Sleep Disorders Center

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WHO WE ARE

First Coast Cardiovascular Institute’s Sleep Disorders Center is comprised of sleep laboratories in Duval & Clay counties. Our sleep labs are dedicated to the diagnosis and treatment of sleep disorders in adults, and are fully accredited by the American Academy of Sleep Medicine.  In 2011-2012, more than 1,500 sleep studies were performed at our laboratories, including diagnostic and titration polysomnography (PSG), multiple sleep latency testing (MSLT), and maintenance of wakefulness testing (MWT).  In addition, we also offer portable home sleep testing (HST). FCCI offers the full spectrum of outpatient clinical care for adult sleep disorders patients, in addition to performance of sleep studies.

In patients with poor quality sleep or daytime sleepiness, the first step toward a better night’s sleep is a comprehensive evaluation by a sleep medicine physician. Your specialist or primary care physician may recommend testing with an overnight and/or daytime sleep study. Once your disorder is diagnosed, a treatment plan will be designed specifically for you. As part of your sleep disorder treatment, your sleep medicine physician may recommend a consultation with a sleep psychologist, psychiatrist, otolaryngologist (ear, nose, and throat specialist), dentist, or a physician specializing in weight reduction.

WHAT WE TREAT

There are many different sleep disorders. We treat all of them for our adult patients, including but not limited to:

  • Obstructive Sleep Apnea (OSA)
  • Restless legs syndrome
  • Insomnia
  • Narcolepsy
  • Idiopathic hypersomnia (daytime sleepiness without an obvious cause)
  • Circadian rhythm sleep disorders
  • Parasomnias (behaving in a way that’s undesirable during sleep, such as sleepwalking)

Once a diagnosis is made, a wide range of effective treatment strategies are available. The majority of sleep problems can be improved, controlled, or eliminated.

COMMON SYMPTOMS OF SLEEP DISORDERS

More than half of adults over the age of 65 years complain of at least one type of sleep problem. As we get older, our sleeping patterns change. However, good restorative sleep is essential to our physical health and emotional well being. Sleep loss impacts all facets of life and virtually all organ systems.

There are many different types of sleep disorders, and many people have more than one sleep problem. Not getting the proper amount or good quality of sleep leads to more than just feeling tired. Sleepiness and sleep disorders may interfere with cognitive function, which can lead to memory impairment in people of all ages, and even personality changes. Excessive daytime sleepiness is particularly common among young adults, the elderly, and shift workers. Adults with daytime sleepiness actually have a high incidence of automobile and occupational accidents, and even job loss.

Sleep disorders such as obstructive sleep apnea can present with a wide variety of complaints, including the following:

  • Excessive daytime sleepiness
  • Daytime fatigue
  • Snoring
  • Difficulty initiating or maintaining sleep
  • Cessation of breathing in sleep
  • Uncomfortable leg sensations/leg jerks in sleep
  • Irritability/Depressed mood
  • Sexual dysfunction
  • Unusual behaviors in sleep (i.e. night terrors, sleepwalking, nocturnal seizures)
    If you suspect you have obstructive sleep apnea, talk to you your primary care physician, cardiologist, or sleep medicine doctor about an evaluation.

Your symptoms and risk factors may be easily assessed using the following “Stop-Bang” criteria:

  • Do you Snore loudly (louder than talking or loud enough to be heard through closed doors)?
  • Do you often feel tired, fatigued, or sleepy during the daytime?
  • Has anyone observed you stop breathing during your sleep?
  • Do you have or are you being treated for high blood pressure?
  • Is your body mass index more than 35.0 kg/m2?
  • Is your age over 50 years?
  • Is your neck circumference more than 40 cm (15.75 inches)?
  • Are you of male gender?

Having at least three positive responses to these questions suggest a high risk for Obstructive Sleep Apnea (OSA). Based on your score, your provider may order home sleep testing to determine whether you indeed have OSA.

