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Sleep Disorders

Learn about sleep apnea, insomnia, narcolepsy, and other common sleep disorders.

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Diagnosis & Testing

Information about sleep assessments, home sleep testing, and in-lab studies.

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CPAP Therapy

Everything you need to know about CPAP machines, masks, and accessories.

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Oral Appliances

Information about oral appliance therapy for sleep apnea and snoring.

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Telehealth Services

Questions about virtual consultations, remote monitoring, and digital health.

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Insurance & Billing

Information about coverage, costs, and reimbursement for sleep services.

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Sleep Disorders

Sleep apnea is a serious sleep disorder characterized by repeated interruptions in breathing during sleep. These interruptions, called apneas, typically last 10 seconds or longer and can occur many times throughout the night.

There are three main types of sleep apnea:

  • Obstructive Sleep Apnea (OSA): The most common form, occurring when throat muscles relax and block the airway during sleep.
  • Central Sleep Apnea (CSA): Less common, occurring when the brain fails to send proper signals to the muscles that control breathing.
  • Complex Sleep Apnea: A combination of both obstructive and central sleep apnea.

Common symptoms include loud snoring, gasping for air during sleep, morning headaches, excessive daytime sleepiness, difficulty concentrating, and irritability. If left untreated, sleep apnea can lead to serious health complications including high blood pressure, heart disease, stroke, diabetes, and depression.

Several factors can increase your risk of developing sleep apnea:

  • Excess weight: Fat deposits around the upper airway can obstruct breathing.
  • Neck circumference: People with thicker necks may have narrower airways.
  • Age: Sleep apnea occurs more frequently in older adults.
  • Gender: Men are 2-3 times more likely to have sleep apnea than women, though women's risk increases after menopause.
  • Family history: Having family members with sleep apnea increases your risk.
  • Nasal obstruction: Allergies, sinus problems, or anatomical issues like a deviated septum.
  • Smoking: Smokers are three times more likely to have obstructive sleep apnea.
  • Alcohol or sedative use: These substances relax the muscles in your throat.
  • Medical conditions: Conditions like hypertension, diabetes, heart disorders, and Parkinson's disease can increase risk.

If you have multiple risk factors, it's especially important to be aware of the symptoms of sleep apnea and discuss any concerns with your healthcare provider.

Sleep apnea and insomnia are distinct sleep disorders, though they can sometimes coexist:

Sleep Apnea:
  • Characterized by pauses in breathing during sleep
  • Often accompanied by loud snoring and gasping
  • People may sleep through the night but wake up feeling unrefreshed
  • Primarily a breathing disorder that affects sleep quality
  • Often unrecognized by the person who has it (usually reported by bed partners)
Insomnia:
  • Difficulty falling asleep or staying asleep
  • Characterized by conscious awareness of inability to sleep
  • People are typically aware they're not sleeping well
  • Primarily a sleep initiation or maintenance disorder
  • Often accompanied by anxiety about sleep

It's important to note that these conditions can overlap. Some people with sleep apnea may develop insomnia symptoms due to frequent awakenings caused by breathing difficulties. Similarly, people with insomnia may be at higher risk for sleep-disordered breathing.

Proper diagnosis is essential as the treatments for these conditions differ significantly. If you're experiencing sleep problems, a comprehensive sleep evaluation can help determine the specific cause and appropriate treatment.

Untreated sleep apnea can lead to numerous serious health consequences:

Cardiovascular Problems:
  • High blood pressure (hypertension)
  • Heart disease and heart failure
  • Irregular heartbeat (arrhythmias)
  • Increased risk of stroke
  • Coronary artery disease
Metabolic Issues:
  • Type 2 diabetes
  • Metabolic syndrome
  • Liver problems
  • Weight gain
Neurological and Mental Health:
  • Morning headaches
  • Depression and anxiety
  • Cognitive impairment
  • Memory problems
  • Increased risk of dementia
Quality of Life:
  • Excessive daytime sleepiness
  • Decreased productivity
  • Relationship problems due to snoring
  • Increased risk of motor vehicle accidents
  • Poor performance at work or school
Surgical and Medication Risks:
  • Complications with medications and general anesthesia
  • Increased risk of post-surgical complications

The good news is that effective treatment of sleep apnea can reduce or eliminate these risks and significantly improve quality of life and overall health.

Yes, children can and do develop sleep apnea. Pediatric obstructive sleep apnea affects an estimated 1-5% of children and can occur at any age, including infancy.

