There are over 80 different sleep disorders.We evaluate and treat adult patients. Signs and symptoms of some sleep disorders may include excessive daytime sleepiness, falling asleep at inappropriate times, loud snoring with interruptions in breathing, leg or arm movements during sleep (or when falling asleep), and having trouble getting to sleep or staying asleep.
Why is treatment for my sleep disorder important?
Almost everyone has lost a night's sleep now and then, but there are those that have such severe sleep disruption, they can not function well during the day. Excessive daytime sleepiness can lead to decreased performance and increased risk of accidents.
The constant obstructed breathing associated with sleep apnea can cause decreased oxygen in your blood, causing your heart to work harder. Over time, a sleep disorder can lead to hypertension, drowsy driving, irregular heart beats, personality changes and inability to think clearly.
How do I make an appointment for an evaluation? There are 2 ways to be referred to our center to have a consultation with a sleep physician: 1. If you can choose any physician without restrictions, you may refer yourself directly to our center.
2. If you are part of an insurance program that requires a referral to go to a specialist, we must have this referral prior to scheduling an appointment. It is important that you check with your insurance company if you have any questions regarding referral procedures or payment authorization.You will be responsible for any charges not covered by your insurance.
What are the costs involved with evaluation and treatment?
The cost of your initial consultation with our staff and the physician will depend on the amount of time involved (usually 45 minutes to 1 hour).Insurance reimbursement varies by company, but most, including Medicare, will reimburse a percentage of these costs. The consultation will determine what type of testing will be required, if any.Most patients require 2 nights of testing in the center.A follow-up appointment with the physician and sleep center staff assures you understand your test results and treatment program.The billed charges do not reflect contracts that we may have in place; most insurance companies have contracts with our center. Please check with your company for any expected out of pocket costs.
We will bill your insurance directly, but you will be responsible for any co-payments or deductibles at the time of service. Our office will handle any pre-authorizations for testing.
Will I need to stay during the day, during the night, or both? Your initial consultation with the Dr. takes place during the day.Your testing will depend on your symptoms and primary complaints, but almost all of our patients require an evening study, with arrival at our center at either 7:30 or 8:30pm.If you routinely sleep during the day due to graveyard shift work, we will try to accommodate your schedule.We advise all of our patients who are tested to plan on arriving for testing in the evening; however, you may have special testing ordered which will require you to also stay the next day.You will be advised of the testing plan during your initial consultation. If you are too sleepy to drive at night or during the day, you should make arrangements for someone to drive you and pick you up.
Typical Sleep Center Bedroom
How & where is a sleep study performed?
We have found that our patients prefer tests in a setting that is warm, friendly and in a surrounding that feels like home, rather than a standard testing facility.Our equipment at the Central Florida Sleep Centers is state of the art.The bedrooms are tastefully decorated with traditional bedroom furnishings, comfortable full and queen mattresses and include cable TV. We have bathrooms next to the bedrooms, and a technologist available to assist you throughout the study.
Your sleep study starts with the Prep sheet given to you during your initial consultation. Copies of individual study preps and instructions are available on our Sleep Library and Events page.
You must follow the Prep to insure good test results. Key points are:
Do not take caffeine or medications containing caffeine (coffee, Coke, Mountain Dew, tea, Excedrin, Midol, etc.), alcohol, or sleeping aids (bring sleeping medications which have been prescribed with you to the study).
Eat regular meals, including dinner. You may bring a light snack if you normally have one later in the evening,
Take daily regular medications, bring all medications you normally take with you. Be sure to fill any prescriptions the sleep physician may have given you during your initial consultation. The center does not stock medications. Shower and wash your hair prior to arrival, but do not use any lotions on your body or hair products after showering.If your body or hair has, oil, spray or gel, we cannot use our electrodes to perform the study (they will not stick). You may use deodorant. Men should be clean-shaven, unless they have beards or mustaches.Wigs, hairpieces and earrings may not be worn during the study. Hair weaves or semi-permanent hairpieces will need to be removed prior to arrival. No naps are allowed the day of the study. You must bring sleeping clothes (sleeping in underwear not allowed!), made of cotton or a cotton blend. They should be loose and comfortable, and must have sleeves that completely cover the shoulder and armpit area (no tank tops!) The bottoms may be shorts or long pants, but must allow access to the lower leg just below the knee. Your hookup and a complete explanation of the test will begin immediately upon your arrival, during which time you will be asked some questions and be "prepped" for the test. You will have time to ask your technologist any additional questions about the procedure.The test is painless, since all monitoring equipment is on the surface of the skin.
Visitors and family members are not allowed to stay in the center. If you have been driven to the center, you will be taken back to your room and should be ready to leave by 7am the next morning.
You may watch TV, read a book, but the lights are turned out at approximately 10:30 p.m. If you have severe sleep apnea during your study, you may be awakened and asked to wear CPAP, which is a mask and headgear that provides an airflow to help keep your airway open as you sleep. We must have a certain number of hours of recording in order for your insurance company to cover the cost of the study. It is important that you arrive on time, but not more than 5 minutes early, on the night of your study. You must make arraignments to be sure you are able to stay until 7am the next morning.
Preparation for a Sleep Study
What does a sleep study record?
A sleep study records the amount of time you sleep, as well as the different stages of sleep. We use a paste adhesive to attach 8 small wires to your scalp, and use tape and paste to attach leads to your face, chin, legs, and abdomen. There are skin sensors that record your respiratory effort and airflow, your heart rate and rhythm, the sound of snoring, the oxygen in your blood, and your body movements. An infrared camera and microphone allow the technologist to see you even though the room is dark.
