CHS Sleep Center treats patients who suffer from insomnia, sleep apnea and other issues related to sleep loss. Chronic and/or consistent sleep loss, which affects 50 to 70 million Americans, can increase health risks associated with diabetes,
high blood pressure, obesity, depression, heart disease and
stroke. We offer a team of experts, including board-certified sleep doctors with a wide range of specialties to best serve your unique needs. Our sleep doctors are dedicated to first-rate patient care and research, which allows us to offer a variety of treatment options available at our sleep diagnostic centers.
Sleep Diagnostic Center
Sleep Medicine Consultations
Before coming to CHS Sleep Center, you first must consult with your primary care doctor. Your doctor will give you a complete physical, checking your height, weight and blood pressure.Your primary care physician will then give you a sleep consult referral.
During your consultation appointment, our doctor will do a short physical exam and discuss the information you provided in a questionnaire completed before your appointment. Based on your symptoms and history, you and the doctor will develop a treatment plan to resolve your sleep complaints.
Schedule Your Sleep
PSG (Polysomnogram) Sleep Study
What is a PSG Sleep Study?
Polysomnography, also called a PSG sleep study, is a test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, heart rate and breathing, as well as eye and leg movements during the study.
Polysomnography usually is done at a sleep disorders unit within a hospital or at a sleep center. You'll be asked to come to the sleep center in the evening for polysomnography so that the test can record your nighttime sleep patterns. Polysomnography is occasionally done during the day to accommodate shift workers who habitually sleep during the day.
In addition to helping diagnose sleep disorders, polysomnography may be used to help adjust your treatment plan if you've already been diagnosed with a sleep disorder.
Why is it done?
Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted and why.The normal process of falling asleep begins with a sleep stage called non-rapid eye movement (NREM) sleep. During this stage, your brain waves, as recorded by electroencephalography (EEG), slow down considerably.Your eyes don't move back and forth rapidly during NREM, in contrast to later stages of sleep. After an hour or two of NREM sleep, your brain activity picks up again, and rapid eye movement (REM) sleep begins. Most dreaming occurs during REM sleep.You normally go through four to six sleep cycles a night, cycling between NREM and REM sleep in about 90 minutes. Your REM stage usually lengthens with each cycle as the night progresses. Sleep disorders can disturb this sleep process.Polysomnography monitors your sleep stages and cycles to identify if or when your sleep patterns are disrupted.Your doctor may recommend polysomnography if he or she suspects you have:Sleep apnea or another sleep-related breathing disorder.In this condition, your breathing repeatedly stops and starts during sleep.Periodic limb movement disorder. In this sleep disorder, you involuntarily flex and extend your legs while sleeping. This condition is sometimes associated with restless legs syndrome.Narcolepsy. You experience overwhelming daytime drowsiness and sudden attacks of sleep in this condition.REM sleep behavior disorder. This sleep disorder involves acting out dreams as you sleep.Unusual behaviors during sleep. Your doctor may perform this test if you do unusual activities during sleep, such as walking, moving around a lot or rhythmic movements.Unexplained chronic insomnia. If you consistently have trouble falling asleep or staying asleep, your doctor may recommend polysomnography.
MSLT (Multiple Sleep Latency Test)
What is a MSLT Sleep Study?
The multiple sleep latency test (MSLT) tests for excessive daytime sleepiness by measuring how quickly you fall asleep in a quiet environment during the day. Also known as a daytime nap study, the MSLT is the standard tool used to diagnose narcolepsy and idiopathic hypersomnia.The MSLT is a full-day test that consists of five scheduled naps separated by two-hour breaks. During each nap trial, you will lie quietly in bed and try to go to sleep. Once the lights go off, the test will measure how long it takes for you to fall asleep. You will be awakened after sleeping 15 minutes. If you do not fall asleep within 20 minutes, the nap trial will end.Each nap will be taken in a dark and quiet sleep environment that is intended for your comfort and to isolate any external factors that may affect your ability to fall asleep. A series of sensors will measure whether you are asleep. The sensors also determine your sleep stage.Excessive daytime sleepiness occurs when you are sleepy when you should be awake and alert. A board-certified sleep medicine physician will recommend an MSLT if he or she suspects you have excessive daytime sleepiness related to narcolepsy or a hypersomnia. The MSLT is offered at AASM-Accredited Sleep Centers. In order to provide the highest level of care for patients, the AASM requires a board certified sleep medcine physician to review the results of the MSLT.
CPAP Titration Study
What is a CPAP Titration Sleep Study?
During a CPAP titration study, members of the sleep team will calibrate your CPAP. The goal is to find the right amount of air pressure to prevent your upper airway from becoming blocked. This eliminates breathing pauses in your sleep.
When you show up for the study in the early evening, you will be fitted with a nasal mask that is connected by a tube to a small electric unit. The fitting process is an important first step in the CPAP titration. Be sure to tell the technologist if the mask is uncomfortable or if there are air leaks around the edges of the mask. The electric unit has a fan that blows air through the tube, into your mask. When you wear the mask, the air will gently blow into the back of your throat.
You will have some time to make yourself at home. There will not be any other patients in your room. You will have a bathroom available to use, and you may have a television that you can watch.