Causes in Children:

The most common cause of sleep apnea in children is enlarged tonsils and adenoids, which can block the upper airway during sleep. Other risk factors include:

  • Obesity
  • Craniofacial abnormalities
  • Neuromuscular disorders
  • Down syndrome
  • Family history of sleep apnea
  • Allergies and asthma
Symptoms in Children:

The symptoms of sleep apnea in children may differ from those in adults:

  • Snoring, gasping, or snorting during sleep
  • Pauses in breathing
  • Restless sleep or sleeping in unusual positions
  • Bedwetting (especially if the child previously stayed dry at night)
  • Night sweats
  • Morning headaches
  • Daytime sleepiness
  • Behavioral problems, hyperactivity, or problems paying attention
  • Poor school performance
  • Growth problems
Diagnosis and Treatment:

If you suspect your child may have sleep apnea, it's important to consult with a pediatrician. Diagnosis typically involves a sleep study, which can be conducted in a sleep lab or sometimes at home.

Treatment options for children with sleep apnea include:

  • Surgical removal of tonsils and adenoids (the most common treatment)
  • Weight management for children who are overweight
  • Continuous Positive Airway Pressure (CPAP) therapy
  • Oral appliances (for older children)
  • Treatment of underlying conditions like allergies

Early identification and treatment of sleep apnea in children is crucial to prevent complications affecting growth, cognitive development, and cardiovascular health.

Diagnosis & Testing

Home sleep testing (HST) is a convenient way to diagnose sleep apnea in the comfort of your own home. Here's how the process works with SleepEz:

  1. Consultation: The process begins with a telehealth consultation with one of our sleep specialists who will evaluate your symptoms and determine if home sleep testing is appropriate for you.
  2. Device Delivery: If home testing is recommended, we'll ship a compact, user-friendly sleep testing device directly to your home, along with detailed instructions.
  3. Setup: The device typically includes:
    • A small recording unit that attaches to a belt worn around your chest
    • A nasal cannula to measure airflow
    • A finger probe to measure oxygen levels
    • Sensors to track breathing effort
  4. Testing Night: You'll wear the device for 1-2 nights while sleeping in your own bed. The device automatically records data about your breathing patterns, oxygen levels, heart rate, and body position.
  5. Return: After completing the test, you'll return the device using our prepaid shipping label.
  6. Analysis: Our board-certified sleep physicians will analyze the data collected by the device.
  7. Results: Within 2-3 business days, you'll receive your results and a comprehensive report.
  8. Follow-up: If the test indicates sleep apnea or another sleep disorder, we'll schedule a telehealth consultation to discuss treatment options.

Home sleep testing is ideal for many patients with suspected sleep apnea, but it may not be appropriate for everyone. Patients with certain medical conditions or suspected of having other sleep disorders may require an in-lab sleep study for more comprehensive monitoring.

Home sleep testing (HST) and in-lab polysomnography (PSG) are both valuable diagnostic tools, but they have significant differences:

Feature Home Sleep Testing In-Lab Sleep Study
Location Your own home and bed Sleep laboratory or hospital
Monitoring Limited parameters: breathing, oxygen levels, heart rate, body position Comprehensive: includes brain waves (EEG), eye movements, muscle activity, and more
Supervision Self-administered Technician present throughout the night
Duration Usually 1-2 nights Typically one night
Comfort More comfortable in familiar environment Less comfortable in unfamiliar setting with more sensors
Cost Less expensive More expensive
Best for Patients with high probability of moderate to severe obstructive sleep apnea without significant comorbidities Patients with complex medical conditions, suspected central sleep apnea, or other sleep disorders

Your healthcare provider will recommend the most appropriate test based on your symptoms, medical history, and other factors. In some cases, if a home sleep test is inconclusive or suggests complex sleep issues, an in-lab study may be recommended as a follow-up.

Home sleep testing (HST) is generally considered accurate for diagnosing moderate to severe obstructive sleep apnea in patients with a high pre-test probability of the condition. However, it's important to understand both the strengths and limitations of this testing method:

Accuracy Factors:
  • High specificity: When HST indicates sleep apnea, it's usually correct (few false positives).
  • Moderate sensitivity: HST may miss milder cases of sleep apnea (potential for false negatives).
  • Device quality: SleepEz uses only medical-grade, FDA-approved testing devices that meet the American Academy of Sleep Medicine standards.
  • Test conditions: The test is most accurate when used correctly and when you sleep adequately during the testing period.
Limitations:
  • HST may underestimate the severity of sleep apnea compared to in-lab studies.
  • HST doesn't measure sleep stages, so it can't detect other sleep disorders like periodic limb movement disorder or REM sleep behavior disorder.
  • Technical issues can occur if sensors become disconnected during sleep.
  • HST assumes all monitoring time is sleep time, which may not be accurate for people with insomnia.
When HST is Most Accurate:
  • For patients with a high probability of moderate to severe OSA
  • For patients without significant comorbid medical conditions
  • When the device is properly applied and functions correctly
  • When the patient sleeps adequately during the test

At SleepEz, our sleep specialists carefully evaluate each patient to determine if home sleep testing is appropriate. If the results are inconclusive or if there are concerns about the accuracy of the test, we may recommend an in-lab sleep study for more comprehensive evaluation.

