Diagnostics and Treatments We May Use

Findings from an individualized physical, as well as the results from specific diagnostic procedures, determine the diagnosis and treatment of each patient. After appropriate data is gathered, the team, consisting of physicians from several specialties, the sleep disorders nurse and specialized sleep technicians meets to review the diagnosis and make a multi-specialty treatment plan. Treatment options may include family teaching/instruction by the staff, providing positive airway pressure, providing behavioral counseling and/or medication and surgical procedures such as a tonsillectomy, adenoidectomy, uvulpapatoplasty and tracheostomy. As part of the diagnostic process, we will take a family history and then may perform some of the following:

• Radiology
  X-rays most often are ordered to assess the soft tissue of the neck to see if there is obvious obstruction.
• Lab Work
  Blood work may be ordered to rule out endocrine and metabolic disorders.
• MRI Scan
  Scans may be ordered to rule out brain stem abnormalities.
• EKG of the Heart
  This may be ordered to assess any potential damage to the heart from untreated or undertreated breathing obstruction.
• Memory Monitor
  Painless memory monitors may be worn for a period of time so that staff can analyze specific brain functions recorded by the monitors.
• Polysomnography
  Overnight sleep studies are done in a soundproof bedroom in the sleep lab. A technician
  monitors the patient throughout the night and video equipment is utilized to record the entire procedure. A computerized sleep system records EEG, ECG, respiratory effort, muscle tone, tidal volume, oxygen saturation and entidal CO2.
• Multiple Sleep Latency Testing
  Objective measurement of the tendency to fall asleep is performed on patients with disorders of excessive sleepiness during multiple opportunities to nap. This test is particularly valuable in diagnosing narcolepsy.
• Portable Studies
  These studies can be done on the nursing unit or in the lab. They are often done with a
  pH probe and are performed at night when the patient is asleep. An apnea monitor is interfaced with a multi-channel recorder to monitor patient’s respiratory effort, airflow, heart rate and oxygen saturation.
• Actigraphy
  This is a study done with a small biomedical instrument, typically worn on the wrist, that measures and records body movement. It can be used to define sleep-wake cycles clearly and objectively based on documenting the body movement during wake and lack of movement during sleep periods.