WHAT TO EXPECT DURING YOUR SLEEP STUDY

Some sleep disorders, such as obstructive sleep apnea, require overnight observation in the sleep laboratory. During an overnight sleep test (polysomnogram), electrodes are placed to record brain activity, eye movements, heart rate, and muscle activity. Additional sensors are placed around the nose, chest, and abdomen to record breathing patterns. On the night of the study, you will be asked to report to the sleep laboratory between 8:00 p.m. and 8:30 p.m. to prepare for the test. You will be allowed to go to sleep at your usual bedtime in a private sleep room. If no other tests are scheduled, you will be free to leave the laboratory in the morning between 5:30 a.m. and 6:00 a.m. Special accommodations can be made as needed for atypical sleeping times.

People with excessive daytime sleepiness in whom narcolepsy is suspected are typically given a multiple sleep latency test (MSLT) on the day following the overnight polysomnogram. During the MSLT, you will be given five opportunities to nap throughout the day (at 2-hour intervals) while electrical activity is recorded from the brain, eyes, and chin muscles. The time it takes to fall asleep during each nap is measured. The test provides an objective measure of daytime sleepiness.

People who serve in special types of jobs or in special circumstances may be required to have a maintenance of wakefulness test (MWT) to determine their ability to remain awake. During the MWT, you will have four trial periods of 40 minutes each (separated by 2-hour intervals) while resting in a semi reclining position. The purpose is to determine how likely you may be to fall asleep during a typical day.
Depending on your clinical history, additional parameters can be recorded during the sleep studies.

Lastly, as part of your sleep evaluation at First Coast Cardiovascular Institute Sleep Disorder Center, you will be asked to complete a series of sleep-related questions when you arrive for your sleep study.

IN PREPERATION FOR YOUR SLEEP TESTING, PLEASE READ THE FOLLOWING INSTRUCTIONS CAREFULLY:

  • Avoid napping the day of the study.
  • Avoid alcohol, caffeine, sedatives, and stimulants for 24 hours, unless otherwise directed by your physician.
  • Eat your regular evening meal before you arrive to the Sleep Disorders Center. Breakfast is provided to those patients required to stay for daytime testing. Notify us in advance of any special dietary needs.
  • On the day of the study, make sure that your hair is free of oil, hair spray, and other products.
  • Bring your regularly scheduled medications and plan to take them as you normally would unless your physician instructs otherwise.
  • Bring comfortable sleep attire (avoid silk). Shower facilities are provided.
  • Bring your sleep questionnaire and sleep log (if applicable), along with a list of your regular medications, including dose strength, and dosing schedule.
  • If you are using positive airway pressure therapy (CPAP/BILEVEL), bring your mask and headgear.
  • Notify us if you have a disability that requires special assistance. You may be required to have a caregiver present during testing.

In preparation for your Multiple Sleep Latency Test (MSLT), or Maintenance of Wakefulness Test (MWT), please read the following instructions carefully:

  • Eat normally the night before and the morning of the study.
  • Breakfast and lunch will be provided if you stayed overnight for the polysomnogram. If you are scheduled for a day study only; please eat a normal meal the night before and the morning before coming to your appointment. Please notify us in advance if you have any special dietary needs.
  • Wear comfortable clothing.
  • On the day of the study, make sure that your hair is free of oil, hair spray, and other products.
  • Bring your regularly scheduled medications and plan to take them as you normally would unless your physician instructs otherwise.
  • Bring reading materials or other activities to occupy free time.
  • Avoid naps, smoking, and physical exertion on the day of the test.
  • Notify us if you have a disability that requires special assistance. You may be required to have a caregiver present during testing.
  • Avoid alcohol, sedatives, stimulants, and caffeinated beverages (coffee, tea and cola) for 24 hours before the study.
  • If you are scheduled for MSLT, please check with your physician regarding changes in medications. Your doctor might advise you not to take any stimulant medication for two weeks prior to the test.
  • If you are scheduled for MWT, please check with your physician regarding changes in medications. Your doctor might advise you to continue to take the stimulant medications on the day of the test.

HOME SLEEP TESTING

Home sleep testing is a portable diagnostic test that helps confirm whether you have obstructive sleep apnea. The testing is done in the comfort of your home, instead of a sleep laboratory, using a reduced amount of sleep monitoring equipment.








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