1. health and fitness
2. disorders
3. sleep disorders

Relax in comfort at Delray Medical Center’s sleep
laboratory. Our sleep center is dedicated to providing
you with personalized service in a hotel-like
environment. Our highly qualified, board certified
sleep professionals will make every effort to ensure
your experience is surprisingly pleasant. We are proud
of the fact that we have had 100% client satisfaction
for 12 years in a row. The center offers a luxurious bed,
fine linens, plush robes and other amenities.
Call to schedule your tour today: 561.495.3171
Name:______________________
Physician:___________________
Appointment Date:____________
Time:_______________________
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About the
Sleep Disorder Laboratory
at Delray Medical Center
Restful sleep is very important to one’s health – not too much or too little
sleep, but just the right amount. However, many people have serious sleep
disorders that interfere with their ability to initiate or maintain sleep – or
cause them to have excessive daytime sleepiness. These disorders stem
from a wide variety of causes and affect all types of people at all ages. The
Sleep Laboratory can provide comprehensive sleep monitoring to aid in the
diagnosis and treatment of sleep disorders.
Pre-registration can be done in person or by telephone. If you wish to
pre-register by phone, call (561) 495-3538. If you wish to pre-register in
person, stop by the outpatient admitting area any weekday prior to your
scheduled appointment. When you check in, the admitting staff will give
you an ID bracelet that you are to wear during your hospital stay.
If you have any questions, or need to cancel or reschedule your evaluation,
please call (561) 495-3171.
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On the Evening of
Your Scheduled Evaluation
•
Please arrive promptly at your scheduled time.
•
On the day of your study, enter the hospital as
you were directed by registration (Pinecrest or
Emergency Room entrance). You will sign-in and
be escorted to the Sleep Laboratory.
•
Parking is available in the Pinecrest designated
area.
•
Please be sure to eat your evening meal before
your arrival at the Sleep Laboratory. An evening
meal will not be provided.
•
If you are presently taking prescribed medication,
please take it prior to arriving for your evaluation
and bring a list of those medications with you
for our medical record. Patients scheduled for
multiple sleep latency tests must also bring a
one-day supply of prescribed medications along
with them when arriving at the sleep laboratory.
•
Please make sure your hair and face are clean
and free of oils, creams, lotions, hairspray,
mousse and gels before your evaluation. Nail
polish or false nails should be removed from
index finger of right and let hand.
•
Please refrain from drinking caffeine the
afternoon and evening of your evaluation. This
includes coffee, tea, soft drinks, chocolate, etc.
•
Please refrain from drinking alcohol.
•
Please bring a loose fitting top. The sleep room
tends to be cool, so dress appropriately.
•
Please leave all valuables at home.
•
Smoking is not permitted on the hospital grounds.
•
We designate 11:00 p.m. as “lights out.” No
reading or TV after this time.
•
If you are scheduled for a multiple sleep latency
test, please bring comfortable street clothing to
change into for the evaluation.
•
Please refrain from naps the day of your sleep
study.
•
Please make arrangements to leave no later than
7:00 a.m. the next morning.
Call to schedule your tour today: 561.495.3171
•
Patients scheduled for a multiple sleep latency
test (MSLT), along with any other overnight
polysomnogram, should make arrangements to
remain until late afternoon of the day following
the overnight study. Usual departure time varies
between 2 and 5 o’clock in the afternoon.
Breakfast and lunch will be provided.
•
Please read and fill out the questionnaire and
bring it with you on the night of the evaluation.
Accommodations
You will stay overnight in a comfortable, private room
with a telephone, color television/DVD player, where
you will be monitored throughout the night by a
sleep technician.
What kinds of events are measured during sleep?
Your sleep patterns, breathing, body movements,
heart activity, oxygen levels and airflow will be
monitored throughout the night. Audiovisual
monitoring will be used to correlate body movements
with physiological changes. Multiple sleep latency
studies are given in a series of four to five naps, each
lasting approximately 20 minutes long with 2-hour
breaks between each nap. During the 2 hour break
period, you will remain awake and out of bed.
