Download Sleep Testing Packet - The Neurology Center

Dear Sleep Patient,
MEDICAL DIRECTOR & BOARD
CERTIFIED SLEEP SPECIALIST
Aman A. Savani, M.D.
BOARD CERTIFIED
SLEEP SPECIALIST
Kalpana Hari Hall, M.D.
Nabil Altememi, M.D.
The Neurology Center for Sleep Disorders welcomes you to our facility. Enclosed in
this packet, you will find general information regarding our sleep lab and tests
performed as well as a questionnaire that should be completed prior to your sleep
study. On the evening of your appointment, please bring the following:
-Completed Sleep Questionnaire
- Insurance Card(s) if you’re new to NCPA and Photo ID for verification
CHIEF EXECUTIVE OFFICER
Anne D. Baccich
- Payments (Self-Pay Patients)
DIRECTOR OF OPERATIONS
Steven R. Long
BUSINESS OFFICE
The Summit Building
8555 16 th Street
Suite 310
Silver Spring, MD 20910
301-562-7200
301-565-6771 Fax
- Copy of order (if referred outside of The Neurology Center)
Once checked in, you will also be given an audio/video consent form that allows us
to record and monitor you while you are sleeping. If your insurance requires a
referral, please be sure that you have your primary care physician fax that to me
PRIOR to your appointment. Some insurance plans will require a prior
authorization that MUST be obtained prior to your study. We will attempt to obtain
this authorization if required. In the event a study is denied by insurance, I will
contact you before the evening of your study. Self-pay patients are required to make
payment in FULL at the time of their scheduled study. We accept cash, all major
credit cards and personal checks. Although we make every effort to confirm overall
coverage from your insurance, we do not obtain specific benefits regarding
deductibles and/or coinsurances. Feel free to contact your Benefits Coordinator or
your insurance plan to obtain these figures.
For scheduling matters regarding your sleep study appointment(s), please contact
central scheduling at (301)562-7200 and one of our specialists will gladly assist
you. Appointments that are missed or cancelled with less than 24 hours notice
will be subject to a $250 fee.
Again, thank you for choosing The Neurology Center for Sleep Disorders and we
hope you enjoy your experience.
Sincerely,
Emily Kittrell
Office Manager
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • https://sleeplab.neurologycenter.com
ABOUT US
The Neurology Center for Sleep Disorders offers comprehensive diagnostic sleep disorder testing at our new office in
Bethesda, Maryland. The Neurology Center for Sleep Disorders will continue the same excellent care The Neurology
Center has been providing for our patients with neurological disorders for the last 45 years. We are dedicated to
providing high-quality diagnostic evaluation and treatment of sleep disorders for the Washington, DC Metro area. Our
new center is located in Bethesda near to NIH and National Naval Medical Center. We provide convenient, state of
the art services to our patients, referring physicians and the community in the specialty of sleep medicine. We strive
to provide excellent service in a first-class luxury setting to maximize patient comfort.
MISSION STATEMENT
Our mission is to provide comprehensive diagnosis and treatment of sleep and wake disorders to the people of the
Washington DC metro area, while also adhering to the highest standards of medical care. We will provide our
patients with a luxurious, safe and secure environment to undergo diagnostic treatment.
OUR LOCATION
Neurology Center for Sleep Disorders is located at 6931 Arlington Road, Suite T-100, in Bethesda, Maryland, close to
NIH and National Naval Medical Center. We are convenient to Bethesda Metro station and the Capital Beltway. For
local residents, we are across the street from Strosniders Hardware store and our building has it own lighted secure
parking garage adjacent to the building.
ENTERING THE BUILDING
Because you’ll be coming after-hours, the building will be locked for obvious security purposes. There is a callbox
near the revolving doors however if you encounter issues entering the building, please call directly to our sleep
technicians at (301) 654-1500 for assistance. We apologize in advance for any inconvenience this may cause.
FAQs
What is a sleep study? A sleep study is a test that is used to
diagnose sleep disorders. There are different types of studies
designed for specific sleep disorders. Most studies occur overnight, but some also can take
place during daylight hours.
What should I expect once I arrive to the sleep lab? Once you arrive to the lab, the
technician will be there to greet you and take you to your room. There you will be shown
around and asked to change into your sleep attire. When you are ready the technician will
come in and start applying sensors to your body. Be prepared to have sensors applied to you
from head to toe. Sensors will be applied to your legs, face, and scalp. You will also be wearing
belts on your chest, and your abdomen. Your heart will also be monitored during the test so be
prepared to have electrodes attached to your body.
