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What Do Sleep Centers Do?

Sleep medicine has begun to establish itself as an important specialism because approximately one-third of adult Americans report problems in getting to sleep or in staying asleep through the night. The main professional and accrediting body for sleep centers and related breathing laboratories is the American Academy of Sleep Medicine (AASM). The majority are run by the larger hospitals and universities. Some are funded by private capital. To identify a center near you, use the search facility on http://www.sleepcenters.org/. Their function is to diagnose and treat a wide range of different disorders. Some are physical, some psychological and some dental. The process of diagnosis is not straightforward. Unlike a physical condition or disorder that can be viewed at the convenience of the doctor or hospital, sleep takes place at night and in essentially private surroundings. There are also problems in relating the patient's personal view of the length and quality of sleep, against the views of a spouse or other family members. If someone feels excessively drowsy during the day, it is not unreasonable to believe sleep must have ...
... been lost or disturbed. But getting evidence of what is actually happening requires serious commitment on both sides.
Diagnosis begins with the subjective. The patient, spouse and family members keep a diary, recording the events of each day and night as they relate to sleep. People may also be given an actigraph to wear. This is a motion sensor and gives a physical record to set against the diary entries. It is possible this may enable doctors to make a diagnosis, but if elements are still unclear, the patient must come into the sleep center for a polysomnogram and, sometimes, a multiple sleep latency test. Overall, this is an objective measure of sleep, monitoring brain activity levels, breathing, and leg and arm movements for up to 24 hours. It is matched by a general health check-up to identify any underlying physical causes of sleep disruption. Psychologists are on hand to evaluate stress levels and other factors contributing to the loss of sleep.
Only when there is a comprehensive diagnosis is it possible to offer the right treatment. This will range from counseling and cognitive behavioral therapy to teach new sleeping habits, through the use of drugs and hormones such as melatonin, to continuous positive airway pressure machines and surgery both medical and dentistry. The intention is to produce both effective treatment for the patient and positive relief for spouse and family who may also be suffering. Hopefully, a significant improvement in the quality of the family's life can be achieved without the need for any long-term use of ambien or an equivalent sleeping pill. This is not to devalue the contribution that such drugs can make in appropriate cases over the short-term. So, for example, it can help a patient to feel more rested and therefore better able to respond to other forms of treatment. But, equally, it can be dangerous. Some disorders involve an abnormal slowing or an actual cessation of breathing during sleep. Producing unconsciousness in a patient may prevent him or her from waking and realizing the need to start breathing again. More generally, the medical profession believes that sleeping pills are overprescribed and any cure for insomnia should be achieved without the patient becoming dependent on ambien.
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