Neurological Institute Outcomes
Introduction to the Scope of Cleveland Clinic's Sleep Disorders Center
Cleveland Clinic’s Sleep Disorders Center, established in 1978, was among the first in the nation dedicated to the diagnosis and treatment of sleep and wake disorders across the entire age spectrum. Accredited by the American Academy of Sleep Medicine, the Sleep Disorders Center provides a comprehensive, multidisciplinary approach to patient care with specialists in Neurology, Pulmonary and Critical Care Medicine, Psychiatry and Psychology, Internal Medicine, Family Medicine, Pediatrics, and Otolaryngology, with over 100 caregivers. The program has 43 beds in 7 sleep laboratory locations within Cleveland Clinic health system.
In 2020, at the beginning of the COVID-19 pandemic, the center's team recognized the need to swiftly pivot to safely accommodate the needs of patients with sleep disorders. Similar to other programs, many outpatient visits were transitioned to telemedicine to ensure continued high quality care of patients. The center's robust infrastructure and existing processes for home sleep apnea testing (HSAT) allowed the ability to rapidly adapt and transition sleep diagnostic testing services to dramatically increase the proportion of HSATs to facilitate the ability to efficiently and safely continue to accommodate the needs of patients. The center has led examination of sleep disorders and COVID-19 outcomes and also has played a prominent role in relaying practical recommendations for the home use of positive airway pressure (PAP) therapy in asymptomatic patients and patients with suspected or confirmed COVID-19.¹
The Sleep Disorders Center 2020 outcomes are reflective of the multifaceted and multidisciplinary strengths of the program described in this summary and include rapid acceleration and continued bolstering of the HSAT program; impact of standard and innovative treatment of obstructive sleep apnea (OSA) and patient-reported outcomes; sleep-disordered breathing and COVID-19 clinical outcomes in adults and children; sleep-disordered breathing and cardiovascular outcomes in bariatric surgery; sleep and circadian rhythm measures in neurodegeneration; hypersomnia disorders in adults with epilepsy; integration of a novel sleep app to facilitate screening of common sleep disorders; and influence of behavioral sleep medicine program-led cognitive behavioral therapy targeted towards insomnia on patient-reported outcomes.
Overall Sleep Studies
2016 – 2020
All sleep lab locations received the distinction of accreditation by the American Academy of Sleep Medicine for providing excellent healthcare and dedication to the advancement of the field of sleep medicine. In 2018, the headquarter lab operations were established in a new state-of-the-art facility. The center's continued increase in services, which includes HSAT, is well beyond national trends. Therefore, patients' access has been substantially enhanced, allowing the center to accommodate and address the epidemic of highly prevalent sleep disorders. The efficient integration of technological systems support, sleep technologists, and physicians has allowed for this remarkable growth, thus establishing Cleveland Clinic as a continued leader in providing the care needed for patients with sleep disorders.
HSAT = home sleep apnea testing, MSLT/MWT = multiple sleep latency test/maintenance of wakefulness test, Other = PAP Nap studies for acclimation, and titration studies with oral pressure therapy, oral appliance, or nasal end expiratory positive pressure, PAP = positive airway pressure titration study, PSG/EEG = polysomnogram alone or in combination with 18-channel electroencephalography, Split study = combination PSG and PAP titration study