Where do I park? Parking is free in the building’s garage, but do not park in the assigned
spaces inside the garage. You may be towed. Likewise do not park in the spaces outside the
building as you may also be towed.
How do I enter the building and the Sleep Center? Use the phone on the outside door
to call the security service to gain access to building. In some cases the techs will greet you at
the door. Take the elevator to the (T) terrace level and use the intercom on the wall next to the
outside door.
What kind of clothing should I bring? Make sure to bring comfortable clothing that you
will sleep in for the night. Remember to keep it modest because the technician will be in your
room applying electrodes to you.
If I wear a hairpiece/wig, will this be a problem? Please remember not to wear any
hairpieces or wigs. An essential part of the sleep study involves the placement of electrodes on
your scalp and body. The technician must have easy access to place these electrodes.
Can I put lotion on? No, do not use body lotion, body oil or makeup before your sleep
study. An essential part of the sleep study involves the placement of electrodes on your scalp
and body. Clean, dry skin and scalp will help ensure we obtain an optimum sleep study.
Can I bring a book to read? Absolutely, bring a book or magazine if you plan on reading.
Your room is equipped with a TV just in case you forget your book or choose to watch TV.
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
FAQ’s (continued)
Can I take a shower in the morning? Yes, your room has a private bathroom with a
shower. In fact, you should plan on showering to remove the electrode paste left in your hair.
Towels, shampoo, and soap will be provided if you choose to take a shower, hair-dryers are also
provided.
Do you offer Wi-Fi? What if I need to make a phone call? Yes, we offer free Wi-Fi
access. If you need to make an urgent outbound call, a phone is available.
Where do I go to receive my CPAP machine and supplies? After your CPAP titration
your physician will order you a CPAP machine and mask. The order will be forwarded to a
medical supply company who specializes in CPAP equipment and this company should work
with your insurance company on payment coverage issues.
How long will the sleep study take? The hookup process will start in the evening
between 9:30-10:30 pm and you will be leaving the next morning between 6-7am.
What are some symptoms associated with sleep apnea? Loud snoring, choking and
gasping during sleep, witnessed episodes, feeling tired when you wake up, excessive daytime
fatigue, morning headaches, and inability to concentrate.
Can I take my normal medications before I go to sleep? You may take your normal
medications before you go to sleep. We ask that you hold off from taking your sleep medication
until all the sensors are attached to you and you’re ready for bed.
Special needs patients. We have accommodations for patients who need to be
accompanied by guardians or caregivers or use wheelchairs. Please inform us if you have any
special needs so we can inform our technicians.
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
Polysomnography (PSG)
About the Test
Your physician has ordered a sleep study, known as polysomnography (PSG). This is a routine
sleep test that is used primarily for the diagnosis of sleep disordered breathing (SBD) or sleep
apnea.
What to Expect
Once you arrive at our sleep center, the technician will be there to greet you and take you to
your room. There, you will be shown around and asked to change into your sleep attire. When
you are ready, and with your consent, the technician will enter your to apply sensors and
electrodes necessary for the test. This process will take up to 30 minutes. Sensors will be
applied to your legs, face, and scalp and flexible belts will be placed around your chest and
abdomen in to get an accurate measure your respiratory effort. Our rooms are completely
private, sound proof, and contain a full bathroom for your convenience. You will be monitored
and video taped only while in bed and only when the study starts.
After the Test
Following the completion of study, the technician will remove the sensors/electrodes and you will be
permitted to shower and get dressed. There will be a short questionnaire and survey for you to fill out
before you leave. Per sleep center protocol, the technologist will not be permitted to discuss the
findings of the study with you; the results will be available after the study has been interpreted by one
of our board certified sleep specialists.
IMPORTANT
Please inform our staff if you have any special needs in order for us to provide for your accommodation.
Phone 301-576-8700
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
CONTINUOUS POSITIVE AIRWAY
PRESSURE (CPAP)
About The Test
Your physician has ordered a CPAP Titration Study to be performed on you. The CPAP titration
study is usually performed after a baseline sleep study (PSG) is done and you have been
diagnosed with some form of sleep breathing disorder. The purpose of this study is to
determine how to optimally treat your sleep apnea by using gentle air pressure generated by a
CPAP machine and choosing the appropriate pressure and mask to eliminate all abnormal
breathing events.
