Diagnosis and Treatment of Sleep Disorders

The Emory Clinic Sleep Disorders Center offers a complete range of diagnostic procedures to identify specific sleep disorders, as well as the latest treatments and therapies to manage the patient's condition. From simple snoring to more severe conditions such as obstructive sleep apnea, the center works with patients to tailor an individualized treatment plan.

Diagnostic Services

The Emory Clinic Sleep Disorders Center uses among the most sophisticated and technologically advanced diagnostic tools available to diagnose patients with sleep disorders. These include:

Polysomnogram

A polysomnogram records information about an individual’s sleep. Sensors are gently attached to a patient’s body which obtain, while the patient sleeps, a continuous recording of brain waves, eye movements, muscle tone, and oxygen levels in the blood, heart rate and rhythm, leg and body movements, sounds made while sleeping, breathing effort, and airflow through the nose and mouth. If other disorders are suspected, additional information is recorded.

The recording is painless, however patients with sensitive skin may notice mild irritation from the sensor adhesive. This equipment can be disconnected during the night, to enable a patient to get out of bed or use the bathroom.

A polysomnogram generally takes place during an overnight stay in the Sleep Center. If you routinely sleep during the day or evenings, your testing hours can be customized with advanced planning. Each of the Sleep Center’s bedrooms are private with an adjoining private bathroom and shower, and patients are monitored from an adjacent control room by an experienced sleep technologist.

Positive Airway Pressure (PAP) Titration Study

If Polysomnography testing shows that an individual demonstrates sleep apnea, a PAP titration study will be ordered to initiate treatment. If the sleep apnea is severe, this may take place during the first overnight sleep study. Otherwise, the individual will need to return for a second all-night sleep study before starting CPAP (Continuous Positive Airway Pressure) therapy.

During the titration study, as the patient sleeps using the CPAP machine, the sleep technologist will record data including the patient’s breathing and make adjustment to the CPAP machine during the night. These adjustments do not require the technologist to awaken the patient. The technologist will use this information to find the level of air pressure that keeps the  airway open and helps the patient to  breathe easily and to reduce the number of times breathing stops to allow better and safer sleep.

Multiple Sleep Latency Test (MSLT)

The MSLT is the standard way to quantify sleepiness and diagnose disorders of excessive sleepiness. Generally used to evaluate for Narcolepsy, this type of polysomnogram is conducted after an overnight polysomnogram to investigate other possible causes of excessive sleepiness (e.g. sleep apnea or periodic limb movements during sleep) and to make sure the patient is not lacking REM (rapid eye movement) sleep. The MSLT begins one-and-a half to two hours after awakening in the morning, with the patient being encouraged to sleep five more times, once every two hours.

Multiple Wakefulness Test (MWT)

This polysomnogram is used to evaluate the ability to stay awake during the day. This is a variation of the MSLT, in which the patient is instructed to attempt to stay awake sitting up in bed, rather than napping, every two hours. MWT testing is available for testing required by the Dept. of Transportation, Federal Airway Adminsitration, and as required by other organizations and employers.

Treatment Services

Our center provides a full range of diagnostic capabilities to manage all types of sleep disorders. Our respected clinical quality is signified by our American Academy of Sleep Medicine (AASM) accreditation. Our board-certified sleep experts provide consultation, treatment coordination and follow-up care with your primary care physician, and work closely with specialists in the fields of cardiology, pulmonology, and neurology.

Our physicians include those named among the “BEST DOCTORS IN AMERICA” and our sleep specialists have performed groundbreaking research on restless legs syndrome, periodic limb movement disorders, sleep apnea, narcolepsy, and excessive daytime sleepiness. Board certified sleep physicians and nurse practitioners utilize medication, CPAP, positioning therapy, weight loss therapy, and oral appliance therapy in the management of sleep disorders.

The current “gold standard” for the treatment of sleep apnea is use of a Continuous Positive Airway Pressure (CPAP) machine. This machine, used with a mask specifically selected by the patient, provides aire pressure that prevents the airway from closing and interrupting breathing. Many types and styles of masks are available, and our staff will work with the patient to determine which works best and is most comfortable for the patient. Consistent use of CPAP for the treatment of sleep apnea is important not only for better sleep, but to avoid more serious consequences of untreated sleep apnea such as:

• Hypertension (high blood pressure)
• Myocardial Infarction (heart attack)
• Stroke
• Arrhythmia (irregular heartbeat)

Everyone has a different experience when using CPAP for the first time. Some find that CPAP is comfortable and easy to use; others find it requires a period of adjustment. Emory Sleep Center is committed to ensuring you receive the education and support required to make your experience with CPAP as successful as possible. Our Center sleep specialists will determine if CPAP is an appropriate treatment method, or whether other treatment methods for sleep apnea should be considered.

Medication

A wide variety of medications are available to manage conditions such as narcolepsy, insomnia, and apneas. Our physicians will develop an individualized medication therapy plan for each patient.

Behavioral Therapy

Behavioral therapies treat the root causes of some sleep disorders. Depending on the type of disorder, recommended programs include:

• Weight loss

• A change in sleep habits

• An exercise regimen