Pacific Sleep Disorders Center
Sleep Disorders

An estimated 12 million Americans suffer from sleep apnea, many more suffer from socially disruptive snoring, chronic insomnia, restless legs, and other disorders. In the past 20 years, significant progress has been made in diagnosing and treating sleep disorders.

Attended Polysomnography (monitored sleep study) is a diagnostic test that has emerged as the gold standard for evaluation of sleep disorders. This technology can be applied to the following:

Excessive daytime sleepiness
Evaluating patients with disorders of initiating and maintaining sleep
Determining the type, frequency and duration of the disordered breathing pattern (sleep apnea)
Disorders of the sleep-wake cycle

:::Brief Introduction to Types of Sleep Disorders

Sleep Apnea Syndrome
Signs and Symptoms: Heavy snoring and breath holding episodes during sleep.
Clinical: Can cause increase in daytime fatigue and sleepiness, auto accidents, high blood pressure, congestive heart faliure, heart attacks, depressive symptoms.
Diagnosis: Polysomnogram

Upper Airway Resistance Syndrome
Signs and Symptoms: Heavy snoring and frequent brain arousals
Clinical: Increase daytime sleepiness, fatigue, and auto accidents
Diagnosis: Polysomnogram

Excessive Snoring
Signs and Symptoms: Heavy snoring
Clinical: Socially disruptive snoring resulting in poor sleep of bedfellows
Diagnosis: Polysomnogram to exclude sleep apnea

Idiopathic Hypersomnia
Definition: Excessive daytime sleepiness despite enough sleep time on regular basis
Clinical: Can cause increase in motor vehicle accidents, social, school, and job disfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test

Narcolepsy
Definition: Excessive sleepiness and fatigue with or without sleep paralysis, sleep hallucinations, and episodes of sudden muscle weakness
Clinical: Can cause increase in motor vehicle accidents, social, school, and job disfunctions
Diagnosis: Polysomnogram and Multiple Sleep Latency Test

Periodic Limb Movement
Definition: Sleep disruptions caused by increase in nocturnal muscle activity in arms and legs causing increase in daytime fatigue and inappropriate sleepiness
Clinical: Can cause increase in motor vehicle accidents, social, school, and job disfunctions
Diagnosis: Polysomnogram

Parasomnia
NREM
Definition:
Intrusion of wakefulness behavior during non-REM (non-dream) sleep. (e.g. sleepwalking)

REM Sleep behavior disorder
Definition: Acting out dreams during REM (dream) sleep
Clinical: Parasomnia can result in injury during sleep to self and/or others
Diagnosis: Polysomnogram

Sleep-Wake Cycle Disorders
Definition: Unusual sleep cycles not conforming to regular night sleep cycle
Clinical: Can result in inappropriate sleepiness during morning hours or late afternoon hours. e.g. night-owls, early-birds, shiftworkers. May result in social, school and job disfunction
Diagnosis: Sleep Diary

Disorders of Initiating and Mantaining Sleep (Insomnia)
Definition: Inability to obtain a refreshing good night sleep on regular basis due to various causes including psychiatric and non-psychiatric problems
Clinical: Can cause increase in daytime fatigue and poor vigilance resulting in social and job disfunction
Diagnosis: Clinical evaluation

Nocturnal Seizures
Definition: Seizure activity during sleep
Diagnosis: Extended polysomnogram

What are the indications for a sleep apnea study/polysomnography?
Excessive snoring associated with the following: restless sleep, mental confusion and morning headaches, hypertension, strokes, congestive heart failure, cardiac arrhythmias, chronic fatigue, or obesity
Breath holding and choking during sleep
Parasomnia
Insomnia (with excessive daytime sleepiness)
Excessive daytime sleepiness/fatigue
Excessive leg movements during sleep/restless legs
In children, symptoms of upper airway obstruction, drop in school grades/Attention Deficit Disorder/restless sleep
Narcolepsy evaluation
Abnormal sleep behaviors

:::Testing Locations

When indicated, polysomnograms are preformed on an out-patient basis. In an environment designed to be restful to the pateint, technologists are able to achieve reliable and acurate results. Equipment and personnel are located in an adjacent room giving the patient privacy and rest.

:::Insurance Coverage

Most Health insurers cover sleep evaluations and treatment. Many may require prior authorization before services are performed.

:::Treatment Options for Obstructive Sleep Apnea
  • Mechanical devices
    Nasal CPAP/BiPAP
    90% sucessful
    Oral appliance
    50% successful
  • Behavior modification
    Weight loss to target weight
    70% successful
  • Medication
    Less than 5% successful
  • Surgery
    UPPP
    40% successful
    Laser assisted and Somnoplasty
    Currently not recommended for moderate to severe sleep apnea.
  • Treatment options for other sleep disorder
:::Resources
AASMNET.org
SleepEducation.com
SleepApnea.org
RLS.org
SleepDisordersGuide.com
Stanislaus Sleep Center Test
:::Consult your sleep specialist


 

Pacific Sleep Center
Stockton Office
Phone: 209 465 5731
Fax: 209 465 0230
1801 E. March Lane, Suite C310
Stockton, CA, 95210
Tracy Office
Phone: 209 835 1163
Fax: 835 1959
1470 Bessie Ave
Tracy, CA 95376

Lodi Office
Phone: 209 210 1020
Fax: 209 210 1022
1930 Tienda Dr., Suite 202
Lodi, CA 95242


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