Sleep Disorder Diagnosis & Treatment
Our team of experts at the University of Chicago Medicine Sleep Center have vast experience in treating a variety of sleep disorders. They have the expertise and depth of knowledge to accurately diagnose your symptoms and get you back on track towards a healthy, restful sleep routine.
Diagnosing Sleep Disorders
Polysomnography
A polysomnogram, also called a sleep study, is a test that records your brain waves, heart rate, breathing and eye and leg movements while you’re sleeping. Sensors placed on your head, face, chest and legs send electrical signals to a computer.
This recording of brain waves and eye movements allows a sleep technologist to determine how deeply you’re sleeping and whether you experience a type of sleep called rapid eye movement (REM).
Breathing monitors capable of detecting changes in air flow and oxygen levels help diagnose the severity of sleep apnea you may have. A finger clip tracks changes in the level of oxygen in your blood. Our sleep laboratory also has the capability of monitoring your ventilation by measuring exhaled and transcutaneous carbon dioxide levels.
Leg sensors show both minor twitches and major movements that can occur during the night.
Polysomnograms take place overnight in the outpatient sleep laboratory. You will be in your own private room with a bathroom, shower and TV.
Polysomnograms are painless. To begin, a sleep technologist applies sensors to your skin and connects them to a computer (the sensors’ wires are long enough to let you move normally in bed). To calibrate the sensors at the beginning of the study, you’ll be asked to move your eyes, clench your teeth and move your legs. The wires are all connected to one main cable; if you need to use the bathroom, the sleep technologist will simply disconnect the main cable and reconnect it when you return.
You are free to read or watch TV. At some point during the night, the sleep technologist will ask you to turn off the lights and TV and try to fall asleep. During your monitoring from a near-by room using a low-light camera, the technologist may return to your room to reapply a loose sensor or if you request assistance.
If you’re worried you won’t sleep during your sleep study, you should know that nearly everyone eventually does. You may not sleep as well as you do at home, but this will not impact your study evaluation. Patients do not need to sleep a full eight hours for an accurate diagnosis. In fact, one to two hours of recorded sleep may be enough to diagnose sleep apnea.
A polysomnogram is recommended in the following cases:
- To diagnose obstructive sleep apnea or other forms of sleep breathing disorders, such as central sleep apnea or sleep hypoventilation.
- To look for behaviors or movements during sleep that can be harmful to the patient or others.
Split Night Polysomnogram with CPAP or Non-invasive Ventilation Titration
If you have significant sleep apnea early on in your sleep study, the second half of the night may be used to determine the continuous positive airway pressure (CPAP) needed for treating your sleep apnea.
At the beginning of the night, you will try on a variety of masks to determine the best fit and comfort. Then, if a split night polysomnogram is needed, the appropriate mask is ready.
Air pressure is first introduced through a CPAP machine at a very low level and then increased during the night. The goal is to find the right level of air pressure that will prevent the collapse of your upper airway. This will eliminate pauses in your breathing and snoring.
A split night polysomnogram with CPAP or non-invasive ventilation titration is recommended in the following cases:
- When significant sleep apnea is detected during the first part of the sleep study.
- To determine the correct levels of positive airway pressure to treat the sleep apnea.
- Non-invasive ventilation can be used in appropriate cases to improve hypoventilation.
Home Sleep Test
Home sleep testing provides a sleep medicine provider with the information he or she needs to diagnose obstructive sleep apnea. Home sleep testing allows you to sleep at home wearing equipment that collects information about how you breathe during sleep. You will usually set up the testing equipment yourself.
There are a variety of home sleep testing devices that have different sensors and equipment. All home sleep test devices measure your breathing and blood oxygen level. Some may also measure your heart rate or other information about your body.
A provider may recommend home sleep testing if:
- It is highly likely that you have moderate to severe obstructive sleep apnea.
- You have no significant medical conditions other than the suspected obstructive sleep apnea.
You should not have a home sleep test if:
- You do not have a high risk of obstructive sleep apnea.
- The provider suspects you may have another sleep disorder.
- You have certain medical conditions including pulmonary diseases, neuromuscular diseases or congestive heart failure.
In these cases, your provider may recommend an in-lab sleep study instead of a home sleep study. An in-lab sleep study provides the most complete evaluation of your sleep.
Additional Diagnostic Services
Actigraphy
Actigraphy is a diagnostic procedure that utilizes a portable wristwatch-like device to record and store information regarding body movements over a period of time (typically 1 to 2 weeks). Actigraphy can be utilized to determine the extent of insomnia symptoms symptoms, rule-out inadequate sleep hygiene, insufficient total sleep time, and circadian rhythm disorders and document sleep/wake patterns.
Maintenance of Wakefulness Test (MWT)
This is a type of sleep study that measures how alert you are during the day. It is used to see how well you can stay awake despite prime sleeping conditions.
Nap Studies/Multiple Sleep Latency Test (MSLT)
This sleep study measures how quickly you fall asleep during the day. It is also known as a nap study and is a way to check for excessive daytime sleepiness.
Sleep Logs
Sleep logs are daily records that track details about your sleep habits and patterns. They are used to get a more in-depth look at what factors could be influencing your sleep.
