Overview
Cleveland Clinic Florida Sleep Disorder Centers are multi-specialty, comprehensive programs dedicated to the diagnosis and treatment of sleep and wake disorders. Sleep disorders can affect the quality and quantity of sleep or can cause difficulty maintaining normal wakefulness — both of which can lead to impaired functioning and a host of other health problems. At Cleveland Clinic Florida, we offer state-of-the art testing for over 80 different types of sleep disorders. Our collaborative team approach involves sleep specialists, pulmonologists, ear-nose-throat specialists, and psychologists or psychiatrists to diagnose and treat problems related to daytime sleepiness, snoring, trouble staying asleep, headaches in the morning, difficult to treat hypertension, etc. All of those could be due to obstructive sleep apnea or other sleep related problems. Do not resign yourself to poor quality sleep, let the experts at Cleveland Clinic Florida help you find a way back to restful, healing sleep.
Common sleep disorders
- Obstructive Sleep Apnea (OSA): Loud disruptive snoring, episodes of observed stoppage of airflow and gasping for breath during sleep, snorts and arousals, daytime sleepiness.
- Idiopathic Daytime Hypersomnia: Excessive daytime sleepiness.
- Narcolepsy: Narcolepsy is a neurological disorder that disturbs the control of sleep and wakefulness. A person with narcolepsy may experience excessive daytime sleepiness with sporadic, uncontrollable episodes of falling asleep during the daytime, sleep paralysis (awakening in the morning or from a nap and being briefly physically unable to move), hypnogogic hallucinations (episodes of being in a dream-like state but still awake), cataplexy (sudden loss of muscle strength triggered by emotion, especially laughter), fragmentation of sleep at night.
- Insomnia: Sleep onset difficulties, multiple nighttime awakenings, or awakening too early in the morning and not being able to fall back to sleep.
- Delayed Sleep Phase Syndrome (DSPS): Unconventional timing of sleep/wake schedule, for example falling asleep at 2:00 am and sleeping until 10:00 am.
- Restless Leg Syndrome (RLS): Uncomfortable leg sensations accompanied by the irresistible urge to move and adjust legs or arms to relieve discomfort. Symptoms usually occur when resting quietly, attempting to fall asleep or during passive restricted activities (on an airplane, at the theater or opera).
- Periodic Limb Movements of Sleep (PLMS): Semi-rhythmic contractions of the limb musculature during sleep, often accompanied by limb jerks, most often involving the feet.
- REM Sleep Behavioral Disorder (RSBD): Dream enactment behaviors occurring at night which may be violent and potentially dangerous to the patient or bed partner, characterized by yelling, cursing, punching, running and other actions triggered by the content of the patients’ dream.
- Parasomnias: Abnormal behaviors associated with sleep such as night terrors, sleep walking, sleep talking.
- Nocturnal Eating: Uncontrolled episodes of eating during the night of which the patient may or may not be aware.
Testing & Diagnosis
In patients who experience trouble sleeping, the first step towards treating these disorders is a comprehensive evaluation:
- PAP troubleshooting for patients who have anxiety about starting.
- PAP therapy, are claustrophobic, or are having difficulty tolerating.
- PAP therapy for their sleep-related breathing disorder.
- Sleep Apnea Management (SAM) Clinic to help patients successfully use PAP therapy.
Home sleep testing
Home sleep testing is a diagnostic test that helps determine whether you have obstructive sleep apnea (OSA) – a potentially serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. The testing is done in the comfort of your home, instead of a sleep laboratory, using a portable sleep monitor
Once home sleep testing has been ordered, you will be scheduled for an appointment with one of our technologists to learn how to operate the device. Our Cleveland Clinic Florida Sleep Disorders Center staff will:
- Document your height, weight and neck circumference.
- Provide you with our HST sleep questionnaire.
- Show you an educational video.
- Demonstrate how to activate the home monitoring equipment for your sleep study.