What to Expect
Similar to a baseline sleep study you will have electrodes or sensors applied to you with the difference
being that the technician will also apply a facial mask for which your air pressure will be delivered. The
technician may have you try on several masks to see which one you will be most comfortable
with.
During The Test
After machine calibrations are done, the technician will ask you to fall asleep. The technician will adjust
the CPAP machine from his/her computer during the night. Feel free to call your technician at any time if
you are having difficulties during your titration so the technician can assist you.
Other forms of Non-Invasive Therapy
BI-LEVEL POSITIVE AIRWAY PRESSURE (BI-PAP)
About The Test
Phone 301-576-8700
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
BIPAP therapy is another form of non-invasive therapy that can be used to eliminate sleep
disordered breathing. BIPAP (Bi-level Positive Airway Pressure) machines are non-invasive
machines that provide a person with a higher pressure when a person breathes in and then
lowers the pressure when the person tries to breathe out. The two pressure settings are IPAP
(inhalation pressure), and EPAP (exhalation pressure). The EPAP allows the person to be able to
breathe out at a lower pressure.
The BIPAP Auto SV is another form of non-invasive therapy. The Bi-PAP Auto SV is intended to
provide non-invasive ventilator support to treat adult patients with sleep apnea and respiratory
insufficiency caused by central and/or mixed apneas and periodic breathing.
SPLIT NIGHT SLEEP STUDY
About The Test
During a split night study a patient is being evaluated for sleep apnea. The first part of study
will consist of a routine sleep study if the is significant sleep apnea or abnormal breathing
activity in the 3-4 hours of the study, the technician wake up the patient, place the CPAP mask
on the patient and turn on the CPAP unit. From there the technician will determine how to
optimally treat your sleep apnea by choosing the appropriate pressure and mask to eliminate all
abnormal breathing events.
After all the Tests
Once the test is over the technician will removed the sensors/electrodes and you are free to take a
shower at that time, there will be a short questionnaire and survey for you to fill out before you leave.
The technologist will not discuss the findings of the study with you; the results are not available until the
interpretation by our sleep physicians is complete.
IMPORTANT
Please inform our staff if you have any special needs in order for us to accommodate.
Phone 301-576-8700
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
Multiple Sleep Latency Test
(MSLT)
About The Test
Your physician has ordered a Multiple Sleep Latency test (MSLT) to be preformed on you. The
purpose of this test is to quantify the degree of daytime sleepiness that you may be
experiencing. This test is usually done in conjunction with an overnight sleep study (PSG)
What to Expect
This test consists of a series of short naps during the day so expect to be in our facility for the
entire day. There will be at least 4 naps with a possibility of a 5th nap. The last nap could start as
late as 3:00 p.m., therefore we advised you to bring a lunch as you will be with us throughout
the afternoon. We will provide you with a very comfortable room and there is also a patient
lounge with a small refrigerator for your use, feel free move about the center to stretch your
legs between naps.
After the Test
Once the test is over the technician will removed the sensors/electrodes and you are free to take a
shower especially if you been all night, there will be a short questionnaire and survey for you to fill out
before you leave. The technologist will not discuss the findings of the study with you; the results are not
available until the interpretation by our sleep physicians is complete.
Parking
All patients will be charged $10 for parking during the day so please remember to bring money for
parking. The sleep lab does not validate parking.
IMPORTANT
Please inform our staff if you have any special needs in order for us to accommodate.
Phone 301-576-8700
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
Home Sleep Study
About the Test
Your physician has ordered a home sleep study. This is a sleep study that is conducted in your
own home.
What to Expect
You will have to pick up the unit at our sleep center located at 6931 Arlington Rd Suite T100
Bethesda, MD 20814. A sleep technologist will greet you and show you how to use the machine
and apply various sensors through your body. If you run into any problems after hours please
contact (301)654-1500 for assistance. During the following morning you will then remove all
the sensors and place them back into the bag and return the equipment back to the sleep
center. If the equipment is not returned to the sleep center the following day, you will be
charged a missed appointment fee of $50.00. If you pick up the equipment on Friday you will
be required to return the equipment on Monday. After the equipment has been returned the
study will be reviewed by a sleep physician. If you need to make a follow up appointment with
one of our sleep physicians please call (301)576-8700 and we will be happy to schedule you.
