Sleep Medicine Services
We Can Help
If you or your healthcare provider suspect that you may have a sleep disorder, the RMH Center for Sleep Medicine is here for you. Our services include the following:
Treatment at the RMH Center for Sleep Medicine begins with a consultation. Patients meet with one of our board certified sleep medicine physicians to assess any possible sleep disorders.
Sleep Study (Polysomnogram)
The next step in treatment for many patients is a sleep study (polysomnogram). Patients participating in a sleep study arrive at the Center and make themselves comfortable in one of the home-like bedrooms. Each room is equipped with a queen-size bed, television, bathroom, individual thermostat and soundproofed walls and windows.
Throughout the night, sleep study patients are monitored by sleep technologists from a central control room. A camera and microphone in each room allows technologists to observe and listen to the patient throughout the study. Electrodes attached to various parts of the patient’s body monitor physiological data such as brain waves, eye movements, muscular contractions, respiratory flow, respiratory effort and blood-oxygen saturation. These measurements will help the physicians diagnose the causes for sleep interruption.
In addition to participating in a sleep study, some patients with Obstructive Sleep Apnea will require the initiation of Continuous Positive Airway Pressure. CPAP acts as a splint for the upper airway, preventing it from collapsing. It is an effective and commonly used treatment for OSA. Once on CPAP, patients may return for CPAP re-titration if their symptoms of sleepiness/fatigue return.
Multiple Sleep Latency Test
MSLT is a means of quantifying levels of daytime sleepiness. It may also be used in diagnosing Narcolepsy. The test measures an individual’s ability to fall asleep and the presence of REM sleep. This test must be preceded by a sleep study. An MSLT may be ordered for the following:
- Suspected Narcolepsy
- Hypnagogic hallucinations (vivid dream-like state occurring at sleep onset)
- Hypnapompic hallucinatioins (vivid dream-like state occurring upon awakening)
- Cataplexy (muscle weakness associated with strong emotion)
- Sleep paralysis
- Successfully treated Obstructive Sleep Apnea with continued excessive daytime sleepiness.
Maintenance of Wakefulness Test
An MWT is the opposite of an MSLT. The test is designed to assess one’s ability to maintain alertness during sleep-inducing or boring conditions. A sleep study does not have to precede an MWT. An MWT may be ordered for the following:
- Commercial truck drivers
- Heavy machinery operators
- Assessing the effectiveness of stimulant therapy (as might be ordered for those with Narcolepsy and/or excessive daytime sleepiness)
In the CPAP Clinic, patients who have recently been diagnosed with sleep apnea may see a physician’s assistant, nurse or sleep technologist who will work to ensure that the patient’s CPAP treatment is as effective as possible. Patients may be seen for:
- Mask fit issues
- Mask leaking
- Pressure/machine problems
- Education about sleep apnea
More about REM
The opening of the RMH Center for Sleep Medicine in late 2003 coincided with the 50th anniversary of the discovery of REM, or Rapid Eye Movement, sleep. This discovery laid the foundation for much of the sleep medicine practiced today.
In 1953, researchers at the University of Chicago first noticed that during sleep, people move their eyes back and forth rapidly under closed eyelids. These periods of REM sleep occur on average about 90 minutes apart and last from several minutes early in the night to up to an hour as the night progresses. During REM sleep, the mind is actively engaged in dreaming while the body is essentially immobilized.
The discovery of REM sleep inspired a number of scientists to begin conducting sleep research. Among them was William C. Dement, MD, PhD, who was involved in the initial discovery of REM sleep at the University of Chicago and was the first to recognize that REM sleep is a distinct state characterized by vivid dreaming and muscle paralysis.
Dr. Dement, now at Stanford University, set up the world’s first sleep center for diagnosing and treating sleep disorders in 1970. In 1975, he founded the American Academy of Sleep Medicine. He also co-edited the definitive textbook in sleep medicine. The board-certified sleep medicine physicians at the RMH Center for Sleep Medicine, William Cale, MD, and Frank Barch, MD, share the distinction of having studied with Dr. Dement, the “father of modern sleep studies.”