Mid-Atlantic Sleep Center
Your Sleep Matters
We aim to deliver comprehensive care in sleep medicine. Our patient-centered model includes total commitment to integrated sleep care. Mid-Atlantic Sleep Center employs cutting edge technologies to identify, screen, diagnose and treat sleep apnea and other sleep disorders which can compromise healthy sleep.
We offer both in lab and at home sleep testing depending on medical condition, insurance coverage and personal preference
Benefits of treating Sleep Apnea
1. Better Sleep Refreshment
People with sleep apnea stop breathing numerous times an hour. With each pause the body wakes a little before resuming breathing, which can keep you from getting enough deep sleep to feel refreshed the next day. Once your body can breathe easily all night, you can expect to feel better rested and have more energy during the day.
2. Lower Risk of Heart Problems & Stroke
The Wisconsin Sleep Cohort Study (WSCH) found that the incidence of hypertension was nearly three times greater in those with a severe number of sleep disturbances compared to those with no disturbances. The incidence of stroke was 4.5 times greater in those with severe sleep disturbance. Increased incidence of arrhythmias (i.e. Afib), dyslipidemia and CHF.
3. Lower Risk of Dementia
A recent meta-analysis found that Alzheimer's disease patients have a 5-fold increased risk of presenting with OSA compared to age-matched controls.
4. Reduced Risk of Depression
As the severity of sleep disturbances increased, the WSCH found that the risk of depression also increased. Any amount of sleep disturbance was associated with an increased risk, but the incidence rate of depression for those with severe disturbances was 2.6 times higher than those with no disturbances.
5. Lower Risk of Mortality
The risk of dying from any cause was three times higher in those with severe sleep disturbances according to the WSCH.
6. Better Management of Diabetes
Having sleep apnea puts you at higher risk for developing diabetes. An analysis of multiple studies published in the Annals of the American Thoracic Society found that treating sleep apnea led to better insulin resistance in those without diabetes. Several studies have found that those with diabetes and untreated sleep apnea have worse control of their blood sugar.
7. Lower Risk of Cancer
Results from a cohort study published in the American Journal of Respiratory and Critical Care Medicine found that those with obstructive sleep apnea had a higher rate of cancer. The most commonly diagnosed cancers were colorectal, prostate, lung and breast. Those affected were men and people under age 65.
8. Reduce Weight Gain
Sleep apnea is a condition that decreases the duration and quality of sleep, so it’s not surprising that it can also contribute to weight gain. This is thought to occur for a few reasons:
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Fatigue – One of the most common symptoms of sleep apnea is daytime sleepiness. This can lead to falling asleep during activities of daily life and, understandably, a lack of interest in participating in physical activity.
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Increased Appetite and Cravings – Studies show that poor sleep, as is the case with sleep apnea, can lead to an increase in appetite and cravings for high-carbohydrate foods. This can lead to increased caloric intake and weight gain.
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Hormonal Changes – Some of the hormones involved in appetite regulation and metabolism are affected by sleep apnea including insulin, leptin, and ghrelin.
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Insulin – Sleep apnea increases the likelihood of insulin resistance, a condition often associated with excess body weight and diabetes. Insulin resistance can promote weight gain because insulin is a hormone that tells our body to store fat and it makes us feel hungrier, thereby increasing food intake.
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Leptin – Leptin levels are elevated in persons with sleep apnea. While leptin is a hormone typically associated with weight loss, the elevated level suggests that sleep apnea may be associated with leptin resistance, a state where the body is less responsive to the weight loss effects of this hormone.
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Ghrelin – Ghrelin, also known as the “hunger hormone”, is elevated in persons with sleep apnea. This could be why they experience an increase in their appetite, which would lead to increased food intake and weight gain.
Common Sleep Terms
AHI (Apnea Hypopnea Index) – The AHI refers to the total number of apnea and hypopnea events that occur each hour of sleep.
An apnea is a complete pause (or cessation) of breathing that lasts at least 10 seconds.