Can I move around or change sleeping positions during my study?
Absolutely, the wires are firmly in place; however, you can not purposely pull or jerk on the wires,or they will have to be repositioned.
Will I be able to get up to use the restroom during the night?
If you must use the restroom during the study, just raise your hand and call your tech's name or just state that you need to use the restroom; they can hear and see you through the monitoring equipment and will come to your room to quickly disconnect the wire harness to allow you full freedom to use the restroom.
What happens after mystudy?
Over 900 pages of data are recorded during the average sleep study. This information needs to be reviewed and organized by a sleep technologist and further reviewed by your sleep physician. This process normally takes 7-10 working days. Once the physician interprets your study, you will be contacted by a member of our staff to discuss the next steps in your care plan. You may be asked to return to the sleep center for an additional night to appropriately apply therapy if you are found to be positive for Obstructive Sleep Apnea.
A copy of the interpreted report and recommendations will always be forwarded to your primary care physician.
When will I receive any CPAP equipment that I may need?
If you received CPAP treatment during your study, you will be contacted after your study is interpreted to arrange delivery of your equipment. If you are not sure that you want the CPAP therapy and would rather speak with the sleep physician first, please tell the procedure and medical equipment coordinator when our office contacts you.
Who delivers the CPAP equipment?
Please understand, our office DOES NOT dispense the equipment; the equipment is provided by an independent Durable Medical Equipment Company (DME). In many cases, the company we must use for your equipment is dictated by your insurance company. Although we may recommend companies which we have found to deliver above average customer service, you are always free to choose ANY company that is covered by your insurance.
We will give you the name and phone number of the DME equipment company we will be using when we contact you regarding the equipment setup. Your DME company will contact you to either set up the equipment in your home or office, or ask you to go to their clinic for setup and training. In some cases, the equipment may be mailed to your home with instructions for use.
How long should I wait to be contacted by the DME company?
Once our office has called you and you have agreed to receive the equipment, you should be contacted by the DME company within 48 hours. If you are not contacted within this time period, please call the number for the DME office which has been provided to you.
If I have trouble with my CPAP equipment use, who should I call?
Unless otherwise specified, the brand and model of mask, equipment and the CPAP settings that were used during your study were given to the DME company for your equipment setup.
If you experience any issues with mask fit or have trouble using the equipment, you must contact the DME company directly. For continued issues, or if the DME company is unresponsive to your needs after several attempts, you should call our office and we will contact the DME company on your behalf to try to resolve the issues.
When will I see the physician after my study?
If you are negative for obstructive sleep apnea and do not have an additional sleep study ordered, you will be contacted to schedule a follow-up appointment with the physician to discuss your study results in detail and formalize a treatment plan.
If your results indicated that you do have obstructive sleep apnea (OSA), and you would like to see the physician prior to receiving your equipment, we can schedule an appointment for you.
For patients who receive CPAP equipment for OSA, we would schedule an appointment in our office approximately 2 weeks after your equipment order is placed. This will allow time for you to use the equipment and hopefully resolve any issues or problems.
If you have major, immediate issues with the equipment use that can not be resolved through the DME company, you should call our office to schedule an office visit prior to your scheduled 2 week follow-up.
What happens if I do not use the equipment?
If you do not use the equipment as ordered, your insurance company may not pay. Most companies require the equipment be used a minimum of 4 hours nightly, at least 70% of the time. All Medicare and several private companies now require Compliance Monitoring of CPAP machines (see below).
What is Compliance Monitoring?
Most CPAP machines have a place to insert a downloadable card or have a connection to be able to download information regarding your use of the equipment. This is compliance monitoring, which is now required by many major insurance companies,including Medicare, in order for your equipment to be covered for payment.
The goal is that you will use your equipment at least 4 hours a night, and nightly for at least 70% of the time in a 30 day period. This is recorded as actual use hours, not just having the machine turned on.
Your insurance company understands that there might be an adjustment period for using the equipment; however, you must meet this minimum criteria with 90 days after your setup,or you will need to be retested for continued coverage of your equipment.
For example, you are set up on March 1. If you use your equipment 4 hours everyday until March 31st, you are compliant with therapy.
If you are set up on March 1, but have difficulty and do not use your equipment 4 hours a night at least 70% of the time for any 30 day period between March 1 until May 31st, you will not be compliant and will need to be retested.
Compliance will be explained in more detail during your office visit.
If all is going well, how often do I need to see the sleep physician?
If you are receiving CPAP equipment, you will be scheduled for follow-up appointments approximately every 2 weeks until you are compliant with therapy. Once compliant, if your insurance requires compliance monitoring, you must have at least one face to face visit with your sleep physician between the 31st and 90th day of your therapy, so he or she can document and verify that you are using your therapy as ordered.
Once compliance has been documented, you will be scheduled for a 3 or 6 month follow-up appointment, and annual appointments thereafter. You may call and schedule an appointment with the sleep physician or nurse practitioner if you have any issues between your routinely scheduled appointments.
You must see the physician at least annually to be able to receive new orders for equipment, supplies, or medications. We can not process any orders if we have not seen you within the past year!
DISCLAIMER-The information contained in this website is for educational use only and is NOT intended nor implied to be a substitute for professional medical advice or instruction in specific medical conditions.Always seek the advice of your physician or other health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.Nothing contained in this service is intended to be for medical diagnosis or treatment.
