SLEEP FROM A TO ZZZZZZZZZ

Everyone, at one time or another, has experienced trouble falling asleep, staying asleep, or has been sleepy during the day.  People with a sleep disorder experience these and more serious problems.  Sleep disorders disrupt and disturb the overall quality of life.  More than 70 million Americans have a sleep disorder, and many of the sufferers are completely unaware of it.  Many of those who are aware of the problem never choose to seek help.

Many of the sleep disorders can lead to serious problems if left untreated.  For example,  obstructive sleep apnea (OSA), a disorder that affects over 20 million Americans, can lead to serious cardiovascular and neurological problems.  However, when treated, apnea patients reduce the risk of those serious conditions and dramatically improve the quality of their lives.

The Sleep Institute is a treatment facility designed to evaluate and treat those sleep disorders that include snoring, sleep apnea, chronic tiredness, and difficulty falling asleep.  We use the most up-to-date techniques to evaluate your sleep problems in our comfortable sleep centers located on our Alpharetta and Johns’ Creek campuses.

SLEEP STUDIES
Often a loved one is the first to notice the sleep apnea sufferer’s symptoms and suspect something may be wrong.  One of our doctors can find out if you only have simple snoring, or if your snoring is a sign of obstructive sleep apnea (OSA).  To evaluate this, you will need to take an overnight sleep study, called a polysomnogram.  Typically, this test is conducted in a sleep center and measures the individual’s heart rate, respiration, brain activity, eye movement, and blood oxygen level.  You will be diagnosed with OSA if two things occur:

•     You stop breathing due to a blockage of the airway for more than 10 seconds while asleep.
•     This happens more than five times per hour of sleep.

If you have OSA, the sleep study will show if it is mild, moderate, or severe.  A person with OSA is often very sleepy during the day because you wake up at the end of the times when you stop breathing.  These brief awakenings keep you from enjoying long periods of deep sleep.  OSA may lead to sleepiness, heart attack, stroke, and automobile accidents.

TREATMENT
Treatment for adult OSA must depend on the individual’s current physical condition, medical condition, and pertinent test results.  Behavioral, mechanical and surgical methods are the most common forms of treatment for sleep apnea in adults. 

BEHAVIORAL TREATMENTS
Individuals with sleep apnea are advised to avoid tobacco, alcohol, sedatives, and medications that relax the airway and/or compromise respiratory function.  Regular exercise and weight reduction often help people with mild to moderate sleep apnea minimize their symptoms.  Sleep apnea sufferers are also advised to avoid sleeping on their backs.

SURGICAL TREATMENTS
There are a variety of surgical treatments available to treat adult sleep apnea.  Surgery to treat adult OSA involves the nose, throat, or neck area.  Sometimes a combination of those areas may be necessary.  The most common surgery to treat OSA is known as uvulopalatopharyngo-plasty or, UPPP, also known as UP3.  In some people, the airway obstruction may be caused by excess tissue in the uvula or soft palate.  In a UP3, part of the soft palate, the uvula, and some of the tissue on the side of the mouth are removed, which usually includes the tonsils, as well.

MECHANICAL TREATMENTS
A common mechanical treatment for adult sleep apnea sufferers is the use of a continuous positive airway pressure device or CPAP.  The individual wears a CPAP device while asleep.  The device works to keep the airway open by continuously blowing air through the nasal passages at a pressure high enough to prevent the airway from collapsing.

EPWORTH SLEEPINESS SCALE
How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired?  Use the following scale to choose the most appropriate number for each situation:

PRIMARY SLEEP DISORDERS
•     Obstructive Sleep Apnea
•     Insomnia
•     Narcolepsy
•     Sleepwalking
•     Sleep Terrors
•     Restless Leg Syndrome
•     Jet Lag
•     Periodic Limb Movement
•     Shift Work
•     Inadequate Sleep Hygiene
(Bad Sleep Habits)                  

The most common sleep related breathing disorders are obstructive sleep apnea (OSA) and loud snoring.  They are both due to the narrowing of the airway during sleep.  Snoring occurs when the tissue in the back of the throat vibrates as you breathe.  Patients who snore are more likely to have OSA than people who do not snore.  Those who snore have an increased risk of developing high blood pressure.

Sleep apnea can occur in males and females of all ages, weights, and ethnicities.  Yet certain risk factors are associated with a higher incidence of sleep apnea such as:

•     Excess weight or obesity (body mass index, or BMI, >25)
•     Family history of sleep apnea
•     Male sex
•     Large neck (greater than 17” in men, greater than 16” in women)
•     Recessed chin
•     Physical abnormality in the nose, throat, or upper airway structure
•     Age
•     Smoking
•     Use of alcohol or sleeping pills
•     Snoring
•     Obstructive Sleep Apnea

Milton Hall

Milton Hall is our facility on our Alpharetta campus that houses our state of the art sleep center, our Nasal, Sinus and Allergy Institute, our Facial Plastic Surgery practice, Infectious Disease Consultants and our fully licensed and accredited surgery center.  Our state of the art sleep center has two luxurious overnight stay rooms complete with the most up-to-date testing equipment.

Johns Creek

Johns Creek is our newest office complete with our state of the art sleep center, our ENT Institute, our Facial Plastic Surgery practice, and Infectious Disease Consultants.  Our state of the art sleep center has four luxurious overnight stay rooms complete with the most up-to-date testing equipment.

The Epworth Sleepiness Scale
This quick test will help determine if you are getting enough sleep. Instructions - Evaluate each Situation listed below and rate your Chance of Dozing in the corresponding column on the right. When finished, add up your points to determine your score.

0=no chance of dozing 1=slight chance of dozing 2=moderate chance of dozing 3=high chance of dozing
SITUATION	CHANCE OF DOZING
Sitting and Reading
Watching TV
Sitting inactive in a public place (e.g. a theater or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in traffic
SCORE 1-6 Congratulations! You are getting enough sleep! 7-8 Your score is average. 9 and up Seek the advice of a sleep specialist without delay.

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