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
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
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.
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