The Apnea-Hypopnea Index (AHI) is the primary metric used to diagnose and classify the severity of sleep apnea. It represents the average number of apneas (complete breathing pauses) and hypopneas (partial breathing reductions) that occur per hour of sleep.

How AHI is Calculated:

AHI = (Total number of apneas + hypopneas) รท Total sleep time in hours

AHI Classification for Adults:
AHI Value Severity Classification Description
Less than 5 Normal No sleep apnea or within normal limits
5 to 14.9 Mild Sleep Apnea Breathing disruptions occur 5-14.9 times per hour
15 to 29.9 Moderate Sleep Apnea Breathing disruptions occur 15-29.9 times per hour
30 or higher Severe Sleep Apnea Breathing disruptions occur 30+ times per hour

It's important to note that the AHI is just one component of sleep apnea diagnosis and treatment planning. Other factors that sleep specialists consider include:

  • Oxygen desaturation levels: How much your oxygen levels drop during apneas
  • Symptom severity: How much your sleep apnea affects your daily life
  • Comorbid conditions: Other health issues that may be affected by sleep apnea
  • REM vs. NREM events: When during sleep the breathing disruptions occur
  • Positional components: Whether sleep apnea is worse in certain sleeping positions

Your SleepEz sleep specialist will explain your AHI and other sleep study results in detail during your follow-up consultation, helping you understand what the numbers mean for your specific situation and treatment options.

Proper preparation for your home sleep test can help ensure accurate results. Here are our recommendations for the day and night of your test:

Before the Test Day:
  • Read all instructions that come with your sleep testing device
  • Watch the instructional video provided by SleepEz
  • Contact our support team if you have any questions
  • Ensure you have a plan for returning the device using the prepaid shipping label
Day of the Test:
  • Maintain your regular routine as much as possible
  • Avoid napping during the day
  • Avoid consuming caffeine after noon
  • Avoid alcohol consumption, as it can affect your sleep patterns
  • Follow your normal evening routine
  • Take your regular medications unless otherwise instructed by your healthcare provider
Setting Up the Device:
  • Set up the device about 30 minutes before your normal bedtime
  • Follow the step-by-step instructions provided
  • Ensure all sensors are properly attached and comfortable
  • Check that indicator lights show the device is working properly
During the Night:
  • Sleep in your normal position(s)
  • If you need to use the bathroom during the night, try to keep the device on if possible
  • If a sensor becomes detached, reattach it according to the instructions
  • Try to sleep for at least 6 hours for the most accurate results
After the Test:
  • Complete the morning questionnaire about your sleep quality
  • Carefully remove and pack the device according to instructions
  • Return the device promptly using the prepaid shipping label

If you experience any technical difficulties during your test, our technical support team is available 24/7 at 877-TECH-HELP (832-4435) to assist you.

CPAP Therapy

Continuous Positive Airway Pressure (CPAP) therapy is the most common and effective treatment for moderate to severe obstructive sleep apnea (OSA).

How CPAP Works:

CPAP therapy works by delivering a constant flow of pressurized air through a mask worn over your nose or mouth (or both) while you sleep. This pressurized air acts as a pneumatic splint that keeps your upper airway open, preventing the collapse or blockage that causes sleep apnea events.

By maintaining an open airway, CPAP therapy:

  • Prevents apneas (breathing pauses) and hypopneas (shallow breathing)
  • Reduces or eliminates snoring
  • Stabilizes oxygen levels throughout the night
  • Improves sleep quality and reduces arousals
  • Reduces the health risks associated with untreated sleep apnea
Components of CPAP Therapy:
  • CPAP Machine: A small, quiet air compressor that draws in room air, filters it, and pressurizes it to the prescribed setting
  • Mask: Available in various styles (nasal pillows, nasal mask, full face mask) to fit different facial structures and breathing preferences
  • Tubing: Connects the machine to the mask, delivering the pressurized air
  • Humidifier: Most modern CPAP machines include a humidifier to add moisture to the air, reducing dryness and improving comfort
  • Filters: Ensure the air delivered is clean and free of dust and allergens
Advanced CPAP Features:

Modern CPAP devices often include advanced features such as:

  • Auto-adjusting pressure (APAP): Automatically adjusts pressure levels throughout the night based on your needs
  • Pressure relief: Temporarily reduces pressure during exhalation for greater comfort
  • Ramp feature: Starts with lower pressure and gradually increases to the prescribed level as you fall asleep
  • Heated tubing: Prevents condensation and enhances humidity delivery
  • Wireless connectivity: Allows for remote monitoring and therapy tracking

At SleepEz, our sleep specialists will help determine the right CPAP device and settings for your specific needs, and provide ongoing support to ensure your therapy is effective and comfortable.

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