After your study is complete
Due to the large amount of data collected during
a sleep study, it’s usually 7 to 10 days before your
physician receives a written report. Please call your
physician for results.
There may be a small amount of cream left in your
hair from the electrodes. To remove: wet your hair
with warm water and wash as usual.
Please let us know if you have any special needs
or concerns, such as oxygen, a wheelchair or if you
require an aide.
1
Commonly
asked Questions
1. What is a sleep study?
A sleep study is the monitoring of your sleep patterns, which include eye movements, leg
movements, muscle tone, respirations, and brain waves.
2. Is a sleep study painful?
No. To monitor sleep, small silver disks are applied to the legs and head, and two Velcro
bands are placed around the midsection.
3. Why is a sleep study necessary?
A sleep study helps identify the reason you are sleeping too much, too little or at inappropriate
times. Once identified, appropriate lifestyle changes or treatments may be established.
4. Who has sleep studies?
Sleep disorders have been identified in men, women and children of all ages.
5. Is there any special preparation for the test?
Yes. Try to follow your normal sleep pattern for three nights prior to the study. On the day
of the study, eat your normal meals, but avoid caffeine after 5:00 p.m. No alcohol or naps
on the day of the test.
6. Is there anything I should bring with me?
Loose fitting sleepwear, your toothbrush and toothpaste, any special snack or beverage
you normally have at bedtime (except alcohol). If you have a favorite pillow, bring it with
you.
7. Can I continue to take my medications?
Yes, unless directed otherwise by your physician.
8. Can I have someone come with me?
Yes, but that person must leave after you are hooked-up and ready for sleep. We must
know in advance if you require an aide to stay the night with you.
9. Can I go to work after the test?
Yes. A shower and amenities are provided for your comfort.
2
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Sleep
History
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
Dear Patient:
You have been scheduled for a sleep study at the Sleep Disorders Laboratory at Delray
Medical Center on ______________. You will check in as directed by the registration
department and then be escorted to the Sleep Laboratory.
We ask that you complete the following sleep history as accurately as possible, in order for
our team of specialists to obtain the most comprehensive picture of your background and
the nature of your present problem. If you currently use oxygen at home please contact
the Sleep Disorder Laboratory prior to your appointment date. Please bring this completed
questionnaire with you on the night study. If you have any questions, please do not hesitate
to call the Sleep Disorder Laboratory at (561) 495-3171.
PLEASE BRING THIS COMPLETED FORM WITH YOU THE NIGHT OF YOUR STUDY.
Name:_________________________________________________ Age: ____________
Address:________________________________________________________________
Phone(s): Home: ________________________ Work: ____________________________
Date of Birth: _______________ Height: _____________Weight: ___________________
Referring Physician:_______________________________________________________
Place of Employment:______________________________________________________
Occupation: _____________________________________________________________
Call to schedule your tour today: 561.495.3171
3
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
Sleep History
(continued)
1. I am having a sleep study because of:
o Excessive fatigue/sleepiness ______ snoring ______ stopping breathing in sleep
o Insomnia (unable to sleep) _____ leg jerks when I sleep
oother __________________
2. I began to have sleeping problems at_____ years of age
3. My life is disrupted by:
owaking up tired ______ trouble paying attention because of sleepiness
ofalling asleep during the day
oworried about my sleep
oother __________________
4. On a typical day I drink:
____ cups of caffeinated coffee ____cups of caffeinated tea ____ glasses of caffeinated soda
5. Do you drink any of the above three hours or less before going to sleep? ____ yes ____ no
6. Do you consume alcoholic beverages? ______ yes ______ no
If YES, please list type and amount per week: Type: _____________ Amount per week _____
7. Do you smoke? ______ yes ______ no
If YES, how much per day? ______
8.
