Home Locations What We Do Patients Physicians Who We Are Resources Contact Us

NPSG Test

What is a Sleep Study or Nocturnal Polysomnogram (NPSG)?

This test measures your breathing during sleep. It also measures your brain, eye movements, muscles, and blood oxygen level. The test looks like a large line graph that shows up on a computer in another room. A technician monitors the signals throughout the night and makes notes about the recording.

Don’t worry.  You will not be in a stainless steel room with doctors watching you through a window! Our tests are performed in comfortable rooms. The rooms are similar to a small hotel room. The test is painless and the equipment used is comfortable. You will have a lot of wires hooked to your head with tape and a special paste. Fortunately the paste rinses out with hot water. There are two belts that go around your chest and a sensor under your nose to measure breathing. Wires that measure your leg movements and a small sensor on one finger are used also. The test is known as the “Gold Standard” of sleep testing and can detect Obstructive Sleep Apnea, Restless Legs, Periodic Limb Movements as well as other disorders.

 

CPAP Test

Continuous Positive Airway Pressure (CPAP) Testing

CPAP stands for continuous positive airway pressure. It keeps your airway open as you sleep by providing you with a steady stream of air. Some people stop breathing while sleeping.  CPAP blows air into the nose while you are sleeping and lets you breathe in and out normally and stops your throat from shutting. A technician will monitor you with the same equipment used during the NPSG test. The CPAP machine will be used and the technician will document your response to the air pressure. The best way to prepare yourself for getting used to CPAP therapy is to relax your upper body and try to breathe in and out normally. It might feel a little unusual, but the test is painless and non invasive.  During the test the pressure is custom set for your body while each breath is monitored. Many patients feel great after breathing normally and sleeping all night during the CPAP test. 

Multiple Sleep Latency Test (MSLT)

This test measures your level of daytime sleepiness. You will be asked to take 5 naps during the day that are 2 hours apart. A technician will monitor your brain and take notes about how long it takes you to fall asleep. The MSLT is used to evaluate people who are thought to have narcolepsy. The test also evaluates people who fall asleep quickly.

Maintenance of Wakefulness Test (MWT)

This test measures your ability to remain awake in a quiet room during the day. You will be given a series of tests and instructed to try and remain awake. The test will be conducted in a quiet sleep lab room with low lighting.

 

Services for CPAP Users

CPAP, or continuous positive airway pressure, is the most effective treatment for obstructive sleep apnea.
Sleep Healers offers several services for current and future CPAP users.

Convenient Locations and Appointment Times

Our technicians are available to conduct personal training on the use of CPAP equipment.
Appointment times are available at our corporate office to meet your needs:
Monday, Wednesday and Friday 8:00 AM -5:00 PM
Tuesday and Thursday 10:00 AM-7:00 PM
Saturday 9:00 AM - 1:00 PM

Additional weekday appointment times are available throughout the Dallas Fort Worth Metroplex.
Please call Sleep Healers at 972-506-7800 for more information

Superior Equipment

Sleep Healers offers the latest whisper-quiet CPAP, Bi-Level and Auto therapy devices available in the marketplace. Sleep Healers also carries a wide range of mask interfaces to fit any patient.
Same-day equipment delivery is available.

Customized CPAP Mask Fitting and Guidance (7 day a week support)

Are you a new CPAP user?  You are not alone. An experienced technician will guide you through the entire CPAP equipment process. After the initial equipment training our comprehensive follow-up program offers 48 hour, 7 day, 21 day and 3 month calls to answer any questions and help you adapt to CPAP therapy.

Successful CPAP users report improvements in:

    * Vitality and motivation
    * Job performance
    * Mood
    * Sexual drive and performance
    * Alertness while driving
    * Quality of life
    * Quality of sleep

Supplies and New Equipment

Are you frustrated with your current CPAP equipment?  Is your current CPAP machine outdated or loud? 
Has your CPAP mask become uncomfortable? We can help.

If your CPAP or Bi-Level device is more than three years old, it may be time to upgrade. Today’s devices and mask interfaces are much smaller and unobtrusive, as well as, quieter and far more comfortable than equipment made even one year ago. 

Sleep Healers offers re-supply of the common items CPAP users need replaced on a quarterly or semi-annual basis. These items include CPAP masks or cushions, CPAP hoses, humidifier chambers, and CPAP device filters. CPAP masks and machines require a prescription from your doctor.

