Sleep Medicine

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Sleep Disorders

For many patients with sleep disorders, a careful history and physical examination are adequate for diagnosis. However, for many patients who snore or have obstructive sleep apnea, objective evaluation of sleep apnea by using polysomnography to measure sleep and breathing is necessary in order to 1) establish the correct diagnosis, 2) establish disease severity, and 3) initiate appropriate treatment.

Three quarters of the patients seen annually in accredited sleep disorders programs are diagnosed with obstructive sleep apnea (OSA). This syndrome is exceedingly common with a prevalence of 4 percent of middle-aged men and 2 percent of middle-aged women. It is more common in minorities and elderly. 

Sleep disordered breathing is even more common with 24 percent of men and 9 percent of women having greater than 5 disordered breathing events each hour. 

Sleep disordered breathing is associated with excessive daytime sleepiness, compromised quality of life, significant social and emotional problems, and significant associations with cardiovascular disease such as hypertension, coronary heart disease, myocardial infarction, and stroke. 

Patients with untreated obstructive sleep apnea are seven times more likely to have automobile accidents than others in the population. 

This syndrome in children impairs learning ability and behavior problems.

Currently, Froedtert Hospital and the affiliated Medical College of Wisconsin physicians are nationally recognized experts in the surgical treatment of Obstructive Sleep Apnea.

The Department of Otolaryngology and Communication Sciences collaborates with the Department of Surgery, Division of Oral and Maxillofacial Surgery to provide comprehensive surgical care. 

Froedtert Hospital performed the first "Somnoplasty" procedure in the Midwest and the first pharyngeal/tongue suspension suture for obstructive sleep apnea syndrome in the nation. 

The upper airway laboratory located in Froedtert Hospital is the only one of its kind in the nation. 

Future developments for the surgical care of obstructive sleep apnea syndrome and snoring include the use of maxillofacial surgery and also minimally invasive techniques such as the pharyngeal suspension suture and radiofrequency reduction of pharyngeal tissues.

Narcolepsy is a disorder with prevalence comparable to that of multiple sclerosis or Parkinson's disease, but only a small fraction of these have been diagnosed. Obtaining a proper diagnosis is difficult with the average time between onset of the disease and diagnosis of 15 years. As an educational and teaching center, FMLH provides resources to the community to identify and treat these patients.

Insomnias are experienced occasionally by virtually everyone in society, however, for more than 60 million Americans it may be a persistent problem. It is associated with acute and chronic medical problems and may be a significant difficulty in those engaged in shift work and other economic activities that are out of phase with societies' normal circadian rhythm.

It is widely recognized that many diseases affect sleep. It is increasingly appreciated how sleep has significant effects on diseases themselves. 

Neurologic disorders that may be particularly important include epilepsy, stroke, dementia, and chronic pain. A variety of pulmonary and cardiovascular diseases affected by sleep include asthma, thrombotic disease, chronic obstructive pulmonary disease, and cardiovascular disease.

A large number of mental and addictive disorders are affected by sleep and are too often inadequately treated. The Stroke and Cardiovascular Centers are important affiliates of any sleep program.
© 2014 Medical College of Wisconsin
Page Updated 01/28/2014