Sleep Medicine

Sleep Medicine Top Conditions Treated

The average individual will spend approximately one third of their life asleep. This time is profoundly important for day-to-day functioning and directly impacts an individual’s functional abilities, concentration, productivity, and memory.

Lack of quality sleep has also been associated with many life-threatening health complications. At PMA, our sleep doctors spend time with patients to properly diagnose sleep disorders and form treatment plans.

We diagnose, treat, and manage the following sleep conditions:

  • Cataplexy
  • Circadian rhythm sleep disorders
  • Idiopathic hypersomnia
  • Insomnia
  • Jet lag
  • Narcolepsy
  • Obstructive sleep apnea (OSA)
  • Parasomnia
  • Periodic limb movement disorder (PLMD)
  • REM Sleep Behavior Disorder
  • Restless legs syndrome (RLS)
  • Restless sleep
  • Shift work sleep disorders
  • Sleepiness
  • Sleepwalking
  • Sleep Related Bruxism
  • Snoring

 Sleep Medicine Services

There are close to 90 internationally recognized and classified sleep disorders. Sleep disorders that remain undiagnosed and untreated can lead to profound daytime functional impairment and life-threatening complications. At PMA, we are pleased to have three board-certified sleep physicians on staff. Drs. Lawrence Stein, Ashtaad Dalal, and Richard Chang provide diagnosis, treatment, and follow-up care for patients with sleep disorders to ensure that an acceptable quality of life is restored and maintained in all patients.

Our sleep physicians work closely with experts in the fields of otolaryngology, oral surgery, dental sleep medicine, and bariatric surgery when formulating the best treatment plan for each patient.

Additionally, we offer a continuous positive airway pressure (CPAP) clinic, which is designed to ensure optimal comfort, acclimatization, and compliance with CPAP therapy.

Sleep problems worsened during the pandemic due to social isolation, lack of normal daytime routines, less outside activity, and less exposure to sunlight. Many sleep disorders, including insomnia, shifts in sleep time, and issues with poor quality sleep, can be treated without medications using cognitive behavioral therapy or CBT. CBT is performed through a series of one-on-one weekly sessions over several weeks to identify thoughts and behaviors that cause or worsen sleep problems and replace them with habits that promote sound sleep.

Additionally, our sleep physicians are experienced with the latest diagnostic tools and treatments for sleep apnea and narcolepsy, including home sleep studies and Provent nasal valve therapy. We also have temporary dental appliances, to test whether or not a more permanent dental appliance is right for you.

Our list of sleep services includes, but is not limited to

  • Cognitive behavioral therapy (CBT) for insomnia
  • Continuous Positive Airway Pressure (CPAP) clinic
  • Diagnostic nasal and/or sinus endoscopy
  • Intranasal or Sinus Procedure
  • Maintenance of wakefulness testing (MWT)
  • Multiple sleep latency testing (MSLT)
  • Polysomnography (overnight, in-lab attended sleep study)
  • Ventilation management

Additional Services

Our list of additional services includes:

  • Durable Medical Equipment (DME)
  • Home sleep study (unattended)

Sleep Disorders and Studies

How We Diagnose Sleep Disorders

There are many signs and symptoms that can indicate a sleep disorder. In some cases, conducting an overnight sleep study or polysomnogram can diagnose specific sleep disorders. If you recognize any of the following patterns in your sleep or life, please schedule an appointment to see a PMA sleep medicine doctor:

  • Breathing cessation while sleeping
  • Inability to sleep
  • Kicking or leg movements during the night
  • Loud snoring
  • Restless sensation in legs prior to bed
  • Unrefreshing sleep
  • Unexplained daytime sleepiness or fatigue
  • Waking regularly throughout the night

Many sleep disorders can be diagnosed with an overnight sleep study, or polysomnogram, according to Dr. Lawrence Stein at Pulmonary and Medical Associates. The sleep study simultaneously records the patient’s brain waves, muscle activity, heart rhythms, belly and chest wall effort, airflow to the nose and mouth, snoring patterns, blood oxygen levels, and nerve impulses to the eye. These factors can help identify the onset of REM (rapid eye movement), dream states and possible impediments to sound sleep.

Sleep apnea is a condition affecting some 15 million Americans and it is among the most common disorders diagnosed at the Lab. Those affected often experience fatigue, headaches, and lethargy. They often have repetitive, involuntary breathing pauses throughout the night due to absent or impaired airflow through the back of the throat. “This results in an adrenaline surge, which in turn causes an elevation in respiratory effort, blood pressure, lung circulatory pressures, and heart rate,” Dr. Stein explains. “The outcome is sleep disruption, loud, irregular snoring, carryover fatigue, and headaches.”

Men are twice as likely as women to suffer from sleep apnea. This is commonly associated with obesity and large neck size and can be exacerbated by alcohol, tobacco and sedative use. Once diagnosed, it can be easily treated with a bedside device, roughly the size of a toaster, called Nasal CPAP (continuous positive airway pressure). A mask attached to the machine blows a constant stream of air into the nose and mouth, acting as a pneumatic splint to prevent the throat from collapsing.

Another common sleep disorder affecting 3-5% of U.S. adults is restless leg syndrome (RLS). Individuals with RLS often experience a pins-and-needles sensation in their legs and feel an irresistible urge to move, making sleep initiation difficult. RLS is often associated with anemia, pregnancy, kidney problems and back problems, says Dr. Stein. Although it can affect individuals of all ages, it is most often seen in older adults. Fortunately, RLS can be treated with a range of therapies.

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