Treating Sleep Disorders
Positive Airway Pressure Therapy
- Continuous Positive Airway Pressure (CPAP) therapy uses a machine to help patients with obstructive sleep apnea breathe more easily during sleep. A CPAP machine sends a constant flow of air pressure to the throat to ensure the airway stays open during sleep.
- Automatic Titrating Continuous Positive Airway Pressure (Auto-PAP) therapy is set within a high- and low-pressure range determined by need. The machine automatically detects how much pressure a patient needs with each breath. The auto-PAP machine increases automatically as needed to allow normal breathing during sleep.
- Bi-level Positive Airway Pressure (Bi-level PAP) therapy delivers two different levels of pressure: one for inhaling, the other for exhaling. These pressures are pre-set (based on a prescription by a sleep specialist) and alternate just like a person’s breathing pattern.
- Non-invasive Ventilation (NIV) therapy is designed to alleviate sleep apnea and to improve ventilation. Our sleep laboratory has significant expertise in treating disorders of sleep hypoventilation with NIV. NIV titration is performed with simultaneous monitoring of breathing, blood oxygen levels and carbon dioxide (CO2) levels.
Advanced Respiratory Care (ARC) program
Patients with complex sleep disordered breathing need care by experts in the field, knowledgeable in management of bi-level positive airway pressure (BPAP) treatment, non-invasive and invasive home ventilation with the use of portable ventilators. Many patients also benefit from oxygen therapy, secretion management with cough assist devices or vest, suction, lung recruitment maneuvers, nebulizers, and medication management for optimization of respiratory status.
Our pulmonary-sleep team has experience in supporting patients and families with these complex needs, coordinating home respiratory therapy support and facilitating transition between inpatient and outpatient settings. We provide care for patients with chronic respiratory failure from neuromuscular diseases including ALS, to severe COPD, obesity hypoventilation syndromes, or other restrictive thoracic diseases. We work together with each patient’s care team for an effective multi-disciplinary approach.
We follow our patients closely, re-evaluating needs as they change and making recommendations to “step-up” or “step-down” treatment interventions.
Oral Appliances
A device similar to a mouth guard that is placed in your mouth and worn while you sleep. It helps snoring and sleep apnea by moving your jaw and tongue forward and keeping your airway open throughout the night.
Oral appliances are a treatment for snoring and mild to moderate obstructive sleep apnea (OSA). an oral appliance is a small plastic device that fits in the mouth during sleep like a sports mouth guard or orthodontic retainer. Oral appliances help prevent the collapse of the tongue and soft tissues in the back of the throat by keeping the airway open during sleep. Oral appliances may be used alone or in combination with other treatments for sleep-related breathing disorders, such as weight management, surgery or continuous positive airway pressure (CPAP).
Potential candidates for oral appliance therapy include:
- Patients with primary snoring or mild obstructive sleep apnea who do not respond to, or are not appropriate for, treatment with behavioral measures such as weight loss or sleep-position change.
- Patients with moderate to severe OSA who are intolerant of or refuse treatment with CPAP therapy or surgical therapy.
Oral appliance therapy works by:
- Repositioning the lower jaw, tongue, soft palate and uvula
- Stabilizing the lower jaw and tongue
- Increasing the muscle tone of the tongue
Positional Therapy
A device that is worn around the waist or back to keep you on your side while sleeping.
Surgical Options
Surgery may be a part of the treatment plan for some patients with sleep apnea or snoring. Your sleep team may recommend surgery if you can’t tolerate CPAP therapy, which is the most effective treatment option for sleep apnea.
Some surgeries are minimally invasive, while others are more complex. The goal of surgery is to treat the areas of the airway that collapse and block your breathing during sleep. Surgery may stiffen, remove or reposition tissues in and around your throat. These surgeries may focus on the:
- Soft palate and uvula
- Tonsils and adenoids
- Tongue
- Upper and lower jaw
There are different types of surgery for sleep apnea and snoring. Surgery may be a multi-step process involving more than one procedure. You may need to continue using CPAP even when surgery successfully reduces the severity of sleep apnea. It is important to follow up regularly with your sleep doctor after surgery.
Surgical options include:
- Uvulopalatopharyngoplasty (UPPP)
- Upper airway stimulation therapy
- Septoplasty and turbinate reduction
- Genioglossus advancement
- Hyoid suspension
- Midline glossectomy and lingualplasty
- Maxillomandibular osteotomy (MMO) and advancement (MMA)
- Palatal implants
- Weight loss surgery
- Laser-assisted uvuloplasty (LAUP)
Note: Surgery is not the right choice for everyone. If you are considering surgery to treat your sleep disorder, your doctor can best advise and will work with a multidisciplinary team to treat your unique needs.
Weight Loss Options
There is a strong correlation between obesity and obstructive sleep apnea. There are several types of weight loss surgery available at the University of Chicago Medical Center, including:
Request an Appointment
You can also make an appointment with our providers by:
– Scheduling a virtual video visit to see a provider from the comfort of your home
– Requesting an online second opinion from our specialists
To speak to someone directly, please call 1-888-824-0200. If you have symptoms of an urgent nature, please call your doctor or go to the emergency room immediately.
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