New Developments at CMC’s Accredited Sleep Center

By Michael Slattery, MD

 

Cayuga Medical Center has a nationally accredited Sleep Disorders Center serving the community. Sleep disorders are a prevalent problem in this country and remain under-diagnosed.

 

An estimated 40 million Americans have some type of sleeping disorder. At least one in every ten adults has some type of sleep disorder. The inability to remain alert can be hazardous for anyone who drives a car; however, it poses even greater dangers for school bus drivers, people in public transportation, truck drivers, and those who operate heavy equipment.

 

What sleep disorders are treated locally?

 

We diagnose and treat the full range of sleep disorders. The most common disorders we see are: sleep apnea (when people stop breathing repeatedly during sleep); parasomnia (behaviors such as sleep walking, dream enactment, and sleep terrors); restless leg syndrome and movement disorders during sleep; narcolepsy (excessive daytime sleepiness, including the tendency to fall asleep at inappropriate, sometimes dangerous times); and insomnia (the inability to go to sleep or remain asleep).

 

Sleep disorders are diagnosed during an overnight sleep study, which collects data on the patient’s breathing, airflow around the nose and mouth, brain waves, heart activity, eye movement, leg movement, and oxygen levels in the blood. 

 

What’s new at the CMC Sleep Disorders Center?

 

All of our sleep study technology and equipment has been updated in keeping with recent advances. We now have the ability to synchronize a digital video of the person sleeping with the simultaneous data on brain wave activity, breathing, and heart rate and rhythm recorded during the sleep study. Superimposing the visible sleep behavior on the physiological data shows us correlations between the two, which helps in diagnosis and treatment.

 

We have incorporated new approaches to treating obstructive sleep apnea. Obstructive sleep apnea events occur when muscles in the throat relax, allowing soft tissues in the upper airway block airflow. These periods of breathing cessation can occur many times an hour and may last for several seconds. This condition can often be successfully treated with CPAP, which stands for continuous positive airway pressure. CPAP is a device that keeps the throat open during sleep with positive airflow.

 

The new CPAP units we use are smaller and quieter, and there are a variety of new masks designed to fit facial features better and more comfortably. For appropriate patients we are now using CPAP units with automatic titration systems. These units are able to sense the minimum airway pressure needed and self-adjust during the night.

 

There has also been significant recent progress in the treatment of patients diagnosed with central sleep apnea. This occurs when the brain fails to signal the respiratory system to breath regularly throughout the night. The adaptive servo-ventilator is a new technology that senses when the patient is not breathing and provides respiratory support only when needed.

 

Are there other new developments in the treatment of common sleep disorders?

 

Yes, there are many recent developments. New medications such as Lunesta, for treating insomnia, are available. New medications for treating restless leg syndrome, Requip and Mirapex, have been approved and are in use. Researchers have also made significant advancements in understanding the causes of narcolepsy. We now know that narcolepsy is related to deficiency in the brain of a neuropeptide called hypocretin, and scientists are working on ways to enhance wakefulness using this new knowledge.

 

Cognitive behavioral therapy has proven to be useful for some individuals with insomnia. Nonpharmaceutical approaches teach people to recognize sleep-inhibiting behaviors and utilize various relaxation strategies to stop the mind from racing. Learning formal relaxation techniques enable people to initiate the relaxation response, which allows them drift off to sleep more easily.

 

When should I see someone about my sleep problems?

 

See your doctor if your sleeping partner is complaining to you about loud snoring, or has observed that you periodically stop breathing during the night. If you experience problems functioning well, even after seven or eight hours of sleep, you should bring this to the attention of your primary care doctor. Finally, sleepwalking, dream enactment, violent thrashing, or sleep terrors that may potentially harm your mate or yourself should be diagnosed and treated.

 

Dr. Slattery is board certified in Neurology, Sleep Medicine, Psychiatry, Clinical Neurophysiology, and Electroencephalography.  He is on the medical staff of Cayuga Medical Center and serves as medical director of the Sleep Disorders Center at Cayuga Medical Center.