SUMMA HEALTH SYSTEM. Sleep Medicine Services
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1 SUMMA HEALTH SYSTEM Sleep Medicine Services
2 Contents Why should I be concerned about a sleep disorder? 2 Evaluate Your Daytime Sleepiness 3 Common sleep disorders 5 About sleep studies 6 What to expect in a sleep study 8 Our staff 10 Summa Sleep Medicine Center locations 12
3 Why choose Summa s Sleep Medicine Services The specialists at Summa s Sleep Medicine Center are committed to improving patient outcomes. Our physicians, recognized by the American Academy of Sleep Medicine, treat thousands of patients each year who experience a wide range of sleep disorders. Some of the key benefits to Summa s Sleep Medicine Services include: Access to board-certified sleep physicians throughout Summit, Stark, Portage and Medina counties Access to a sleep psychologist Easy access to convenient and comfortable testing locations Registered sleep technicians monitor patients during the sleep tests Appointments to accommodate your personal wake and sleep cycles Financial assistance to those who qualify Summa s Sleep Medicine Services can help get you the rest you need to effectively go about your day. 1
4 Why should I be concerned about a sleep disorder? According to the World Sleep Foundation, nearly half of all Americans have difficulty sleeping. Untreated sleep disorders can lead to serious health problems including: Shorter lifespan Premature stroke Heart attack Shortness of breath High blood pressure Increase risk of diabetes Symptoms of sleep disorders, both physical and behavioral, include: Snoring Gasping for air during sleep Unusual behaviors like walking and talking during sleep Insomnia Risk factors vary, but may include: Family history of sleep disorders Physical abnormalities involving the upper airway Excess body weight Use of alcohol and/or medications that cause sleepiness Use of antidepressants Consumption of caffeine Stress Chemical imbalance Autoimmune deficiency Disorder involving the neurological, metabolic or endocrine system, such as epilepsy 2
5 Evaluate Your Daytime Sleepiness The Epworth Sleepiness Scale* is used to determine your level of daytime sleepiness. If you score 10 or more on this test, you should talk with your primary care physician or a sleep specialist to determine the cause and identify whether you have an underlying sleep disorder. Use the following scale to choose the most appropriate number for each situation: = would never doze or sleep 1 = slight chance of dozing or sleeping 2 = moderate chance of dozing or sleeping 3 = high chance of dozing or sleeping Situation Chance of Dozing or Sleeping Sitting and reading Watching TV Sitting inactive in a public place Being a passenger in a motor vehicle for an hour or more Lying down in the afternoon Sitting and talking to someone Sitting quietly after lunch (no alcohol) Stopped for a few minutes in traffic while driving Total score *Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991;14(6): This copyrighted material is used with permission granted by the Associated Professional Sleep Societies January Unauthorized copying, printing or distribution of this material is strictly prohibited. 3
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7 Common sleep disorders There are a number of conditions that could result in sleep disorders. They include sleep apnea, restless leg(s) syndrome, narcolepsy and insomnia. The sleep specialists at Summa Health System have extensive training in treatment options, effective medications and behavioral therapy. Sleep Apnea: This is the most common sleep disorder, which includes a disruption of breathing during sleep and frequent awakenings. Untreated obstructive sleep apnea can lead to an increased risk of stroke and heart problems. Treatment options include lifestyle modification, dental appliances, surgery or use of a positive airway pressure (PAP) machine. Snoring: The vibration of tissue in a partially obstructed airway, resulting in sleep disruptions and abnormal breathing patterns. Treatment options include lifestyle modification, surgery, dental appliances or change in sleep position. Insomnia: A condition in which a person has difficulty falling asleep or frequently wakes up during the night. Treatment options include prescription medication, behavioral management techniques or both. Narcolepsy: A neurological condition characterized by daytime sleep attacks, a lack of energy, muscle weakness, disturbing dreams, sleepiness and/or muscle paralysis. Treatment usually involves medication and adjustments in lifestyle. Nightmares: Disturbing dreams that disrupt the ability to stay asleep and can contribute to difficulty falling asleep. Nightmares frequently cause distress especially at night but also during the daytime. Treatments include behavior, relaxation, and rescripting techniques. Parasomnia: A sleep disorder where a person is aroused during sleep, resulting in unusual behavior such as sleep walking, sleep terror, nightmares and sleep eating. Treatment involves behavioral therapy, prescription medication and/ or identification and treatment of an underlying medical condition. 5
8 About sleep studies What is a sleep study? A sleep study includes single or multiple diagnostic tests performed by a qualified technician to help diagnose a number of sleep disorders. The tests are non-invasive; no needles, injectable dyes, IVs or shots are used. A patient goes through a PAP titration study at Summa Wadsworth-Rittman Hospital Sleep Medicine Center. Why are sleep studies ordered? It is critical that your specialist identify the reason for your sleeping problems, because treatment choices depend on the type of disorder. Sleep studies will help your doctor identify: Sleep-related breathing disorders, such as sleep apnea Narcolepsy Behaviors that could be harmful to the patient or others Correct levels of CPAP (continuous positive airway pressure) 6
