Fisher-Titus Sleep Center

To diagnose a potential sleep disorder, a painless evaluation called a sleep “test” or sleep “study” (also known as polysomnography) is performed during a patient’s normal sleeping hours. Small metal discs (electrodes) are placed on the scalp, face, chest and legs to monitor the brain, breathing and muscle movements while you sleep.

Treatment varies depending on your condition. The Sleep Center offers a variety of treatments for various sleep disorders, including positive airway pressure, also known as PAP or CPAP, which is less invasive and less costly than surgery and is considered the “gold standard” treatment of Sleep Apnea, one of the most well-known sleep disorders. Through our PAP NAP program, patients receive one-on-one education from our qualified technologists regarding PAP treatments. Other treatments include oral appliances for very mild Sleep Apnea or Bruxism, medication and behavioral therapy for Insomnia, Narcolepsy, Periodic Limb Movement Disorder (PLMD) and more.

Obstructive Sleep Apnea, or OSA, occurs when the muscles in the throat relax too much during sleep and block the airway. More specifically, the base of the tongue and the uvula relax and sag, causing the airway to collapse and sometimes close completely. Most people think it just causes loud snoring. However, when the snoring stops or pauses, the sleeper periodically stops breathing, and this lack of oxygen causes the sleeper to awaken and gasp for breath. In a patient with OSA, this cycle may be repeated as many as 600 times per night. Pauses where breathing has stopped may last for 10 seconds or more each time.

Other conditions that may cause OSA can include a smaller-than-normal jaw, large tongue, enlarged tonsils or tissues that partially block the entrance to the airway.

While most OSA sleepers do not remember awakening many times during the night, this condition puts enormous stress on the heart, increased blood pressure, severe/dangerous drops in blood oxygen levels, and fragmented sleep. Persons who experience OSA wake feeling un-refreshed and exhausted during the day despite the fact that the person feels he/she “slept fine” through the night. OSA can even be fatal… it’s important to speak to your doctor about your symptoms and concerns.

Symptoms of Obstructive Sleep Apnea can Include:

• Chronic snoring
• Sleeplessness and fatigue
• Irritability
• Depression
• Shortness of breath
• Gasping during sleep
• Frequent awakening during the night

It is not uncommon for children to also experience obstructive sleep apnea. The Sleep Center treats children ages 3 and older for OSA and other sleep disorders. While children may often be unable to verbalize or identify symptoms of OSA or other sleep disorders, it is important for parents and guardians to note unusual behavior in their children that may indicate an issue, such as frequent fatigue, complaints of tiredness, irritability or trouble focusing or paying attention in school.

Diagnosis & Treatment of Sleep Apnea

At the Fisher-Titus Sleep Center, our highly qualified and experienced physicians and technologists are dedicated to diagnosing and treating obstructive sleep apnea. One of the most common treatments for OSA is Positive Airway Pressure, also known as PAP, CPAP or BPAP. PAP is known as the “gold standard” treatment for OSA, and is often less costly and less invasive than surgical intervention.

PAP treatment involves the use of a small, quiet device which circulates room air into a small mask which is worn on the nose or nose and mouth during sleep. The air is pushed gently into the airway to create an “air splint.” This helps patients breathe more easily and thus sleep more soundly throughout the night.

To help educate patients regarding their first PAP treatments, the Sleep Center offers its PAP NAP program, in which our highly trained technologists work one-on-one with patients to help them learn about the use of PAP and how to cope with this new way of sleeping. Contact us today to learn more about our PAP NAP program or how we can help you with your obstructive sleep apnea.

Bruxism, also known as teeth grinding, is a common sleep disorder. Sleepers affected with bruxism often grind their teeth or clench their jaw unknowingly during sleep, but can wake up feeling real pain. Bruxism is not only painful, but can lead to other issues such as severe or chronic headaches, mouth, jaw and tooth pain and other dental complications such as weakening or damaging of the teeth.

Bed partners of those with bruxism also find that the disorder disrupts their own sleep, as the sound of teeth grinding can be loud and off-putting. Any disruption of a valuable good night's sleep can have adverse effects on the sufferer as well as their bed partners, and lead to further issues such as fatigue, irritability and stress, which then hinder the ability to perform daily tasks and responsibilities effectively, as well as have drastic effects on happiness and quality of life.

Bruxism is often caused by stress or tension, especially if felt prior to bedtime. To help alleviate symptoms of bruxism, relaxation techniques are recommended. Stretching, hot showers or baths, moderate exercise – although not right before bedtime, but during the day or several hours before bedtime – are shown to help relax muscles and ease stress and tension of the upper body and facial region.

As bruxism can occur in adults and children alike, the Fisher-Titus Sleep Center helps diagnose and treat adults and children ages 3 and older. By performing a sleep study, or sleep test, our physicians and technologists can help determine a path of treatment as well as if bruxism is part of a more severe sleep disorder such as sleep apnea.

Common treatment of bruxism often involves fitting a patient with a mouth guard. The mouth guard, often made of a soft plastic material, helps keep teeth aligned properly and prevents contact between the upper and lower teeth which leads to the grinding or clinching. This treatment is frequently effective and available at a relatively low cost.

At the Fisher-Titus Sleep Center, we understand the value of a restful night's sleep, and our staff is here to help you rest easy. Too often, people don't do anything about treating bruxism, believing there is not much that can be done to remedy the situation or that disrupted sleep is commonplace or inevitable. Meanwhile, countless nights are lost without getting the rest and sleep that their bodies require.

Narcolepsy is one of the more severe and potentially dangerous forms of sleep disorders. It occurs when a patient’s body is unable to properly regulate its sleep cycles. As a result, a person suffering from narcolepsy can experience spontaneous episodes of sleep at any time, especially during the daytime, without forewarning or without particular feelings of tiredness leading up to sleep.

In order to understand narcolepsy, it’s first helpful to understand a normal sleep cycle. A typical sleep cycle consists of four stages of NREM, or non-rapid eye movement sleep, and then progresses into REM, or rapid eye movement sleep.

• Stage 1 of NREM sleep consists of light sleep in which the sleeper can be awakened easily
• Stage 2 begins as light sleep and progresses into a deeper state of sleep
• Stage 3 is an even deeper stage of NREM sleep
• Stage 4 is the deepest

About an hour and a half into the NREM sleep cycle is when REM sleep normally occurs. This is the state of sleep in which dreaming takes place, and is often marked by increased brain activity and muscle tension.

Symptoms & Effects

In a person with narcolepsy, instead of progressing through the stages of NREM sleep before REM sleep, REM sleep occurs almost instantly and at any time during the day. This poses real dangers to the person suffering with narcolepsy as well as to those within his or her environment, as instantaneous sleep can occur during conversation, while driving, at work, while caring for others – the possibilities and situations are infinite. Other symptoms and effects of narcolepsy include the uncontrollable urge to fall asleep, no matter the time of day, as well as extreme muscle weakness when surprised or laughing.

Not only can bouts of narcolepsy create potentially harmful situations, but those who experience narcolepsy often attempt to self-regulate the disorder through excessive coffee consumption, other caffeinated beverages or stimulants in order to stay awake, which can cause a variety of additional health issues.