A hypopnea is a significant reduction in breathing that lasts at least 10 seconds.
Collectively, apnea and hypopnea disrupt sleep by causing mini awakenings and drops in oxygen levels. The severity of sleep apnea is measured by the frequency of apnea and hypopnea each hour.
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0-5 apnea + hypopnea events per hour = normal
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6-15 apnea + hypopnea events per hour = mild sleep apnea
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16-29 apnea + hypopnea events per hour = moderate sleep apnea
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30 or greater apnea + hypopnea events per hour = severe sleep apnea
Arousal – An arousal is a brief awakening from sleep that lasts at least 3 seconds. Apnea and hypopnea events often cause arousals from sleep because a person will wake briefly to breathe normally again. Most arousals from sleep are brief enough that a person does not remember them. Nonetheless, they are disruptive to sleep and may cause daytime sleepiness or fatigue.
Sleep Efficiency – Sleep efficiency refers to the percentage of time a person sleeps, in relation to the amount of time a person spends in bed. The percentage is calculated by dividing Total Sleep Time by Total Time in bed. Normal sleep efficiency is considered to be 80% or greater. For example, if a person spends 8 hours in bed (from 10 p.m. to 6 a.m), at least 6.4 hours or more should be spent sleeping to achieve an 80% or greater sleep efficiency. Most healthy and young adults have sleep efficiencies above 90%.
Sleep Latency – Sleep latency refers to the amount of time it takes a person to fall to sleep. For example, if a person goes to bed at 10:00 and falls to sleep at 10:15, the sleep latency is 15 minutes. Normal sleep latency is 5-15 minutes. Sleep latency less than five minutes may suggest some degree of excessive sleepiness. Sleep latency greater than 15 minutes may suggest some difficulty with sleep initiation.
Sleep Architecture – Sleep architecture refers to the structure of sleep. There are four stages of sleep that make up each sleep cycle. Each sleep cycle lasts about 90-120 minutes; thus, a person should have 4-5 cycles of sleep each night.
Stages of Sleep – As stated above, there are four stages of sleep with the following descriptions:
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Stage 1 sleep is the first and earliest stage of sleep. Often referred to as “drowsiness” or “pre-sleep”, it is very light sleep. During this stage, individuals usually have an awareness of their surroundings and may not perceive themselves to be asleep. Only about 5-10% of total sleep time is spent in Stage 1 sleep.
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Stage 2 sleep is the predominant sleep stage during a normal night of sleep. An individual does not have an awareness of surroundings during this stage and is approaching a deeper state of sleep. About 25-45% of sleep time is spent in this stage.
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Stage 3 sleep is deep sleep. During this stage, individuals are more difficult to wake from sleep and if they do wake from this stage, they typically feel drowsy. About 20-25% of sleep is comprised of deep sleep. Older individuals tend to have a lower percentage of deep sleep.
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Stage R sleep is REM sleep. Rapid Eye Movement (REM) sleep is otherwise referred to as dream sleep. About 20-30% of sleep time is spent in this stage, with the largest majority of REM occurring late in the night.
REM Latency – REM latency refers to the amount of time it takes a person to achieve REM (or dream) sleep after the person has initially fallen to sleep. As REM is the fourth and final stage of a sleep cycle, normal individuals achieve their first period of REM sleep about 70-110 minutes after falling to sleep.
Oxygen Saturation (SaO2) – Oxygen saturation refers to oxygen levels in the blood. Normal oxygen saturation in a healthy adult is 94-100%. In persons with sleep apnea or lung disease, oxygen saturation levels are often reduced.
Periodic Limb Movement Index (PLMI) – Periodic Limb Movements are leg jerks during sleep that occur every 5-20 seconds. If the leg jerks are robust, they may cause a person to briefly awaken from sleep. The (PLMI) is a measure of the number of leg jerks each hour of sleep. If leg movements are excessive, treatment with supplements or medication may be indicated.