Do you feel tired during the day? Do you wake up feeling unrested? Do you snore? Do you find it hard to get out of bed in the morning? Do you have trouble sleeping? When you wake up, do you feel irritable or stressed? Do you feel your sleep disturbance is affecting your life?

If you have answered “yes” to any of these questions, you may have a sleep disorder. Many sleep disorders are treatable. You must first see a physician certified in sleep medicine in order to evaluate the sleep problems. You should seek consultation if:

• You snore and are overweight
• You answer "yes" to any of the following questions:

• You score 9 or more on Epworth Sleepiness Test

Use the following scale for each situation:

0 = No chance of dozing
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing

How likely are you to doze off or fall asleep in the following situations?

If you score 9 or more on the Epworth Sleepiness Test, you may have a sleep disorder. Tell your Sleep Center physician about your score.

Try these helpful suggestions:

• Get up at the same time every day
• Go to bed only when sleepy
• Establish relaxing pre-sleep rituals such as a warm bath, light snack, or meditation
• Confine vigorous exercise to at least six hours before bedtime, and do mild exercise - such as simple stretching or walking - at least four hours prior to bedtime
• Keep a regular schedule. Regular times for meals, medications, chores, and other activities help keep our “inner clock” running smoothly
• Avoid caffeine within six hours of bedtime
• Don't drink alcohol, especially when sleepy. Even a small dose of alcohol can have a potent effect when combined with tiredness
• Tobacco is a stimulant. Avoid smoking, especially close to bedtime
• Try to avoid napping, but if the urge to sleep is irresistible, try napping at the same time every day; mid-afternoon is the best time for most people. Limit naps to 20 minutes
• Avoid sleeping pills, or use them conservatively. Most doctors avoid prescribing sleeping pills for periods longer than three weeks. Do not drink alcohol while taking sleeping pills

Keep a Sleep Log and bring it to the Sleep Center.

• Sleep Apnea - Periodic pauses of breathing associated with snoring and daytime sleepiness. This results in poor quality and restless sleep due to the lack of oxygen, and subsequently daytime drowsiness. Most people are unaware that they have this problem, but the health effects can result in hypertension, cardiac rhythm disturbances, and even sudden death
• Insomnia - The inability to fall asleep or stay asleep. Poor sleep during the night can be a serious problem in itself and can result in decreased wakefulness, concentration, and performance during the day. There are many causes of insomnia, most of which can be treated. Unfortunately, many people do not realize that medical help is available for insomnia, and continue to suffer the effects of poor or diminished sleep
• Narcolepsy - Affects 1 in 2,000 Americans and is characterized by uncontrollable attacks of sleepiness. In addition some patients experience impaired concentration, blurred vision, brief episodes of muscle weakness without loss of consciousness, total paralysis that lasts a few seconds to minutes usually at sleep onset or offset, hallucinations at sleep onset or offset and disturbed night-time sleep
• Restless Leg Syndrome - Involuntary muscle spasms such as periodic leg movements. Patients may have a creeping or crawling sensation, usually on the legs, but sometimes on the arms
• Parasomnias - Sleep-disruptive events such as sleepwalking, nightmares, sleep talking, bruxism (teeth grinding), bedwetting, sleep terrors

Most patients will have an initial consultation which will include a medical and surgical history. If you can, keep a Sleep Log for two weeks and bring it to your initial consultation. Some patients will also have pulmonary function tests and blood work.

After consultation with a sleep specialist, each patient is diagnosed. In some cases one visit is sufficient for a diagnosis to be made and a treatment plan formulated. In many cases the evaluation will require a sleep study. A sleep study or polysomnography (PSG) may be performed during a period of one or two nights. Rarely daytime studies will be required and may be suggested by your physician. Hospitalization is not required although the study is done in the hospital; overnight tests are completed by 8 A.M. It is usually not necessary to miss a day of work.

During a sleep study, the patient is monitored by painless, noninvasive technology. PSG records breathing, heart rate, brain waves, oxygen levels and eye and leg movement. After evaluation the appropriate therapy is determined. Treatment for a sleep disorder may include a prescription for a device to aid the patient's breathing while sleeping (called CPAP or BiPAP), medication, or light therapy as well as neuropsychiatric interventions, including biofeedback. If indicated, referral to or consultations with other specialists might be recommended to aid in diagnosis and therapy.

How to Make Your Overnight Study Comfortable

To ensure that your sleep study is technically accurate and that your overnight stay in the laboratory is a comfortable one, you are asked to prepare for your study in the following ways:

• Pack a small bag with all of the items you will need for an overnight stay away from home. These items include bed clothes and toiletries (shampoo, soap, toothbrush, toothpaste, etc.)
• Pack your prescription medication. The sleep lab does not stock or dispense any prescription or nonprescription medication
• Our technical staff consists of both men and women. There is only one technician on duty at a time. We cannot accommodate requests regarding the gender of your technician
• If you are in the habit of reading before going to sleep, bring a book or other reading material
• Unless otherwise instructed by a physician from the Center for Sleep Medicine, do not alter your sleep schedule during the week prior to your study. This helps to ensure that your night in the laboratory is representative of a typical night of sleep
• Please arrive at the laboratory on time. After 7:00 P.M., if you expect to be delayed for your study, please call 212-241-2989
• Avoid caffeinated food or beverages after noon on the day of the study
• Do not drink alcohol on the day of your study.
• It is advisable that your skin and hair are clean. This improves the ability to apply and remove electrodes. Use shampoo, but no oil or conditioners, on your hair, scalp, or skin
• If you develop a cold or respiratory infection this will affect reliability of study results. Please contact us immediately so that you can be rescheduled for a different night
• The test will conclude at your normal wake up time. Electrode paste will be applied to your skin and scalp. If you wish, you may shower in the morning before leaving the laboratory
• If the technologist observes a severe degree sleep apnea you may be advised not to drive home by yourself