When you are ready to go to sleep, tell the sleep technologist. The technologist will attach sensors to your body to monitor your sleep in just the same way as in the in-lab sleep study. These sensors measure your brain waves, heart rate, breathing, oxygen levels and leg and arm movements. The wires are long enough to let you move around and turn over in bed. You will be asked to move your eyes, clench your teeth and move your legs. This will make sure that the sensors are working.
At certain intervals throughout the night, the technologist will remotely change the air pressure you receive through your mask. Pressure starts at a very low level and gradually increases. If problems are detected, the technologist may come into the bedroom to adjust or replace the CPAP mask. Tell the technologist if you are experiencing any discomfort with the CPAP treatment.
In the morning the technologist will test and then remove the sensors. The CPAP titration study is complete once you are awake and the sensors have been removed. You are free to leave and return to your normal activities.
What is a BiPAP Sleep Study?
BiPAP (also referred to as BPAP) stands for Bilevel Positive Airway Pressure, and is very similar in function and design to a CPAP machine (continuous positive airway pressure). Similar to a CPAP machine, A BiPAP machine is a non-invasive form of therapy for patients suffering from sleep apnea. Both machine types deliver pressurized air through a mask to the patient's airways. The air pressure keeps the throat muscles from collapsing and reducing obstructions by acting as a splint. Both CPAP and BiPAP machines allow patients to breathe easily and regularly throughout the night.
What Makes BiPAP Different from CPAP?
For the most part, CPAP machines have been the go-to treatment for obstructive sleep apnea. CPAP machines deliver a steady, continuous stream of pressurized air to patient's airways to prevent them from collapsing and causing apnea events. After a CPAP titration study, your sleep technician and doctor will determine the pressure settings for your CPAP machine and set the machine to deliver that exact amount of pressure continuously.
CPAP machines can only be set to a single pressure that remains consistent throughout the night. However, many CPAP machines have a ramp feature that starts off with a lower pressure setting and gradually builds to the prescribed pressure. This comfort feature simply makes the pressure at the beginning more tolerable and less immediate, once the pressure builds to the required setting, it stays at that setting for the rest of the night.
What is BiPAP Good For?
One of the complaints about CPAP devices is that some patients find the constant singular pressure difficult to exhale against. For patients with higher pressure strengths, exhaling against the incoming air can feel difficult, as if they're having to force their breathing out. BiPAPs can also be set to include a breath timing feature that measures the amount of breaths per minute a person should be taking. If the time between breaths exceeds the set limit, the machine can force the person to breath by temporarily increasing the air pressure. The main difference between BiPAP and CPAP machines is that BiPAP machines have two pressure settings: the prescribed pressure for inhalation (ipap), and a lower pressure for exhalation (epap). The dual settings allow the patient to get more air in and out of their lungs.
MWT (Maintenance of Wakefulness Test)
What is a MWT Sleep Study?
The Maintenance of Wakefulness Test (MWT) is used to measure how alert you are during the day. It shows whether or not you are able to stay awake for a defined period of time. This is an indicator of how well you are able to function and remain alert in quiet times of inactivity.
The test is based on the idea that your ability to stay awake may be more important to know in some cases than how fast you fall asleep. This is the case when the MWT is used to see how well a sleep disorders patient is able to stay awake after starting treatment. It is also used to help judge whether a patient is too tired to drive or perform other daily tasks.
The test isolates you from outside factors that can influence your ability to fall asleep. These factors include such things as the following:
Temperature (too hot or too cold)
The MWT is used to see if someone with a sleep disorder is responding well to treatment. Results of multiple tests may be compared over a period of time. This can show if treatment is helping a patient overcome sleepiness.
The MWT may be used to evaluate how well a person with a sleep disorder is able to stay awake. This is critical when the person’s job involves public transportation or safety. The results of the test will be only one factor used to assess the potential risk of a work-related accident.
There is little evidence to show how accurate the test is when children take it.
In Home Sleep Studies
A home sleep apnea test is designed to be a convenient way to collect information about your sleep. On the day of your test:
Try to follow your regular routine as much as possible.
Eliminate use of caffeine after lunch
If you are on a regular medication, speak with your board-certified sleep medicine physician. Your doctor may recommend that you temporarily discontinue using the medication. Before your home sleep apnea test, you may have to go to the doctor’s office to pick up the equipment. Alternatively, someone may deliver the home sleep apnea test to your home. A member of the sleep team will give you instructions on how to use the home sleep apnea test device. This is an opportunity for you to ask questions if there is anything you do not understand.
You can go to sleep at your regular bedtime. When you are ready to sleep, you will attach the sensors to your body as instructed. You may be asked to keep a sleep log or to press a button on the machine when you get into bed. When you wake up in the morning, you can remove the sensors. You may have to take the device back to the sleep center.
Members of the sleep team will score and interpret the information collected through home sleep apnea testing. This may take several days or weeks. The board certified sleep physician will contact you to discuss the results. If the results are unclear, the physician may recommend an in-lab sleep study.
You may need an additional in-lab sleep study if:
Your home sleep apnea test did not record enough data for a physician to make a diagnosis
Your home sleep apnea test results indicate that you do not have obstructive sleep apnea and the physician suspects another sleep disorder
If you are diagnosed with obstructive sleep apnea, the board certified sleep physician will discuss treatment options with you and develop a plan.