Please call Sleep Healers at 972-506-7800 and choose option 2 to speak with a Patient Care Representative.

Insurance Benefit Verification

Our Patient Care Representatives can verify insurance coverage. Supplies can be ordered, billed to your insurance company, and shipped to your home on demand or on a regular schedule.

Electronic Data Download Available

Sleep Healers can assist patients with submitting compliance data required by many insurance companies and some employers. It’s very important that patients be able to show they are using their device and that it is making a positive impact on their condition.

 

 

Therapy and Treatment Options

Common therapy options include CPAP, (Continuous Positive Airway Pressure), surgery, and Oral Appliance Therapy. CPAP blows air into the nose while you are sleeping and lets you breathe in and out normally and stops your throat from shutting.  Oral appliance therapy is similar to 2 retainers on your top and bottom teeth.  The device holds the jaw forward. This helps stop the snoring. A trained doctor will need to decide what is right for you based on the information from your testing and by looking at your airway.

An Otolaryngologist, also known as an Ear Nose & Throat doctor may evaluate you and decide surgery would be appropriate. The most common surgeries reduce tissues in the structures of the nose and throat.

If your doctor prescribes a CPAP machine for use at home a trained technician will meet with you and teach you how to use it. The machine is to be worn while sleeping to allow you to breathe normally during the night and prevent your airway from shutting. Our comprehensive tracking and follow-up program will answer questions and help you adapt to CPAP Therapy.

Continuous positive airway pressure (CPAP) is the standard 1st-line therapy for most patients diagnosed with obstructive sleep apnea. Obstructive sleep apnea occurs when the upper airway closes or becomes overly narrow as the muscles in the oropharynx (mouth and throat) relax during sleep. This results in inadequate or stopped breathing, which reduces oxygen in the blood and causes arousal from sleep. The CPAP machine counteracts this sequence of events by delivering compressed air to the oropharynx, opening the airway with increased air pressure so that unobstructed breathing becomes possible, reducing and/or preventing the airway from shutting.

For many patients, using CPAP results in immediate improvement in sleep and improvement in quality of life largely related to decreased daytime sleepiness. However, if CPAP is not worn each night while sleeping most nights of the week, the breathing problems are essentially untreated and you receive little or no benefit from the device.

When CPAP is refused or not tolerated, a number of 2nd-line treatments are available including, uvulopalatopharyngoplasty (UPPP), radiofrequency ablation, jaw surgery, and bariatric surgery, for eligible candidates. UPPP, radiofrequency ablation, and jaw surgery are surgical techniques to remove or shrink and scar redundant tissue that is causing the obstruction or to otherwise minimize the obstruction. The goal of bariatric surgery is to reduce body weight and fat, which may shrink the oropharyngeal tissue causing the obstruction.

Other less invasive techniques include oral appliances, which are worn overnight and hold the jaw forward; positional therapy, devices to prevent lying on your back during sleep; pharyngeal or laryngeal exercises to improve muscle tone; non-surgical weight loss programs; and physical-exercise programs.

 

Therapy and Treatment Options – Frequently Asked Questions

Do I have any options after going to the Sleep Center besides CPAP or major surgery? 
Yes, there are several options ranging from non-invasive, to office-based procedures, to minor surgical procedures performed in a hospital or surgery center setting.

How does my physician decide what procedure(s) will work for me? 
A simple physical examination by an otolaryngologist or oral surgeon who specializes in sleep medicine can localize the site(s) of obstruction.

What is the Pillar procedure? 
3-5 small rods are injected into the roof of the mouth to create a scar in the muscular layer. This scar stabilizes the palate during sleep which diminishes or eliminates the vibration and snoring sound. This procedure is appropriate for patients that primarily snore while sleeping. Reducing the vibration or snoring sound does not eliminate OSA. Obstructive sleep apnea patients may need to seek other treatment options.

What is Celon Pro Sleep/Pro Breathe? 
 Like the Pillar Procedure, the Celon procedure is another technique to stiffen the roof of the mouth to eliminate vibration & snoring during sleep. It employs radiofrequency energy to create a scar. The advantages are that no foreign material is left in the roof of the mouth, and it is less expensive than the Pillar Procedure in many cases.

