Elliot Hospital - Services:Center for Sleep Evaluation

Center for Sleep Evaluation at Elliot Hospital, established in 1984, has served the community of Southern New Hampshire for 20 years. The Center is devoted to diagnosis and treatment of the full range of sleep disorders. The Center specializes in pediatric, adolescent, adult, and geriatric sleep problems. The major sleep disorders include snoring and sleep-related breathing problems, daytime sleepiness, difficulty falling and remaining asleep, disturbance of the sleep/wake cycle (biological clock), and parasomnias (e.g., nightmares, sleep-walking, bed-wetting).

Once your sleep disorder is diagnosed, the staff at The Center for Sleep Evaluation will work with your physician to develop a treatment plan to fit your needs. Treatments for sleep disorders may include use of a simple medical device, medication, lifestyle changes, or corrective surgery. Our goal is to restore you to a natural balance of sleep and wake. The Center for Sleep Evaluation promotes a healthier community through public education, medical evaluation, and testing.

Accreditation by the American Academy of Sleep Medicine
Accreditation means that the Center has met the highest quality of care in the practice of sleep medicine and has the board-certified sleep specialists on staff and facilities to diagnose and treat the full range of sleep disorders.

Snoring and Sleep Breathing Disorders If you snore loudly, awaken short of breath, find it hard to stay awake during the day, have many headaches or experience memory problems, you may be suffering from Sleep Apnea Syndrome which is characterized by snoring and recurrent pauses in breathing during sleep. The frequency of the breathing interruptions varies with the severity of the disorder. A person with a severe case of sleep apnea could stop breathing hundreds of times each night. Although sleep apnea can occur in any age group, it is most prevalent among men age 35-60 and women age 45-55.

Excessive Daytime Drowsiness/Sleepiness
An adequate amount of sleep should leave you feeling refreshed. Sometimes people find themselves drowsy or sleepy throughout the day due to a variety of causes.

Narcolepsy
People with narcolepsy have uncontrollable urges to sleep at inappropriate times. These "sleep attacks" can be accompanied by muscular weakness. Strong emotions (laughter, anger, surprise, sadness) may trigger these attacks.

Periodic Leg Movements
Periodic leg movements, sometimes associated with "restless legs," are involuntary movements or jerks of your legs that occur during sleep. This may disturb a restful sleep and often results in daytime sleepiness.

Insomnia
If you have trouble falling or staying asleep, or waking too early in the morning, you could be experiencing insomnia. An irregular sleep schedule, depression, medications, caffeine, anxiety, stress, or an undiagnosed medical problem may be the cause.

"Biological Clock" Disorders (Timing of sleep)
Sometimes the body's natural timekeeper or "biological clock" is out of sync with the demands of life. This causes one to feel sleepy and feel alert at the wrong time. This happens most often in teenagers, elderly, shift workers, or individuals who rapidly cross time zones.

Other Sleep Disorders
Other sleep disorders which may cause poor sleep quality or excessive daytime drowsiness or sleepiness are sleep walking, night tremors, teeth grinding, bed wetting, and shift work.

Through the consultation with specialists in sleep medicine and the use of specialized sleep tests, the specific causes of these sleep problems can be identified and the appropriate treatment can be started. The Center for Sleep Evaluation has sleep specialists with expertise in adult and pediatric sleep disorders.

Sleep Laboratory Testing:
If the patient requires sleep laboratory testing as part of their diagnostic evaluation, a sleep study is scheduled for a later date. Sleep studies require spending one to two nights in our state-of-the-art sleep laboratory, which is equipped with the most advanced equipment in the field. Patients stay in large, comfortable, private rooms overlooking the hills of Manchester, New Hampshire. While you sleep, an experienced sleep technologist records information about your sleep. During the test, continuous recordings are made of the brain waves, heart beat, movements, breathing, and blood oxygen. All of these procedures are noninvasive and cause no discomfort.

Sometimes, an additional daytime test is needed to measure daytime sleepiness. This daytime test is called a Multiple Sleep Latency Test (MSLT). During the MSLT, the patient will nap at regular intervals during the day. As in the night studies, continuous recordings are made of the patient's sleeping, breathing, and heart rate patterns. The MSLT documents excessive daytime sleepiness and can aid in the diagnosis of sleep apnea, narcolepsy, sleep/wake cycle disorders, etc. A board-certified sleep specialist prepares a report from the information gathered from the test.

Treatment and Follow-up:
Results of the diagnostic tests are reviewed by the treatment team and a diagnosis is made. The patients will return to the Center for a completion evaluation. The diagnosis is discussed with the patient, and treatment recommendations are made. It the patient is self-referred, treatment may be started by the Center staff at that time. If the patient is referred by their own physician, a detailed letter is sent to the physician with a review of the test results, diagnosis, and treatment recommendations.

Referrals:
Any individual with a sleep complaint can be seen at the Center. Many patients are referred by their physicians, but self-referrals are also accepted. The referring individual should call the Center to schedule an appointment. The first appointment will be an office visit which includes an interview with a sleep-specialist and a brief physical exam. During the visit, a decision will made if a formal sleep study is needed. For further information about sleep disorders or to schedule an appointment, call The Center for Sleep Evaluation at 663-6680.

The Center for Sleep Evaluation is located on the 2nd floor of the Elliot Hospital, One Elliot Way, Manchester, New Hampshire.

Sleep Diary
When you are having difficulty sleeping, it can be helpful to record information about your sleep in a sleep diary or log. The diary helps identify the timing and amount of sleep you are getting and can help pinpoint specific triggers of your sleep problem.

Measure Your Sleepiness with the Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations, in contrast to just feeling tired? This refers to your usual way of life in recent times. Even if you have not done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation.

0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing

Chance of Dozing	Situation
________	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 lunch without alcohol
________	In a car, while stopped for a few minutes in traffic

1 - 6 Congratulations, you are getting enough sleep!
7 - 8 Your score is average
9 + Seek the advice of a sleep specialist without delay