Phone 301-576-8700
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
DIRECTIONS TO
THE NEUROLOGY CENTER FOR SLEEP DISORDERS
6931 ARLINGTON ROAD, SUITE T-100
BETHESDA, MARYLAND 20814
301-576-8700
From the North
 Take Interstate 270 south to Rockledge Drive (exit 1)
 Turn left on Rockledge Drive. Turn right onto Old Georgetown Road (Rt. 187)
 Follow Old Georgetown Road about 4 miles to Arlington Road
 Turn right onto Arlington Road. Turn left into 6931 Arlington Road driveway entrance (park
in the garage to left)
From the South
 Take Wisconsin Avenue (Rt. 355) (past Friendship Heights)
 Turn left onto Bradley Blvd. (Rt. 191)
 Turn right onto Arlington Road
 Turn right at the first driveway entrance at 6931 Arlington Road (park in the garage to left)
From the East
 Go west on the Capital Beltway (I-495/ outer loop) to Connecticut Avenue (Rt. 185),
south towards Washington, DC
 Follow Connecticut Avenue south to Bradley Lane
 Turn right onto Bradley Lane. Follow Bradley Lane across Wisconsin Ave. to Arlington Road.
 Turn right onto Arlington Road
 Turn right at the first driveway entrance at 6931 Arlington Road (park in the garage to left)
From the West
 Go east on the Capital Beltway (I-495/ inner loop) to Old Georgetown Road (Rt. 187),
south towards Bethesda
 Follow Old Georgetown Road south about 4 miles to Arlington Road
 Turn right onto Arlington Road Turn left into 6931 Arlington Road driveway entrance (park
in the garage to left)
Parking
Please park in unassigned spaces only. Parking is free between 7 pm and 7 am nightly.
Google Maps
https://www.google.com/maps/place/6931+Arlington+Rd+%23100,+Bethesda,+MD+20814/@38.97856
96,-77.0978758,18z/data=!4m2!3m1!1s0x89b7c97e95223bad:0x1412161b120d9abc
6931 Arlington Road, T-100 • Bethesda, MD 20814 • 301.576.8700 • Fax 301.654.1765 • www.neurologycenter.com
http://sleeplab.neurologycenter.com
Questionnaire
Patient Name: ________________________ Sex: _________ Age: _________ Date:__________
Occupation: ______________________________
Referring Physician: ______________________ Family physician (PCP): ____________________
Marital status: {} Single
{} Married
{} Divorced
{} Widowed
Please complete the following questionnaire.
Sleep Complaints:
{} Trouble sleeping at night
For how long? ______________________________
{} Being sleepy all day
For how long? ______________________________
{} Snoring
For how long? ______________________________
{} Other, explain ________________________________________________________________
Sleep Pattern
Typical Bedtime: _______________
Typical amount of time it takes to fall asleep: ________________
Typical amount of time it takes to back to sleep after an awakening: __________________
Typical number of awakenings per night: ______________
Typical wake up time:
weekday ____________
weekend ____________
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Typical time you get out of bed:
weekday ____________
weekend ____________
Total amount of sleep per night: ________________
Number of naps per day: ___________
Please check all of the following statements that are true about your sleep:
Sleep Habits
{} I usually watch TV or read in bed prior to sleep
{} I often travel across 2 or more time zones
{} I drink alcohol prior to bedtime
{} I smoke prior to bedtime or when I awaken during the night
{} I eat a snack at bedtime
{} I eat if I wake up during the night
{} I typically wake up from sleep to go to the bathroom
{} I have trouble falling to sleep
{} I often wake up during the night
{} I am unable to fall back to sleep easily if I wake up during the night
{} I think a lot when I am trying to fall asleep
{} I have nightmares as an adult
{} I experience a tingling sensation in my legs when I try to fall asleep
{} I sweat a great deal during sleep
{} I cannot sleep on my back
Breathing
{} I have been told I stop breathing while I sleep
{} I wake up at night choking, or gasping for air
{} I have been told I snore
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{} I have been told I only snore when I am sleeping on my back
{} I have been awakened by my own snoring
Restlessness
{} My legs and arms are uncomfortable when I lie down
{} I have to move my legs or walk to relieve the uncomfortable feelings in my legs
{} I am a restless sleeper
{} I have been told that I kick or jerk my legs and/or arms during sleep
{} I have a hard time falling asleep because of my leg movements
{} I have talked in my sleep as an adult
{} I have walked in my sleep as an adult
{} I grind my teeth in my sleep
Daytime Sleepiness
{} I take daytime naps
{} I have a tendency to fall asleep during the day
{} I have fallen asleep while driving
{} I have been in auto accidents because I have fallen asleep while driving
{} I fall asleep while watch TV
{} I fall asleep during conversations
{} I have had injuries because of my sleepiness
{} I have had hallucinations when falling asleep or waking up.