The portable sleep monitor is easy to activate. It includes a recording device, sensors, and belts and is powered by AA batteries. It records information including your airflow, breathing effort, blood oxygen levels and snoring during your sleep. You will have the opportunity to practice applying the device with one of our sleep technologists so you are more comfortable using the equipment on your own.
Treatments
Services we offer
Diagnostic Nocturnal Polysomnogram – This is for diagnostic purposes only, Polysomnography (PSG or Baseline) is a test usually performed at night and is used to diagnose many different sleep disorders. Keep in mind that measuring devices are not painful and no needles are involved.
- PSG measures the following.
- EEG (Electroencephalograph): monitors brain waves to help determine your stage of sleep.
- EOG (electrooculograph): monitors eye movements.
- EMG (electromyograph): monitors limb movements and chin activity.
- ECG (electrocardiograph): measures heart rate rhythm.
- Sensors called thermocouples or pressure catheters are used to monitor breathing from the nose and mouth.
- Belts places around the chest and abdomen measure respiratory effort.
- Oxygen is monitored by a finger probe that goes on the finger.
CPAP Titration – Once polysomnography (PSG) establishes that a patient has Obstructive Sleep Apnea, the next step is to determine the level of CPAP the patient requires. PSG Measurements are taken while the CPAP is applied. Pressure is started at a low level and increased throughout the night by the sleep technologist until a therapeutic level is reached – this is called a titration. CPAP titration is only performed on patients who have obstructive sleep apnea.
BiPAP Titration – Is like a CPAP titration, however when you breathe in you get one pressure and when you breathe out it lowers the pressure. This is used if the patient is Hypoxic or experiencing Aerophagia (Air swallowing).
ASV Titration – This is used to treat patients with Cheyne Stokes Respirations (CSR) or Central Sleep Apnea.
Multiple Sleep Latency Test (MSLT) – Is used to diagnose narcolepsy and idiopathic hypersomnia. This test involves taking a series of naps throughout the day. All patients will spend the night prior to the MSLT in the lab for a PSG, so the monitoring devices described in the PSG section are already in place.
During each nap opportunity, the patient is allowed a certain amount of time to fall asleep and then a certain amount of time to sleep. The technologist monitors to make sure the patient is not sleeping between nap opportunities.
Maintenance of Wakefulness Test (MWT) – The Maintenance of Wakefulness test (MWT) is a way to evaluate the ability to stay awake during the day. A Diagnostic Nocturnal Polysomnogram is required the night prior to the daytime MWT. After the PSG is complete, the MWT testing is spread over the following day. There are 4 tests spaced 2 hours apart. After being asked to stay awake, sensors on the head and chest record your brain wave activity, eye movements, muscle contractions, and heart activity to accurately detect if you fall asleep. The information we collect during your study is reviewed and analyzed by a sleep specialist.
Split Night Sleep Study – Split night Sleep Study combines diagnostic polysomnography and CPAP titration into one night. A portion of the night is used to establish that the patient has obstructive sleep apnea using the PSG measurements.
The second portion of the night is used for CPAP titration to determine the optimum pressure. CPAP titration requires approximately four hours. The following reasons why performing a split night study is either not possible or not desirable:
- Patients takes too long to fall asleep.
- AHI (Apnea Hypopnea Index) is too low to meet the split night criteria. However this does not mean that the patient does not have apnea.
- Not enough time to do a proper titration.
- Type of apnea.
Appointments & Locations
To schedule a consultation, call Cleveland Clinic Indian River Hospital and Cleveland Clinic Weston Hospital at 877.463.2010 or Cleveland Clinic Martin Health at 844.630.4968. You can also make an appointment online.
Locations
Cleveland Clinic Florida / Weston Sleep Disorders Center
3100 Cleveland Clinic Blvd, Bldg D
Weston, FL 33331
954.487.2405
Martin North Hospital
200 SE Hospital Ave.
Stuart , Florida 34994
772.287.5200
Martin Health at Palm City
3066 SW Martin Downs Blvd.
Palm City , Florida 34990
772.781.2791
Indian River Hospital Sleep Disorders Center
3395 11th Court
Vero Beach , Florida 32960
772.563.4403