9 Types of sleep studies Polysomnogram An overnight test that records brain activity, EKG, eye movements, heart rate, level of oxygen in the blood, air movement through the nose and chest movements that indicate whether you re making an effort to breathe. PAP/Bilevel Titration Study A test performed after a polysomnogram, which utilizes positive airway pressure (PAP) to determine the proper pressure levels needed for the patient s treatment. Multiple Sleep Latency Test A daytime test to determine how sleepy you are. The test monitors for brain activity to determine whether the person falls asleep and, if so, what stages of sleep are reached. Maintenance of Wakefulness Test A daytime test that measures your ability to stay awake and alert. Home Sleep Test A home sleep test monitors a limited number of parameters compared to an in-lab sleep study and is performed in your own home. This test is a screening assessment for sleep apnea while an in-lab test is a diagnostic assessment. An individual s medical history will determine if this test is appropriate for them. 7
10 What to expect in a sleep Referral/registration You must be referred by a doctor to get a sleep study. Consult with your primary care physician or a sleep specialist to determine whether you are a candidate. To schedule a sleep study, refer to the back page of this booklet to call to schedule your test. We have locations in Summit, Portage and Medina counties. Insurance coverage Eligibility requirements and coverage vary from one policy to another. Your physician s office will verify coverage with your insurance plan and obtain prior authorization for your sleep study. Please present a current insurance card when you arrive for your appointment. Charges not covered by insurance will be the responsibility of the patient. Preparing for the test Prior to arrival for your test: Avoid alcohol and caffeine consumption If possible, do not take over-thecounter medications the day of your study Do not apply any product to your hair or skin the day of the test (hand lotion, conditioner, styling products, etc). Do not wear braids, wigs, hairpieces or pins You should continue to take prescribed medicines (insulin, heart prescriptions, etc.) at your usual times throughout the day Items to bring: Loose-fitting sleep clothes and your own pillow (if desired) Current insurance card Prescription medications that you take at night or first thing in the morning Photo ID Watch to learn more about what happens during a sleep study at summahealth.org/sleepstudy 8
11 study Upon arrival: You will be led to your private, home-like bedroom Your sleep technologist will explain the procedure and equipment to you and answer any questions You will complete remaining paperwork You will change into your sleep clothes The technician will apply the electrodes and sensors to your body. These are used to monitor your movements and activities. Test Results At the conclusion of your test, the sleep technologist will wake you (usually around 5:30 a.m.), and you will be asked to complete a postsleep questionnaire. The data from your test will be scored and interpreted, and then sent to your physician within five business days. We encourage you to follow up with your physician who ordered the test to discuss your results after each visit. From your test results, your physician will determine whether treatment is necessary and, if so, what treatment. If you have a positive test result and have had a follow-up test to determine PAP settings, we will refer you to a durable medical equipment company to get your equipment. If behavioral changes are needed, we may refer you to a behavioral health specialist. A sleep study room at Summa Neuroscience Center on White Pond Drive in Akron. 9
12 Our Staff Sleep medicine physicians Sleep physicians at Summa Health System are board-certified or board-qualified in internal medicine, neurology, pulmonary medicine and sleep medicine. Sleep physicians can order a sleep test, interpret the test results and recommend the proper course of treatment. Sleep psychologist An important part of treatment is the role of a psychologist specializing in sleep disorders. The psychologist provides behavioral therapies tailored to sleeping disorders, help patients comply with sleep apnea treatment plans, evaluate patients sleep studies and treats depression and anxiety, which can accompany sleep disorders. Sleep technologists Specially trained sleep technicians explain the process of a sleep study, answer questions and monitor the brain waves, heart rate and other activities of the patient during the study. To find the location of a sleep specialist, call (800)
13 Summa s Sleep Medicine Physicians Summa Physicians Inc. Benjamin P. Graef, D.O. Summa Psychiatry Associates Erin Farrer, Ph.D. Neurology & Neuroscience Associates (NNA) Zachary R. Lewton, M.D. Ravi C. Madala, M.D. Jose C. Rafecas, M.D. Frankie J. Roman, M.D. Lawrence M. Saltis, M.D. Lung, Allergy and Sleep Center of America Harish Kakarala, M.D.* Kar-Ming Lo, M.D.* Timothy Murray, M.D.* Michael A. Passero, M.D.* Sanjiv Tewari, M.D.* Gina Chen, M.D. Independent Laura A. Mooney, M.D.* Masroor Mustafa, M.D.* Respiratory Critical Care and Sleep Associates Nader A. Botros, M.D. Albert Kim, M.D. Matthew L. Krauza, M.D. Hitesh Makkar, M.D. Chad Paxson, D.O. *Does not review studies at Summa Western Reserve Hospital 11
14 Our Locations Summa Neuroscience Center 701 White Pond Drive, Suite 210 Akron, OH (330) Summa Barberton Hospital 155 Fifth St. NE, Fourth Floor Barberton, OH (330) Summa Wadsworth-Rittman Hospital Founders Hall 195 Wadsworth Road, Suite 403 Wadsworth, OH (330) Summa Western Reserve Hospital rd St., Fourth Floor Cuyahoga Falls, OH (330) Summa Health Center at Green 1700 Boettler Road, Suite 215 Uniontown, OH (330) Summa Health Center at Lake Medina 3780 Medina Road (Route 18), Suite 230, Medina, OH (330) Summa Health Center at Western Reserve 5655 Hudson Drive, Suite 120 Hudson, OH (330) Robinson Health Center at Streetsboro 9318 State Route 14 Streetsboro, OH (330) Robinson Memorial Hospital 6847 N. Chestnut Street Ravenna, OH (330) To learn more about our services and see what happens during a sleep study, visit summahealth.org/sleep 12
15 HUDSON 80 STREETSBORO SUMMIT 8 PORTAGE MEDINA 18 MONTROSE CUYAHOGA FALLS RAVENNA 71 MEDINA WADSWORTH BARBERTON UNIONTOWN 77 13
16 To learn more about our services and see what happens during a sleep study, visit summahealth.org/sleep BAR /CPS/JM-9/12
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