At the Sanford Sleep Disorders Center, a sleep specialist will evaluate your situation with the use of a sleep study known as a polysomnogram or PSG. A PSG is an outpatient overnight sleep test where the technician places dime-sized sensors at various points on the patient’s body to record brain waves, muscle activity, leg and arm movements and heart rhythms.

Other body functions during sleep, such as oxygen levels, breathing rates and airflow at the nose and mouth are also recorded. This evaluation helps determine if the patient suffers from a sleep disorder, the type and severity of the disorder and how best to treat the condition. Follow up visits are scheduled and additional appointments are made as needed.

The Sleep Disorders Center deals with the diagnosis and treatment of all types of sleep disorders. The most common disorders are Sleep Apnea, Narcolepsy and Insomnia.

Sleep Apnea
When a person stops and then starts breathing again many times during the night.

Narcolepsy
When a person falls asleep suddenly many times during the day.

Chronic Insomnia 
When a person has trouble falling asleep or staying asleep night after night.

Sleep Apnea

Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep. Each episode, called an apnea lasts long enough so that one or more breaths are missed, and such episodes occur repeatedly throughout sleep. Sleep apnea is a common sleep disorder that can be potentially very serious, and even life-threatening. Each pause in breathing typically lasts at least 10 seconds or more, and the pauses can occur 20 to 30 times or more an hour.

Common Symptoms

• Loud snoring that may be heard throughout the house.
• Snoring that is interrupted by pauses and then gasps.
• Frequent daytime exhaustion.
• High Blood Pressure
• Falling asleep at inopportune times, such as at work or while driving.
• Short attention spans.
• Forgetfulness, irritability, anxiety or depression.
• Awaking frequently, gasping for air, and thrashing about during sleep.
• Loss of interest in sex.

Types of Sleep Apnea

• Obstructive Sleep Apnea
  Obstructive sleep apnea is often called the upper-airway apnea. It is also the most common and severe form of sleep apnea. During sleep, the muscles located at the base of the tongue relax and sag, obstructing the airway causing breathing to become difficult and noisy. A listener hears snores with broken pauses when breathing stops. The muscles of the diaphragm and chest must work harder as the pressure to breathe increases. Sleep is temporarily interrupted, activating the throat muscles and "uncorking" the airway. A listener hears deep gasps as breathing starts, awakening the sleeper. Awakenings are generally so brief and incomplete that the sleeper does not remember them. Someone with obstructive sleep apnea may stop breathing for 10 seconds or longer, have an awakening dozens, even hundreds of times each night.
  
  Each time breathing stops, the level of oxygen in the bloodstream falls, forcing the heart to work harder to circulate blood. Blood pressure rises and may stay elevated after breathing restarts. The heart sometimes beats irregularly and may even pause. Avoid taking alcohol, sleeping pills and tranquilizers at bedtime. They can further reduce muscle tone and may make the airway more susceptible to collapse.
  
  Most people with obstructive sleep apnea have no obvious physical abnormality that interferes with breathing; some conditions make people more susceptible to obstructive sleep apnea.
  • Smaller-than-normal jaw
  • Large tongue
  • Enlarged tonsils
  • Tissues that partially blocks the entrance to the airway

Obstructive sleep apnea primarily strikes overweight men. Female hormones and a different throat anatomy may protect women until menopause. In later years, the gap between the sexes narrows although it never disappears entirely.

• Central Sleep Apnea
  This form of sleep apnea differs from obstructive in that the airway stays open; it is the diaphragm and chest muscles that stop working. The decreased levels of oxygen signal the brain causing the sleeper to awaken and resume breathing.
  
  As people grow older, central sleep apnea becomes more common. As many as one in four people age 60 or older experience disturbed breathing during sleep. The problem is usually mild and it tends to be more frequent and severe in people who have congestive heart failure or neurologic disorders. People tend to be more aware of frequent awakenings if they have central sleep apnea than if they have obstructive sleep apnea.

What Causes Sleep Apnea

During sleep, muscles relax more than during waking hours. The muscles involved in breathing do the same. For some people with sleep apnea, their muscles in the throat area relax too much. The reason for this is still unknown. This compromises breathing and makes sleep time risky.

Some people have narrower than normal throat passages, which causes the passage to close when the muscles relax. In still other cases, the trouble stems from the part of the brain that controls breathing during sleep. The brain forgets to send the necessary instructions to the muscles that control breathing.

What Treatment Offers

People with sleep apnea can benefit not only from specific treatments for apnea, but by making a few minor adjustments in their lifestyle.

Specific Treatments

Continuous positive airway pressure or CPAP is an effective method of treatment for obstructive sleep apnea. During this treatment, a mask is placed over your nose during sleep. Air is forced through the nasal passages by an air compressor, causing the air passageways to remain open. Recent studies have suggested that CPAP may also be effective in the treatment of central apnea, as well.

For some people, oral devices are used to open the airway by bringing the jaw, tongue and soft palate forward.

If your sleep apnea problem is caused by such physical abnormalities as enlarged tonsils or adenoids, your doctor may suggest surgically removing them. Other problems may include nasal polyps, a deviated nasal septum or malformations of the jaw or soft palate.

Lifestyle adjustments

• Weight loss. A minimal weight loss may improve breathing, making sleep more restful and diminishing daytime sleepiness.
• Avoid alcohol and sleeping pills. Both depress breathing which makes apnea more frequent and more severe.
• Use all drugs with care. Medications for headache, anxiety and other common problems can affect sleep and breathing.
• Sleep on your side. Some sleep apnea suffers are only affected when they sleep on their backs. If you have a problem sleeping on your side, try placing pillows behind your back or attaching a tennis ball to the back of your pajamas.
• Decongestion medications may be helpful in reducing snoring and the likelihood of apnea.

Snoring should not be taken lightly. Loud snoring may be your body's way of telling you that something is seriously wrong with your breathing during sleep. When you snore, your airway is not fully open. Because the passage way is narrowed, the noise of snoring is the result of the air being forced through the passage.

Between 10 and 30 percent of all adults snore and suffer from no serious medical consequences. However, an estimated 5 in 100 people who snore extremely loud are suffering from obstructive sleep apnea, a potentially life-threatening disorder.

Our sleep specialists will work to diagnose breathing disorders in the earlier more treatable stages of the disorder. With proper treatment, sleep apneas' potentially life-threatening consequences can be prevented or reversed.

Narcolepsy

Narcolepsy is a neurological disorder that causes extreme sleepiness and may even make a person fall asleep suddenly and without warning. Specific causes of narcolepsy are not known, but people with narcolepsy are lacking hypocretin, a brain chemical which regulates sleep and wakefulness.

Common Symptoms

• Excessive daytime sleepiness
• Cataplexy

People often have these symptoms when they are experiencing intense emotions, such as laughter, sadness, surprise, or frustration.

Chronic Insomnia

Almost everyone will be affected by insomnia at some point during life. Insomnia is a short term or chronic inability to get high quality sleep – is a common sleep problem and can be caused by a variety of things including stress, an altered sleep schedule or poor bedtime habits. Whether your problem is an occasional sleepless night or a series of them, plenty of solutions exist to help you get better sleep.

Common Symptoms

• Difficulty falling asleep despite being tired
• Relying on sleeping pills or alcohol to fall asleep
• Awakening frequently or lying awake in the middle of the night
• Awakening too early in the morning and not feeling refreshed
• Daytime drowsiness, fatigue, or irritability
• Difficulty concentrating; poor job/school performance
• Lower reaction times and diminished mental alertness; increased likelihood of accidents
• Weakened immune system
• Increased risk of depression, anxiety and substance abuse

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