Sleep Disorders

Diagnosis

Sleep disorders are diagnosed through evaluation by a sleep specialist, who reviews your medical history, sleep patterns, and symptoms. Input from a bed partner may help provide additional details. Your specialist may perform a physical exam and ask you to keep a sleep log to track daily activities and sleep patterns.

Common tests for diagnosing sleep disorders include:

• Actigraphy: A wrist-worn monitor tracks arm and leg movements over several days to weeks, providing information on sleep-wake cycles and treatment effectiveness.

• Sleep study (polysomnography): Measures brain waves, oxygen levels, heart rate, breathing, and eye and leg movements. Testing may occur in a sleep center or hospital unit and can inform CPAP settings for sleep apnea.

• Home sleep apnea test: Simplified monitoring of breathing rate, airflow, oxygen levels, heart rate, and sometimes blood vessel tone. Data is uploaded for review by a sleep specialist.

• Multiple sleep latency test (MSLT): Measures daytime sleepiness through 4 to 5 scheduled naps in a quiet, dark room.

• Maintenance of wakefulness test (MWT): Evaluates daytime alertness over 4 to 5 scheduled naps, focusing on the ability to stay awake.

• Upper airway nerve stimulation therapy evaluation: Tests help determine whether a surgically implanted device is suitable for obstructive sleep apnea.

• Overnight oximetry test: Measures oxygen levels and heart rate overnight using a finger monitor to detect drops in oxygen, often associated with sleep apnea.

Treatment

Treatment for sleep disorders depends on the specific condition and the severity of symptoms. Options may include lifestyle changes, devices, therapies, medications, or surgery.

• Healthy lifestyle choices: Weight management, good sleep habits, regular physical activity, limiting alcohol and caffeine near bedtime, and avoiding recreational drugs.

• Treatment of underlying health conditions: Managing medical or mental health issues that contribute to sleep problems.

• Cognitive behavioral therapy for insomnia (CBT-I): Addresses thoughts and behaviors that interfere with sleep. Strategies may include relaxation techniques, consistent sleep-wake schedules, and limiting naps.

• Continuous positive airway pressure (CPAP) therapy: Standard treatment for obstructive sleep apnea. The machine delivers airflow through a mask to keep the airway open during sleep.

• Bilevel positive airway pressure (BPAP): Used for those who cannot tolerate CPAP or have respiratory muscle issues.

• Oral appliances: Custom-made mouthpieces that advance the lower jaw and tongue to reduce airway blockage.

• Surgical options: Procedures to reduce upper airway obstruction, including nasal or jaw surgeries and soft tissue reduction.

• Upper airway nerve stimulation therapy: FDA-approved Inspire system for obstructive sleep apnea when CPAP is not effective. A small generator placed under the chest skin sends pulses to the nerve under the tongue, opening the airway during sleep.

• Medications and supplements: May be recommended for certain sleep disorders based on individual needs.