Please list all current medications.
a. Name__________________________
b. Name__________________________
c. Name__________________________
d. Name__________________________
Dosage __________
Dosage __________
Dosage __________
Dosage __________
9. Do you currently, or have you ever done, shift work? ______ yes ______ no
If YES, please list the dates (mo/yr to mo/yr): _____________________
Please describe the type of shift work: __________________________________________
10. What are your working hours now? ____ AM/PM ____ AM/PM ____ Retired
11. On Workdays
I try to get to sleep at __________ AM/PM
I wake up at __________ AM/PM
I get out of bed at _________ AM/PM
When I am not working
I go to sleep at __________ AM/PM
I wake up at _________ AM/PM
I get out of bed at __________ AM/PM
12. What are your working hours now? ____ AM/PM ____ AM/PM ____ Retired
4
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Sleep History
(continued)
13. On Workdays
I try to get to sleep at __________ AM/PM
I wake up at __________ AM/PM
I get out of bed at _________ AM/PM
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
When I am not working
I go to sleep at __________ AM/PM
I wake up at _________ AM/PM
I get out of bed at __________ AM/PM
14. It takes more than 30 minutes to fall asleep ______ yes ______ no
It takes me more than 60 minutes to fall asleep ______ yes ______ no
15. Have you ever been through long periods of stress? ______ yes ______ no
If YES, please describe: _____________________________________________________
16. Did you receive any inpatient hospitalization or psychiatric treatment or counseling related to
the above? _______ yes ______ no
If YES, please describe _____________________________________________________
17. Have you ever had any head injuries? ______ yes ______ no
If YES, please describe: _____________________________________________________
Did you lose consciousness? _____ yes ______ no
18. Please circle a number between one and ten that indicates your general level of well being
at the present time:
1
2
3
4
5
6
7
8
9
10
Feeling very poor
Feeling very well
19. Please circle a number between one and ten that indicates how much stress you are currently
experiencing:
1
2
3
4
5
6
7
8
9
10
No stressExtreme stress
20.Do you experience chronic pain: ______ yes ______ no
If YES, please describe: _____________________________________________________
21. Do you experience chronic pain at night? ______ yes ______ no
If YES, please describe: _____________________________________________________
22.What do you do to help alleviate your pain? __________________________________
23.Please circle a number between one and ten that indicates your current pain level.
1
2
3
4
5
6
7
8
9
10
No painExtreme pain
24.Do you feel your personality has changed recently? ______ yes ______ no
25.Have you ever seen a psychiatrist or a psychologist? ______ yes ______ no
Call to schedule your tour today: 561.495.3171
5
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
Sleep History
(continued)
26.What position do you generally sleep in?
______ back ______ stomach ______ right side ______ left side
27.Have you gained or lost weight recently? ______ yes ______ no
If YES, how much ___ lost ___ gained ___ lbs. Over what period of time? _____________
28.I exercise:
___ rarely or never ___ 1x/week ___ 2x/week ___ 3x/week ___ 4x/week ___ 5x/week
Describe types of exercise: __________________________________________________
29.Do you have any allergies? ______ yes ______ no
If YES, please list allergies: __________________________________________________
30.Do you have a Deviated Septum? ______ yes ______ no
31. Do you frequently get a “stuffy nose”? ______ yes ______ no
32.Have you noticed a change in your voice? ______ yes ______ no
33.Please list all previous surgeries including tonsils, adenoids, etc.
1. _________________ Date____________ 2. _________________ Date ____________
3. _________________ Date____________ 4. _________________ Date ____________
34.Do you use any mechanical/electrical aids such as a cardiac pacemaker, hearing aids,
in-dwelling stimulators, or other devices? ______ yes ______no
If YES, please list aids: ______________________________________________________
35.Do you use oxygen at home? ______ yes ______ no
If YES, what is the liter amount? ________________
36.Do you currently use CPAP or BIPAP devices? ______ yes ______ no
If YES, list know pressure: ______________
Please have bed partner or other person who has seen you sleep to answer the following: ____ N/A
