Can a relative or caregiver stay the night of the study?
- On the day of the procedure, should I remove any hair or skin products?
- May I take a shower and dress for work the morning after the study?
- What time will I be able to leave?
- Who do I follow up with regarding the results of my study?
Important Questions to Ask Before Your Sleep Study
A sleep study can be conducted in either a hospital or in an independent facility. Ask if the sleep lab or sleep center to which you have been referred is accredited by the American Academy of Sleep Medicine (AASM). This recognition denotes that the facility adheres to the highest standards of care for sleep disorder patients. A list of accredited sleep facilities is available at www.aasmnet.org.
Also, find out whether your insurance carrier requires testing in an accredited facility in order to cover the cost of the procedure. In many states, medical insurance will not reimburse the cost of sleep studies unless they are conducted at an AASM accredited facility.
Treating Sleep Problems
After the sleep study has been conducted and reviewed, several conditions may be diagnosed, and various specific treatments may be recommended. There is a wide range of methods for treating sleep problems.
- Medications may be prescribed by your physician.
- Sometimes a sleep psychologist is called upon to recommend alternative approaches that may include addressing patients’ pessimism about their sleep.
- Recommendations for improving sleep hygiene such as diet, sleep environment, bedtime rituals and other factors may be indicated.
- Positive airway pressure may be recommended nightly for those who suffer from sleep disorders such as sleep apnea or snoring.
- Some patients may be candidates for night-time oral or dental appliances to reduce snoring and apnea. The American Academy of Dental Sleep Medicine lists dental sleep medicine specialists by state.
- Establishing a relationship with a Board Certified Sleep Specialist is valuable in continuing care for patients suffering from a sleep disorder and is highly recommended for appropriate follow up care.
Sleep Problems and the Importance of After Care
Patients will often need continuing support in terms of evaluating and managing their response to various medications, treatment methods or recommended behavioral measures. Sometimes, a primary physician will prescribe the initial treatments and continue seeing the patient for follow-up treatments; whereas in other settings, after care occurs in dedicated sleep clinics.
In addition to medications and behavioral measures, some sleep disorders, such as sleep apnea (in which breathing is briefly and repeatedly interrupted during sleep), may include the use of medical equipment during sleep, such as CPAP therapy. CPAP is an air pressure system that helps hold the air passages in the nose and throat open during sleep and eliminates snoring and pauses in breathing. Proper fitting and instruction for use of CPAP equipment – whether simple nosepieces or more elaborate masks – is critical to ensure your comfort and willingness to continue with treatment.
Some treatment methods may be challenging to follow and having continuing care available from a certified sleep specialist to oversee a patient’s progress is crucial. Ask your primary care physician or sleep doctor if continuing after care will be offered at the referred sleep clinic.
You Are Not Alone
According to recent polls conducted by the National Sleep Foundation, nearly 7 out of 10 Americans say they experience frequent sleep problems. However, when proper diagnosis and treatment of sleep disorders occurs, the feeling of sleepiness declines, memory improves and safety risks decrease dramatically. In fact, sleep disorder specialists help an estimated 85 to 90% of their patients get better sleep. With the wealth of treatment options now available, a good night’s sleep is within reach.
(Information courtesy of National Sleep Foundation.)
Since 2002, Valley Sleep Center has provided Arizona with diagnostic sleep disorder testing in a home-like atmosphere, ensuring a comfortable, relaxing experience for their patients. Their physicians are Board Certified Sleep Medicine Specialists and are accredited by the American Academy of Sleep Medicine. They provide diagnostic testing for a multitude of sleep-related disorders including insomnia, sleep apnea, snoring, excessive daytime sleepiness, hypertension, sleepwalking, and pediatric sleep problems.
For more information contact Lauri Leadley at 480-830-3900.