Rest Assured: Newton-Wellesley Hospital Offers Advanced Sleep Technology

The Sleep Center
A good night's sleep is essential for good overall health; however, more than 100 million Americans fail to get the rest they need each night. Diagnosis and treatment of sleep problems can lead to a better quality of life. To provide patients with the best environment to evaluate their sleep issues, Newton-Wellesley Hospital is opening a new, advanced sleep lab in early 2009 at the Newton Marriott pending final approval from the Department of Public Health. The Sleep Center uses the latest techniques for the diagnosis and management of sleep disorders. Sleep Center physicians are medical specialists in treating sleep disorders and are leaders in this field.

 

“Relocating our Sleep Center to the Marriott will offer patients the most comfortable environment for sleeping outside of their own bedroom,” says Avi Almozlino, MD, Chief of Neurology and Director of the Sleep Center at Newton-Wellesley. “This home-like environment is quiet and comfortable with the best accommodations including a top-quality mattress and luxury bed linens. We want our patients to get a good night of sleep in the Lab so our technicians are able to collect the necessary data.”

The Newton-Wellesley Hospital Sleep Center will occupy a first floor wing of the Boston Marriott – Newton. Each room will have an individual patio opening to the river providing patients with a relaxing and serene setting. Patients also have a private waiting area within the hotel facility.

“We are fortunate to be able to offer the most advanced sleep technology in an accessible, suburban setting with the conveniences and comforts of the patient’s very own bedroom,” adds Dr. Almozlino.

A Good Night's Rest
According to Dr. Almozlino, sleep problems are becoming more prevalent and affect many households. If left untreated they can cause daytime fatigue, tiredness, cognitive difficulties and can even be life threatening.

“Both the quantity and the quality of sleep are very important to a patient’s overall health,” says Dr. Almozlino. “An accurate diagnosis and the appropriate treatment can have a dramatic effect and significantly enhance quality of life.”

The team of specialists at Newton-Wellesley have had specialized training in the diagnosis of sleep disorders. Dr. Almozlino and Aran Kadar, MD, Co-Director of the Sleep Center, are both board certified in sleep medicine in addition to their primary specialty.

Many factors including personal lifestyle and exercise habits, medical illnesses, stress, environmental factors, work schedules, psychiatric disorders and medical conditions can all affect sleep.

“We work with each patient to determine what might be causing his or her sleep problems and create treatment plans specific to meet that patient’s individual needs,” says Dr. Almozlino.

The Newton-Wellesley Hospital sleep specialists use specific diagnostic procedures to determine each patient’s diagnosis and treatment. Various technology may be used as part of the diagnostic process including:

  • Diagnostic Sleep Studies – Overnight sleep studies conducted in the Sleep Lab. A technician monitors the patient throughout the night and a computerized sleep system records various brain activity and body systems.
  • Radiology – X-rays may be ordered to assess the upper airways and determine if an obstruction could be causing the sleep problem.
  • Lab Work – Blood work may be ordered to rule out endocrine and metabolic disorders.
  • MRI Scan – Scans may be ordered to rule out brain stem abnormalities.
  • Heart studies – EKG and ultrasound to assess for any potential associations between the damaged heart and an untreated or under-treated sleep breathing disorder.

The Sleep Study
“A laboratory sleep study is considered the ‘gold standard’ to accurately diagnose sleep disorders,” says Dr. Almozlino. “In order to fully understand a patient’s sleep, it is necessary to observe and record the activities of the brain and various body systems and their relationships while the patient sleeps throughout the night.”

 

After the study, a sleep specialist will review and analyze the recorded data to help patients understand their specific sleep patterns and sleep problems. Based on these results, the physician is able to make treatment recommendations.

One of the major conditions affecting sleep is obstructive sleep apnea. Patients with sleep apnea have episodic difficulty breathing during sleep due to a narrowing of the upper airway. This diminished breathing disrupts sleep and may lead to insufficient oxygen levels in the blood. This upper airway obstruction is more common during sleep because the muscles in the throat relax and the throat partially closes.

