Torrance Memorial comprehensive Sleep Disorders Center includes sleep studies
for those experiencing ongoing difficulty falling asleep, maintaining
sleep, and exhibiting excessive sleepiness during waking hours or undergoing
bariatric surgery. The studies, which are conducted in home-like settings,
provide essential data on sleep patterns.
Sleep Consultation
During an initial sleep consultation, a sleep specialist will interview
the patient about his/her sleep habits. The specialist uses the patient's
history to evaluate symptoms such as difficulty falling asleep, difficulty
staying asleep, daytime sleepiness or fatigue, breathing problems during
sleep, restless legs at night and other various troublesome behaviors.
The sleep specialist may recommend an overnight sleep study known as a
Polysomnogram, to further evaluate patients. Consultations are performed
in our medical director’s private practice. Dr Kneisley’s
private practice can be reached at 310-530-8822.
Sleep Study
A sleep study, or Polysomnogram (PSG), is an overnight recording of sleep
patterns and behaviors associated with sleep. It is performed in order
to determine what stages of sleep an individual achieves and whether any
sleep-related abnormalities are present. A variety of sensors are applied
with paste or tape to the body's surface to record brain waves, eye
movements, muscle tone, body movements, heart rate and breathing patterns.
Audiovisual recordings are also made, and the oxygen content of the blood
is measured non-invasively with a simple clip on the index finger. These
procedures are painless, and although there are connecting wires to the
sensors, the patient is free to get up and walk around as needed.
During the sleep study, every attempt is made to allow for a normal night's
sleep. Some people typically sleep better or worse when away from home,
but in either case this does not usually affect the quality of the sleep
study. The Torrance Memorial Sleep Disorders Center has a homey, bedroom-like
atmosphere with select comfort beds and cable TV. Patients wear their
own bedclothes and can bring their favorite pillow, blanket. A trained
sleep technologist is there to explain the procedure, operate the diagnostic
equipment, and is stationed all night in an adjacent control room to both
monitor the sleep recording and ensure the patient's comfort.
Following the sleep study, a board-certified sleep specialist interprets
the recording. The findings are integrated with the patient's sleep
history to determine a diagnosis and make the appropriate treatment recommendations.
A sleep study report is also sent to the patient's primary care physician,
who should review the results with the patient at a follow-up office visit.
Titration Study (CPAP)
As a result of a sleep study (Polysomnogram or PSG), a patient may be diagnosed
with Obstructive Sleep Apnea (OSA), and may be sent by the primary care
physician back to the sleep center for another sleep study with CPAP (pronounced
— see-pap). CPAP stands for Continuous Positive Airway Pressure
and is the most effective and widely used method of treating sleep apnea.
While asleep, this system gently delivers air into a person's airway
through a specially designed mask, which fits over the nose or mouth,
thereby creating enough pressure to keep the airway open and produce immediate
relief from sleep apnea and snoring. Most people find they get used to
the CPAP apparatus after a few minutes and have little difficulty sleeping
with it in place. It is important to note that the CPAP does not breathe
for the person, but instead allows the person to breathe at a normal rate.
At the beginning of a CPAP study sensors are applied to the patient's
body as they were for the Polysomnogram and again brain waves, eye movements,
muscle tone, breathing patterns and blood oxygen levels are monitored.
Before the patient falls asleep, the sleep technologist will fit the patient
with the CPAP mask and make sure it is comfortable for the patient.
PSG CPAP
In some cases, both diagnosis and treatment of a breathing problem while
sleeping can be accomplished in a single night's study, rather than
two separate studies. As with the polysomnogram (PSG), sensors measure
the patient's brain waves, eye movements, muscle tone, breathing patterns
and blood oxygen levels. Once asleep, the technologist carefully monitors
the sleep diagnostic equipment for any sign of disrupted breathing during
sleep. If interruptions in the patient's breathing (known as sleep
apnea) are observed, the technologist will apply CAP during the second
half of the sleep study.