The sleep conditions we evaluate and treat – for patients of all ages – include the following:
● Insomnia ● Interrupted or shallow nighttime breathing (apnea, hypopnea)
● Nocturnal movement disorders and seizure
● Abnormal behaviors during sleep e.g., sleepwalking (parasomnias)
● Excessive daytime sleepiness ● Daytime fatigue
When you come to our office with symptoms of a disturbed sleep pattern, you receive a comprehensive assessment based on our study of several of your organ systems including your brain, nerves, throat, lungs, cardiovascular system and extremities.
First, you will have a lengthy interview with our Medical Director that includes:
- a battery of multiple-choice questions about your symptoms and medical history; and
- open-ended questions about your health, answered in your own words.
(You will already have answered certain general questions, which are given to all patients, prior to seeing the doctor.)
The interview is followed by a physical exam, focusing on the organs most commonly implicated in sleep disorders.
After all the information gleaned from the interview and physical exam has been brought together and analyzed, we draw up a list of the actual, probable and possible factors underlying your condition. (It is rare for a disorder to be caused by just one factor.)
At this point, we will recommend preliminary, practical steps you can take to bring about some improvement in your symptoms. But in most cases further testing is required to identify the unique combination of factors underlying your sleep problems. We may ask you to keep a sleep diary in which you record your sleep-related experiences each day. Or we may arrange for you to use a scientific monitoring device at home or in a sleep laboratory. To learn about such monitoring, see “Sleep Studies.”
With this additional data about your sleep in hand, we will plan and initiate a program of treatment. It is important to understand that most sleep disorders are chronic conditions that are unlikely to be resolved in a few days, weeks, or months. In many instances, treatment entails a period of fine tuning and modification followed by long-term use of the tools and procedures we have developed for you.
Crucial to the success of your treatment will be your adherence to the regimen we prescribe, as well as your collaboration in our monitoring protocols.
For example, if you suffer from sleep apnea (repeated stoppages in breathing), the recommended treatment may be long term use of a “PAP” machine, which carries air into your nostrils via an airtight interface/mask so that your airways are kept open through the night. During the first week or two of PAP treatment, several adjustments to the equipment may be needed in response to operational or comfort issues. This process calls for frequent communication with the physician and staff.
Once the optimal array of modifications seems to have been found, we will ask you to come in for a review every three to six months, and after a while, if all indicators are stable, annually. We believe such sustained follow-up – which is not a feature of all sleep medicine practices – is essential if the risk of adverse developments, such as heart attack, hypertension or stroke, is to be minimized and your daytime cognitive performance maintained at the highest possible level.
During your follow-ups we may prescribe medications to ensure a schedule of sleep and wakefulness that meets your rest and activity needs.