1. How often do you see the patient sleeping?
2. What sounds have you heard?
_____ snoring lightly _____ snoring loudly ______choking ______ stop breathing
_____ moving/twitching arms/legs _____ grinding teeth ______ sleep walking _____ bedwetting
_____ sitting up while sleeping _____ biting tongue _____ crying out while asleep
_____ awakens complaining of pain ________________________________other
3. Have you ever seen the patient fall asleep during the day or evening activities or in a
dangerous situation? ______ yes ______ no
6
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PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
Sleep History
(continued)
ALWAYS
FREQUENTLY
OCCASIONALLY
SELDOM
NEVER
Have trouble going to sleep
Wake-up and cannot go back to sleep
Drink alcohol before going to bed
Have hallucinations
Experience your jaw go suddenly slack when
laughing, excited or emotional
Find yourself somewhere and do not know
how you got there
Wet the bed
Talk in your sleep
Go to the bathroom during the night
Sleepwalk
Awaken from sleep short of breath
Awaken at night with heartburn, belching,
wheezing or with a cough
Snore
Snore loud enough others complain
Have trouble sleeping when you have a cold
Suddenly wake-up gasping for air
Have breathing problems during the night
Fall asleep during the day
Wake up with chest pain
Wake up with palpitations
Fall asleep involuntarily
Fall asleep while driving
Fall asleep while laughing or crying
Fall asleep during physical activity
Experience loss of muscle tone
when extremely emotional
Have trouble at school/work due to sleepiness
Feel unable to move when waking up
or falling asleep
Call to schedule your tour today: 561.495.3171
7
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
Section III.
Please Check  How Often you:
ALWAYS
FREQUENTLY
OCCASIONALLY
SELDOM
NEVER
Have nightmares
Remember your dreams
Have thoughts racing through your mind
Feel sad and depressed
Notice that parts of your body jerk (arms, legs . . .)
Have muscular tension
Kick during the night
Experience crawling, aching or prickly feelings in your legs
Experience any type of leg pain during the night
Have morning jaw pain
Grind teeth during sleep
Are bothered by pain during the night
Are awakened by pain during the night
Wake-up with pain in neck, spine or joints
Fall out of bed
1. Describe any other complaints that relate to your sleep problem
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
2. Describe any activity your sleep problem may have aggravated or interfered with
(work, family, physical activity, etc.)
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
8
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Sleep
Diary
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
PLEASE START FILLING OUT THIS DIARY THE DAY YOU RECEIVE IT.
ANSWER ALL THE QUESTIONS IN THE MORNING AFTER WAKING FOR THE DAY.
This is a very important tool for the use of the sleep physician to understand and know everything
possible about your sleep. Please take the time to fill it out to the best of your ability.
DAY
At what time
did you go to
bed?
How long did it
take you to fall
asleep?
How many times
did you wake up
at night?
How many
hours did you
sleep?
What time did
you wake up?
Did you take
any sleeping
pills?
In general, how did you
feel when you woke up?
1
oVery Refreshed
oSomewhat Refreshed
oFatigued
2
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
3
4
5
6
7
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
8
oVery Refreshed
oSomewhat Refreshed
oFatigued
9
oVery Refreshed
oSomewhat Refreshed
oFatigued
10
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
11
13
oVery Refreshed
oSomewhat Refreshed
oFatigued
oVery Refreshed
oSomewhat Refreshed
oFatigued
14
oVery Refreshed
oSomewhat Refreshed
oFatigued
12
Call to schedule your tour today: 561.495.3171
9
PLEASE TEAR OUT
AND RETURN
TO PHYSICIAN
10
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Types of
Sleep Disorders
Insomnia
Definition: Insomnia is difficulty maintaining or falling asleep. Many factors can cause insomnia:
Stress, depression, stimulants (caffeine, nicotine), alcohol, erratic hours, a sedentary lifestyle. There
are also physical reasons that will disrupt sleep, such as periodic leg movements, pain or sleep
apnea.
Symptoms: Poor sleep every night or several nights a month and daytime fatigue.
Evaluation: A sleep study may be indicated after your physician rules out other causes.
