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What is Sleep Medicine?
How Do We Study Sleep?
Sleep patients often present with multiple problems. The AASM recommends that patients consult a sleep medicine specialist before undergoing a sleep study in order to avoid unnecessary testing. Winthrop’s SDC specialists are committed to evaluating patients’ overall health, not only focusing on diagnosing the presence or absence of a sleep disorder. Prior to undergoing a long and detailed sleep study, a SDC patient meets with a sleep medicine physician to learn about how the study will be conducted, clarify what, specifically, will be investigated and understand the possible outcomes. This serves to reduce anxiety considerably.
The Sleep Interview
A careful, detailed patient interview is the mainstay of physician consultation at the Sleep Disorders Center. One of the most important components of the sleep evaluation, the interview is considered a very effective way to begin identifying a patient’s sleep problems. A good assessment conducted by an experienced practitioner can take an hour or less. It is important that patients be accompanied by someone who knows how they sleep. With adults, it is advantageous to meet not only the patient, but also the bed partner, who has witnessed sounds, behaviors or activities arising from sleep. Children must be accompanied by a legal guardian to assist with obtaining the patient’s history.
The Sleep Study
Also known as a polysomnogram, a sleep study investigates how the patient sleeps and whether sleep is normal or abnormal. The Winthrop Sleep Disorders Center conducts the most advanced sleep studies, designated Level I by the AASM.
Patients are usually studied during their normal sleeping hours. While most studies are conducted at night, a person working the night shift and sleeping during the day can schedule a daytime sleep study. Similarly, if an individual sleeps at odd hours, accommodations can be made. The SDC’s priority is capturing the best picture of a patient’s usual sleep with the least disruption to routine.
A dedicated sleep technician is present for the duration of every study — all night or day — to monitor multiple channels of biological activity. The activities are recorded on the most advanced computerized platforms using the latest software, with the technicians highly trained in sleep data acquisition and sleep monitoring; they are comfortable with patients of all ages.
Upon arriving at the SDC, the patient is made to feel at home, settled into a private room and oriented to the amenities, including a private rest room and shower, as well as a flat screen TV with cable and DVD capability. Patients who need to go to work are awakened on time.
A sleep study is not painful. While many sensors are placed for monitoring heart rate, breathing, oxygen levels, brain waves and other functions, they are applied with gentle hypoallergenic adhesives or special bandages. No needles are involved, and most patients can fall asleep normally. Every room is equipped with a TV, and while watching TV at bedtime is not recommended, many patients need this in order to fall asleep. If a patient takes sleeping medication regularly, most of the time, with the physician’s approval, it can be taken during the sleep study.
Children under-18 must be accompanied by a legal guardian during sleep study testing. The SDC provides accommodations for the adult to sleep in the Center so that both the child and guardian are comfortable with their surroundings.
Understanding Sleep Study Results
At Winthrop, once a patient has completed a sleep study, the acquired data is carefully scrutinized by the registered polysomnographic technologists, who examine the stages of sleep measured and relevant events that occurred during sleep, including breathing abnormalities, limb movements, sleep fragmentation, teeth grinding, heart burn and other findings.
After this process, a secondary survey of the results is reviewed by a SDC physician, who interprets the technical data, creating a polysomnographic report. Patients consult with the sleep specialist to review their “sleep architecture” (the shape of their sleep) and discuss the findings underscoring the diagnosis. Depending on the diagnosis, a personalized treatment program is designed and therapy begins.
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