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With the most active sleep disorders program in the Chicago area, the University of Chicago Hospitals have been a long-time leader in research and treatment of sleep disorders. In 1953, University of Chicago researchers were the first to define rapid-eye-movement (REM) sleep, the sleep stage which includes dreaming. Also in the 1950s, researchers here first identified narcolepsy, a rare disorder of excessive sleep. More recently, University of Chicago researchers established the relationship between narcolepsy and the immune system — an important step toward effective treatment of this condition.
About Sleep Disorders and Symptoms
Our need for sleep and normal sleeping patterns change as we age. Children generally require more sleep per day and experience longer periods of delta (deep) sleep. Older adults experience less delta sleep and generally require fewer hours of sleep overall.
There are many different types of sleep disorders that can affect children and adults of all ages and interfere with normal functioning. Disturbed sleep can be a periodic annoyance, or can be chronic and disabling. In fact, researchers are finding that sleep disorders can contribute to medical or emotional problems. For example, sleep apnea has been linked to hypertension and other cardiac disease.
Diagnosis
It is important to understand the precise nature of the sleep problem so it can be treated. Diagnosis begins with a physical examination and may also include neurological or psychological evaluation, blood tests, pulmonary function tests, or other procedures.
A detailed sleep study (polysomnogram) provides physiological clues about the patient's symptoms. The polysomnogram is a computerized study of the person's sleep pattern and bodily responses during sleep. Using non-invasive electrodes, the polysomnogram records heart rhythm, breathing, eye movements, electrical brain activity, and other body functions throughout the sleep cycle. Additional monitoring may be conducted to study specific problems. For example, persons with suspected sleep apnea may need measurement of nasal or oral airflow with blood oxygen saturation (oxymetry). Infants who are at risk for sudden infant death syndrome (SIDS) may receive additional monitoring of their respirations and breathing effort.
This testing is performed overnight. Patients stay in private rooms, with unobtrusive electrodes and sensors that are discreetly linked from the patient's room to a central room staffed by sleep specialists. We make every effort to keep patients as comfortable as possible throughout the testing. Polysomnogram testing is usually completed by 7 a.m., so patients can wake, shower at the hospital, and then go to work or their normal daily routine.
Special accommodations are available for parents whose children are undergoing a sleep study.
Depending on the symptoms, additional tests may be conducted on-site to confirm a diagnosis, including:
- Multiple sleep latency testing, for narcolepsy.
- Continuous positive airway pressure, for sleep apnea.
- Prolonged activity monitoring, to measure abnormal circadian (sleep-wake) cycles.
- Nocturnal penile tumescence, used in evaluating causes of impotence.
- Monitoring of breathing efforts, for infants at risk for Sudden Infant Death Syndrome.
Treatment
The comprehensive sleep disorders center at the University of Chicago Hospitals has been accredited by the American Sleep Disorders Association since 1982. It also is certified by the American Board of Sleep Disorders Medicine.
The approach here combines neurologic, medical and psychiatric expertise. Neurologists specializing in sleep disorders also consult with University of Chicago pulmonologists, otolaryngologists and other subspecialists when appropriate for a patient's needs.
Usually, sleep disorders can be treated by non-invasive methods. In some cases, treatment may be as simple as changes in the sleep environment or in daily routines. Often, short-term or long-term medications can resolve sleep disorders. Patients with sleep apnea may find relief with nasal CPAP (ventilation assistance) or losing weight. Upper airway surgery, performed by University of Chicago otolaryngologists, may be necessary for severe sleep apnea.
In some cases, the sleep disorder is a symptom of another health problem such as congestive heart failure or neurologic disease. When this occurs, the sleep specialist consults with other subspecialists here to recommend treatment that addresses the underlying health concern as well as the sleep disorder.
Psychological conditions such as anxiety or depression also can trigger sleep disorders. The sleep specialists collaborate with psychiatrists and behavioral psychologists to provide effective care.
Children with sleep disorders benefit from the expertise of a physician who specializes in pediatric sleep disorders.
Clinical Trials
Patients with sleep disorders may be eligible for clinical trials of new drugs and other therapies.
U of C Research in Sleep Disorders
Physicians and scientists here continue to study the patterns of sleep in our lives, the effects of sleep irregularities, and the role of circadian function on health and disease. Researchers are finding that sleep patterns play an important role in a person's overall health status. |