The obstruction typically resolves when the patient briefly and partially awakens, returning normal muscle tone to the throat. These micro-awakenings are called arousals and can occur many times per hour. As a result, patients do not sleep as deeply and this may repeatedly stress the heart and blood vessels. Noticeable sleep time symptoms include loud snoring, difficulty breathing, respiratory pauses or snorts and restless sleep. Daytime symptoms include irritability, sleepiness, difficulties in memory and attention and bad mood.

If a patient’s initial sleep test reveals sleep apnea, it is common to perform a second test to determine the best treatment plan. Usually, the least invasive and most successful form of treatment for sleep apnea is a continuous positive airway pressure (CPAP) machine. This involves breathing through a nose mask that is connected to a small, quiet air pump that keeps the airway open. The second sleep test is needed to adjust the CPAP machine to a comfortable setting to correct the sleep apnea.

“Sleep apnea disorder is actually very common and can have a serious impact on a patient’s health and quality of life. If left untreated obstructive sleep apnea can increase a patient’s chance of both heart disease and stroke,” adds Dr. Almozlino. “While sleep apnea can affect anyone, patients who are male, obese or have a family history may be more at risk.”

Weight loss and other interventions may also help patients manage sleep apnea. Patients must be referred by their physicians for sleep studies at the Newton-Wellesley Sleep Center.

Dr. Almozlino, Dr. Kadar and their dedicated team also diagnose and treat a variety of other conditions that affect the quantity and quality of sleep.

Insomnia – Insomnia is a sleep disorder where people experience poor sleep or have trouble sleeping. Insomnia can include difficulty falling asleep, difficulty staying asleep (waking throughout the night) and waking too early in the morning. This disorder occurs in patients of all ages and can last for one or two nights or continue for months and even years. Insomnia can be caused by psychological conditions such as persistent stress and depression. It can also be caused by poor lifestyle habits like inappropriate exercise habits and work schedules and overeating or consuming stimulant drugs and caffeine at night. Environmental factors like persistent noise and light at night can also disturb sleep and cause insomnia.

Narcolepsy – Narcolepsy is a sleep disorder characterized by constant sleepiness and a tendency to sleep at inappropriate times. Patients with narcolepsy may suffer from sleep attacks during the day and a chronic feeling of tiredness. While there is no cure for narcolepsy, physicians can provide treatment to help patients keep awake and active in everyday life.

Restless Legs Syndrome (RLS) – RLS is characterized by restless unpleasant sensations in the legs while sitting or lying still, especially in the evening or at bedtime, which can cause severe insomnia. Stretching or moving the legs can temporarily relieve these sensations.

Periodic Limb Movement Disorder (PLMD) – PLMD is characterized by involuntary limb movements during sleep, which may cause multiple micro-awakenings known as arousals, throughout the night. This creates an overall feeling of restless sleep or a poor night’s sleep. PLMD is commonly associated with RLS.

According to Dr. Almozlino, certain habits and behaviors can help people achieve a better night of restorative sleep.

“Good sleep hygiene is a key component of a good night’s rest,” says Dr. Almozlino. “While some people naturally fall asleep and stay asleep throughout the night, others need to follow specific practices to help them attain a better night of sleep.”

Tips for good sleep hygiene include:

  • Maintain a routine sleeping and waking schedule even on the weekends.
  • Use the bedroom only for sleep, sickness and sex.
  • Avoid caffeine and alcoholic beverages within four to six hours of bedtime.
  • Find a relaxing activity before bed to relieve stress and encourage sleep.
  • Avoid taking naps after 3:00 pm.
  • Create a comfortable environment for sleep (minimizing light, noise and extreme temperatures).
  • Avoid nicotine.
  • Eat a light snack and avoid filling up on large meals close to bedtime.
  • Avoid strenuous exercise within four hours of bedtime.

“At Newton-Wellesley Hospital, we have the resources available to help patients determine what might be causing their sleep problems as well as a variety of treatment options to improve their overall quality of life,” says Dr. Almozlino.

 

For more information about physicians or services at Newton-Wellesley Hospital, contact CareFinder at 1-866-NWH-DOCS (694-3627) or visit our website at www.nwh.org/sleep.

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