What are the other surgical options & who would perform these? 
Most procedures are performed by an otolaryngologist (Ear, Nose & Throat surgeon) or an oral surgeon. The procedures alter the upper airway anatomy at the site(s) of obstruction during sleep. Each person is different and will need to be examined to determine the site of obstruction and appropriate treatment. The nasal airway can be opened & streamlined by straightening the nasal septum (septoplasty), with turbinate reduction. Large tonsils can be removed via tonsillectomy. Sometimes, a small portion of the uvula & soft palate can be trimmed as well (uvulopalatopharyngoplasty or UPPP). A relatively large tongue can be addressed by moving the jaw forward to pull the tongue away from the back of the throat, or by passing a suture through the back of the tongue to pull the tongue forward so it won't fall back during sleep. Finally, the bones & soft tissue lower in the neck can be supported by suturing them to the inside surface of the chin. Morbidly obese patients may benefit from a tracheostomy.

Will insurance cover these options? 
In general, insurance only covers CPAP or surgical procedures at this time. Some insurance plans may cover oral appliances with the diagnosis of OSA. Most other options are out of pocket expenses, but certainly qualify under medical savings accounts. Please call Sleep Healers at 972-506-7800 to verify your benefits or refer you to a doctor that can help you.

Do I really need to stop snoring now or be treated for snoring and Sleep Apnea?
Obstructive sleep apnea (OSA) is a very dangerous condition. If you or a loved one snore loudly at night, please have a sleep study done to rule out this potentially fatal condition. Sleep apnea sufferers have a greater risk for heart attacks and strokes. They also may suffer from daytime drowsiness and short term memory loss. Being treated for OSA and snoring has eliminated nightmares, sleep apnea, and reduced blood pressure levels. It has corrected chronic snoring, and improved chronic fatigue and fibromyalgia. Proper treatment has also reduced pain levels throughout the body, improved weight maintenance and increased energy levels. Snoring occurs when the airway or passage through which we breathe becomes partially blocked or occluded. An example would be a tongue that falls back as we drift off into deeper sleep. As the diameter or size of the airway passage is shrinking, the net result is a vibration of the throat, or snoring. Sleep-disordered breathing is due to the flexibility of the upper airway in humans. While this flexibility allows for speech, it also allows the airway to collapse during the deep muscular relaxation of sleep and can contribute to significant health problems and a reduced quality of life.

What are some signs and Symptoms of Sleep Apnea?
Nocturnal signs and symptoms associated with OSA include drooling, dry mouth, sleep restlessness, witnessed apneas or pauses in breathing, choking or gasping and sweating. Most all sleep apnea sufferers snore while sleeping. A sleep study should be done to determine the seriousness of one’s condition. People most likely to have or develop sleep apnea include those who snore, or who are also overweight, or have high blood pressure. Another concern would be people who have some physical abnormality in the nose (deviated septum), throat, or other parts of the upper airway. Many people are unaware that they snore or have sleep apnea, but feel tired during the day and don't know why.

Do custom oral appliances work?
Yes, a custom oral appliance worn while sleeping holds the lower jaw forward and open, preventing the tongue and throat tissues from collapsing. Sleep Healers can refer you to a qualified sleep dentist that can determine your needs. Oral appliances have been shown to be very effective, especially for treating mild to moderate sleep apnea, and in some cases severe sleep apnea.

What is a TAP appliance?
 The Thornton Adjustable Positioner® (TAP®) is a custom adjustable oral appliance that is worn while sleeping. The appliance holds the lower jaw forward, preventing the tongue and the soft tissue of the throat from collapsing into the airway.
The purpose of the TAP® is to prevent snoring and sleep apnea, and thereby improving the health and quality of life for people who suffer from sleep-disordered breathing. The Thornton Adjustable Positioner (TAP®) oral appliance, is composed of two separate arches (maxillary and mandibular) containing an advancing mechanism which permits advancement of the lower jaw. The arches are custom made for each patient. The appliance has been evaluated for treating patients with severe sleep apnea and can also be combined with CPAP therapy for treating extremely severe patients if necessary.