Possible Treatment: Lifestyle changes or medication.
Sleep Apnea
Definition: People who have sleep apnea stop breathing during the night, many times, making it
hard to get enough oxygen or restful sleep. Sleep Apnea may take three forms:
• Obstructive sleep apnea is the most common form of the disorder and results when
structures in the throat block the flow of air in and out of the lungs during sleep.
• Central sleep apnea results from the brain not sending signals telling you to breathe,
thereby causing you to periodically stop breathing during sleep.
•
Mixed sleep apnea is a combination of obstructive and central sleep apnea.
Symptoms:
• Extremely loud, heavy snoring often interrupted by pauses and gaps
• Daytime sleepiness, sometimes falling asleep at work, while driving or during conversation
• Loss of energy – constant fatigue
• Irritability, short temper
• Morning headaches
• Change in mood or behavior, anxiety or depression
Evaluation: A complete sleep history and an evaluation at the Sleep Center may be used to
help diagnose sleep apnea.
Possible treatment: – Continuous Positive Airway Pressure (CPAP) – a mask is worn over the
nose that provides a small amount of pressure to keep the throat open.
• Lifestyle changes – avoid alcohol, lose weight (if you are more than 35 pounds overweight)
• Surgery – uvulopalatopharyngeoplasty (UPPP). A surgical widening of the upper airway.
Call to schedule your tour today: 561.495.3171
11
Types of
Sleep Disorders
Narcolepsy
Definition: Narcolepsy is a syndrome of excessive daytime sleepiness with intrusions of REM (Rapid
Eye Movement) sleep into wakefulness.
Symptoms: The typical age of onset is during the second decade, usually around the age of 12 years.
Symptoms include:
1. Excessive daytime sleepiness.
2. Cataplexy – a brief sudden loss of skeletal muscle tone, often following an emotional
stimulus such as laughter, anger or excitement.
3. Sleep paralysis – is the total inability to move any muscles while falling asleep or waking.
4. Hypnagogic hallucinations – vivid dream like experiences that occur as the individual is
falling asleep.
Evaluation: A sleep history questionnaire and MSLT (multiple sleep latency test) are used to
help diagnose narcolepsy.
Possible Treatment: The symptoms of narcolepsy can usually be controlled with medications
and short naps during the day.
Parasomnias
Definition: Parasomnias are undesirable behaviors that either occur exclusively during sleep or
are exaggerated by sleep. Examples are sleep walking (somnambulism) or bed wetting (enuresis).
Symptoms: Night terrors, sleep walking, bruxism (tooth grinding) or any abnormal behaviors
during sleep can be symptoms of Parasomnias.
Evaluation: A complete history questionnaire and evaluation at the Sleep Center may be used
to diagnose Parasomnias.
Possible treatment: Some children will outgrow symptoms, but if disruptive or dangerous
symptoms persist, medications may help.
Periodic Leg Movements
Definition: Periodic leg movements are brief muscle contractions that cause leg jerks that last a
second or two, occurring roughly every 30 seconds. They may last for an hour or more, several
times a night, and may cause hundreds of mini arousals each night causing disruption of sleep
patterns.
Symptoms: Difficulty in maintaining sleep excessive sleepiness during the day.
Evaluation: A complete sleep history questionnaire and evaluation at the Sleep Center may
diagnose periodic leg movements.
12
Possible treatment: Medications have been used successfully to help control periodic
movements of sleep. Evening exercise and a warm bath often proves helpful.
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Tips for Good Sleep Hygiene
1. Establish and maintain a daily schedule of activities
every day of the week. Try to eat at regular times. Keep same
bedtime hours, even through the weekend.
2. Keep a regular wake-up time each morning, no matter
what time you went to bed the day before. Maintain this wakeup time regardless of how poor your previous night’s sleep
was. This is the strongest signal you can give your internal
clock to set the circadian rhythm. Eventually the body adjusts
to this schedule, and that leads to a regular time of sleep
onset.
