Piedmont Health Group: Your Community Provider for Better Health Care*

Frequently Asked Questions

Q. Why am I scheduled for two appointments?

A. If the initial sleep study shows evidence of a breathing disorder associated with sleep (i.e., Sleep Apnea), patients often require a second study in which a special mask (called a CPAP device) will be applied to your nose and/or mouth. During this test, pressurized air is gently delivered while you breathe in order to open your airway and prevent episodes of diminished/absent breathing and snoring. Since our laboratory is very busy, patients often have to wait several weeks for an appointment. By scheduling both appointments at the same time, we can make certain that only a small amount of time elapses between your first and second appointment. This gives the sleep specialist adequate time to review your initial study and send a copy to your physician. It also allows treatment of your problem to be started more quickly. If you do not meet criteria for a CPAP device, your second appointment will be cancelled, and you will be notified.

Q. If I am found to have sleep apnea, what kinds of treatments are available?

A. Depending upon the severity of your sleep disorder, a number of different options are available. Weight loss can help in a few cases. However, non-surgical weight loss is only effective in 5% of cases. Unfortunately, 25% - 30% of sleep apnea patients are NOT overweight. For very mild cases, a specially fitted oral device (oral appliance) can be placed in your mouth while you sleep at night. In some cases surgery may be an option. Unfortunately, some procedures (palatal implants and uvuloplasty) are for snoring only (not sleep apnea) and not covered by insurance. A surgical procedure called UPP can be effective in some cases. The most widely used, effective, and non-surgical treatment is CPAP. In select cases, positional changes while you sleep may be used in conjunction with one of these treatments.

Q. What is CPAP?

A. CPAP (continuous positive airway pressure) is a type of mask attached by tubing to a small machine. CPAP delivers pressurized air gently to your airway while you sleep. The constant pressure serves as a 'splint' to prevent episodes of decreased or absent breathing while you sleep. It also reduces snoring. In some cases, a type of pressurized air called BiPAP may be recommended. This device delivers different pressures when you breathe in than when you breathe out.

Q. Why go to all the trouble of wearing a CPAP machine every night? Why can't you just let me snore?

A. Unfortunately, sleep apnea is not as simple as 'snoring'. In recent years, doctors have become increasingly aware that patients who suffer from untreated sleep apnea are at elevated risk for stroke, heart attack, heart failure, and uncontrolled high blood pressure. There may also be a relationship with diabetes. Patients with sleep apnea often stop breathing entirely hundreds of times per night. Some of these episodes can last for almost a minute or more. When this occurs, the blood oxygen level can fall significantly. The body's response to these spells is to cause the patient to partially arouse many times during the night. This results in chronic sleep deprivation. Consequences include daytime fatigue, poor concentration and memory difficulty, depression, and an increased risk of accidents (motor vehicle and work-related).

Q. Why does it take so long to get the results of my study?

A. A sleep study often lasts from 6 - 8 hours. During this period of time, continuous recordings of your breathing, brain activity, heart rate, movements, oxygen levels, etc. are captured and saved. It is easy to imagine the amount of data this creates. A sleep technician reviews all of this data and scores respiratory events, sleep stages, movements and other sleep events. This information along with the actual study is then reviewed again by a doctor who specializes in sleep disorders and a report is created. This process usually takes 1 - 2 weeks. We want to provide your doctor with the most accurate information possible. Please bear with us during this important process.

Q. Where and how do I obtain my CPAP equipment?

A. If your doctor determines that CPAP is the right treatment for you, equipment can be obtained from a variety of DME (durable medical equipment) providers or respiratory therapy companies. We have dedicated a lot of time and effort into making this process as easy as possible for you. We have staff who can assist with insurance, and our doctors have created CPAP clinics where a respiratory therapist and a doctor are available to ensure your success with CPAP.

One of the major reasons patients are not compliant with therapy over the long-term is the lack of regular follow-up. It is important to make sure patients are tolerating their CPAP. Mask fit, pressure settings, equipment replacement, humidification of air, and device type are all important factors.

We work closely with a company called Cardiosom of the Piedmont to provide CPAP equipment and close follow-up of our patients. We have found them to be unique among providers with regard to meticulous follow-up of sleep apnea patients. They have a national presence and have created time-tested methods for the follow-up of patients, and this has led to some of the highest compliance rates anywhere.

However, which DME vendor you want to use is your choice, and there are several in our area.

Q. What is an MSLT?

A. An MSLT (multiple sleep latency test) is a test performed the day after a sleep study in which the patient is asked to try to fall asleep multiple times through the day. It is a measure of the tendency to fall asleep. It is a useful way to quantitate patient reports of excessive daytime sleepiness. It can also help with the diagnosis of sleep disorders including narcolepsy.

Q. Why was I asked to stop some of my medications before my sleep study?

A. Some medications can affect the results of a sleep study. Certain antidepressants and sedatives can reduce the quantity of specific types of sleep. This can result in a study that may underestimate the true severity of your sleep disorder. On occasion, the sleep specialist or your doctor may recommend a follow-up study after you have been tapered off of some of your medications for 1 - 2 weeks. This will result in a better study.

Q. How am I supposed to sleep with all of these wires and straps attached to my body?

A. Many of our patients come to the lab with complaints of inability to sleep. We understand that trying to get a good night's sleep is difficult with all of the recording devices attached to your body. We make every effort to ensure that these critical devices do not disrupt your sleep unnecessarily. However, you must understand that these instruments are critical to gathering important data about your sleep patterns. We understand that your sleep may not be as good as when you are in your own bed. Please let us know if there is anything we can do to make your night more restful.

Q. Why is there a $250 cancellation fee?

A. The cancellation fee only applies if you fail to give 48 hrs notice to the laboratory that you will be unable to keep your appointment. Exceptions will be made on a case-by-case basis. If you fail to give adequate notice, there is not enough time to contact another patient to take your place. This is unfair to other patients who may be waiting for an opening. Further, it is unfair to the laboratory as the technicians are being paid to staff an empty bed. We only ask for common courtesy.