What is the SomnoDent® MAS 
The SomnoMed MAS™ is a Mandibular Advancement Splint (MAS) that treats both snoring and obstructive sleep apnea (OSA), by advancing the lower jaw forward. It is a custom-made device consisting of upper and lower dental plates with a unique patented fin-coupling mechanism. The SomnoDent® MAS is an oral device, which fits over the upper and lower teeth, much like a sports mouthguard. However unlike a sports mouthguard it is a discreet, precision-made and clinically-tested medical device that is recognized for its clinical validity. The SomnoDent® MAS is a highly effective treatment method for Obstructive Sleep Apnea (OSA) for patients unable to tolerate CPAP therapy.
The device can be adjustable. This feature provides incremental and adjustable levels of jaw advancement, which improves the effectiveness and comfort-level of treatment as the jaw is moved only as far as is required to alleviate snoring and reduce OSA. The SomnoDent® MAS is a custom made device that allows for full range of mouth opening and closing. Its streamlined design also allows the patient to achieve full lip seal to prevent irritation from dry mouth. 

What is Maxillomandibular advancement surgery?
Maxillomandibular advancement surgery, or moving the upper and lower jaw forward opens the structures of the throat to prevent the airway from collapsing during sleep. By moving the upper jaw (maxilla) and lower jaw (mandible) forward, the entire airway can be enlarged. This procedure serves as the most effective surgical treatment for obstructive sleep apnea. It is performed on patients with moderate to severe obstructive sleep apnea as the only treatment, or when other procedures have failed. It is also performed in patients with significant jaw deformity that contribute to obstructive sleep apnea. 

 

Sleep Specialists

When should I see a Sleep Specialist?

Patients suffering from complex sleep disorders such as Circadian Rhythm disturbances, Parasomnias, Chronic insomnia, Hypersomnia and combinations of disorders may want to seek a consultation with a sleep specialist. Patients with other conditions such as Restless Leg Syndrome, Periodic Limb Movements, Narcolepsy, and medication management issues may want to be referred to a specialist.
Sleep Healers works closely with physicians that are Board certified Sleep medicine and can help you get help even if you have tried and failed previous treatments.

 

NCV - EMG Test

NCV EMG Study Instructions

What is the NCV - EMG Test and Why is it Performed?

NCV stands for Nerve Conduction Velocity. The NCV diagnostic exam evaluates motor and sensory nerve function throughout the body.
The Electromyography (EMG) test records elec-trical signals generated by a muscle when it con-tracts and localizes abnormalities or nerve damage. Doctors often order these electrodiagnostic stud-ies to evaluate radiculopathy or pinched nerves in the neck or lower back, arm and leg pain, and numbness / weakness of the extremities. NCV and EMG studies help evaluate problems such as carpal tunnel syndrome and nerve disease or polyneuropathy which can be caused by diabetes.
Nerve conduction velocity testing is used to determine the adequacy of the conduction of the nerve impulse.

Common Indications for NCV Studies

Polyneuropathy
Polyneuropathy or Peripheral neuropathy is the simultaneous mal-function of many peripheral nerves throughout the body. Common causes include infections, toxins, drugs, cancers, nutritional deficiencies, and disorders. Diabetic neuropathy is the most common form.

Carpal Tunnel Syndrome
Carpal Tunnel Syndromeresults from compression of the median nerve, which is located at the palm side of the wrist (an area called the carpal tunnel). Carpal tun-nel syndrome is common-especially among women aged 30 to 50 years. The median nerve serves the thumb side of the hand. The compression results when swelling or bands of fibrous tissue form.

Ulnar Neuropathy
Ulnar Neuropathyis a disorder caused by compression of the ulnar nerve at the elbow. The ulnar nerve passes close to the surface of the skin at the elbow (“funny bone”) and is easily dam-aged by repeatedly leaning on the elbow, by bending the elbow for prolonged periods, or sometimes abnormal bone growth in the area.

How will the test feel?
The EMG and NCV studies are considered mildly uncomfortable.
You will feel a brief snapping sensation on the skin that is only momentary during the NCV test.
The impulse may feel like a mild electric shock. The sensation feels different to everyone. It may be uncomfortable to you; however you should feel no pain once the test is finished.
Often the nerve conduction test is followed by electromyography (EMG) which involves needles being placed into the muscle and you contracting that muscle. This can be uncomfortable during the test, and you may feel muscle soreness at the site of the needles afterwards as well.