3. Do not linger in the bed in the morning. Staying in bed
for excessively long periods of time can lead to fragmented
and shallow sleep. Trying to make up for lost sleep causes the
circadian rhythm to be delayed by several hours, preventing
you from sleeping at your desired time the next night. You
may be starting a vicious cycle of poor sleep. Reducing the
time spent in bed can be beneficial because you are more
likely to become sleepy at the desired time the next night.
4. Limit naps during the day, particularly if you are a poor
sleeper. Naps usually reduce the amount of sleep you need at
night, causing light sleep difficulties falling asleep.
5. Maintain a regular daily program of exercise at an
appropriate time. If you are a particularly poor sleeper, try
to exercise in the late afternoon or early evening. However,
do not exercise vigorously right before going to bed – your
system may become too stimulated to relax and you will have
difficulty going to sleep.
6. Approach bedtime as relaxed as possible. Plan to spend
your evening winding down from the activities of the day
doing something enjoyable and relaxing. Too many people
view their bedtime as a chance to review the day’s problems
and tomorrow’s plans. This stimulates your mind and prevents
sleep. At the bedtime hour, chances are you cannot take any
action to resolve work or other problems, so you are only
creating anxiety by thinking about them. Discipline yourself
not to think upsetting thoughts in bed – be prepared to
consciously replace them with pleasing and relaxing thoughts.
7. Establish a routine transition period to prepare for your
bedtime and do it daily, even when traveling. Set aside some
time for gradual unwinding from the stressful events of the
day. Make a list of things to do the next day so you don’t stay
awake thinking of unfinished business. Also, establish regular
bedtime rituals, such as locking doors, turning down the heat,
a warm bath, and brushing teeth. Once in bed, establish a
routine for relaxation – closing your eyes, getting comfortable
in bed, and thinking of calm mental images.
Call to schedule your tour today: 561.495.3171
8. If you cannot fall asleep easily, get out of bed and
do something different. Remember that it should no be
an activity that is strenuous or stimulating. Try to select an
activity, such as reading, that will prepare you for relaxation
and sleep.
9. Make your bedroom conducive to sleep. Use a
mattress that is comfortable for you and control light and
sound if they disturb your sleep. Avoid either excessively
warm or excessively cold rooms as they might cause sleep
interruptions. The ideal temperature for sleep is thought to be
between 64 and 66 degrees Fahrenheit.
10. Avoid using the bedroom for other activities unrelated
to sleep. You should associate the bedroom with relaxation
and break the conditioned association of sleepiness with the
bedroom environment. Watching television, reading, knitting,
exercising and similar activities done in the bedroom can
trigger a “wake-up” response.
11. Avoid eating heavy meals prior to bedtime, as well
as going to bed hungry. Hunger often disturbs sleep, so a
light meal or a small glass of milk will make you feel more
comfortable. The amino acid in milk (tryptophan) is thought to
help induce sleep, and carbohydrates are thought to move it
to the brain faster, so a glass of warm milk and crackers may
be a ritual that will prepare you for sleep.
12. Avoid taking stimulants before bedtime. This includes
coffee, tea, alcohol, nicotine, diet drinks containing caffeine,
and food with caffeine derivatives (such as chocolate). People
with insomnia often are sensitive to small doses of stimulants
such as caffeine. Nicotine stimulates the central nervous
system and heavy smokers have been found to sleep less
soundly than nonsmokers. If used in moderation, alcohol can
be a relaxant.
13. Avoid taking sleeping medicines. Sleeping pills are not a
long-term solution to poor sleep, and their use can aggravate
sleeping problems.
The important thing about sleep hygiene is that you can
take positive steps to improve sleeping habits. Don’t
“give up” on these tips after only a few nights. The body
needs time for the type of conditioning incorporated into
these guidelines. And if your daytime worries are affecting
your nighttime sleep, you’ll need time to learn the mental
habits necessary for relaxation. Remember, hygiene means
practicing that which is conducive to your health - and good
sleep habits are worth the practice.
13
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