{} I have had an inability to move while falling asleep or waking up
Habits
Do you smoke? {} Yes {} No
If yes: How much? ______________
For how long? __________________
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Do you drink alcohol? {} Yes {} No
If yes: How often? ______________
For how long? __________________
Social History
{} Sleep Alone
{} Share a bed with someone
{} Share a bedroom, but have separate beds
{} Share a home, but have separate rooms
Employment Status: {} Employed
{} Unemployed
{} Retired
{} My job requires that I drive me vehicle
{} I work with dangerous equipment
{} I am a shift worker
{} I am currently a student
Medical History
Vital statistics
What is your: Height? ____ feet _____ inches Weight? ______ pounds Neck Size: _______
What was your weight one year ago? ______ pounds Five years ago? ______pounds
Current Medications
Medication
Dose
# Times Per Day
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Allergies: ______________________________________________________________________
Past Sleep Evaluation and Treatment
{} I have had a previous sleep disorder evaluation
{} I have had a previous overnight study
{} I have had a daytime nap study
{} I have been prescribed a CPAP or BIPAP machine for home use
{} I have had surgical treatment for a sleep disorder
{} I have been prescribed medication for a sleep disorder
{} I have been treated for a sleep disorder
Past Medical History
{} Hypertension (high blood pressure)
{} Hepatitis/jaundice
{} Heart Disease
{} Hearing Impairment
{} Diabetes
{} Depression or severe anxiety
{} Stomach or colon problems
{} Alcoholism
{} Lung problems/COPD/asthma
{} Chemical dependency or abuse
{} Reflux
{} Fibromyalgia
Female
{} Stroke
{} Premenstrual syndrome
{} TIA “Light Stroke”
{} Menopause
{} Blackouts
{} Seizures
Male
{} Back or joint problems
{} Prostate problems
{} Cancer
{} Erectile dysfunction/impotence
{} Thyroid cancer
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List all other past medical problems and dates:
List Surgeries and the year
Check any of the following symptoms you have had in the past 12 months
Yes
No
Yes
No
{}
{} Frequent headaches
{}
{} Frequent heartburn/Indigestion
{}
{} Fainting or passing out
{}
{} Abdominal pain
{}
{} Sudden loss of vision
{}
{} Frequent constipation
{}
{} Inability to speak
{}
{} Frequent diarrhea
{}
{} Hearing loss
{}
{} Rectal bleeding/black stools
{}
{} Hoarseness
{}
{} Difficulty urinating/incontinence
{}
{} Nosebleeds
{}
{} Blood in urine
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{}
{}
Cough for more than 2 weeks
{}
{} Urinating more than 2 times per night
{}
{}
Coughing up blood
{}
{} Pain in joints or bones
{}
{}
Shortness of breath
{}
{} Unusual bruising or bleeding
{}
{}
Swelling in feet or ankles
{}
{} Epilepsy/seizures
{}
{}
Chest pain, pressure
{}
{} Change in wart, mole or skin growth
{}
{}
Irregular heartbeat
{}
{} Weight loss of more than 5-10 pounds
{}
{}
Difficulty swallowing food
Family History
Has an immediate relative had any of the following?
Yes
No
Relation
Yes No
Relation
{}
{} Cancer
____________
{}
{} Stroke
______________
{}
{} Diabetes
____________
{}
{} Anxiety/Depression
______________
{}
{} Hypertension
____________
{}
{} Sleep apnea
______________
{}
{} Heart Disease
____________
{}
{} Narcolepsy
______________
{}
{} Thyroid Disease ____________
{}
{} Other ___________
______________
Using the Answer Key below, please circle the number that best applies to your life over the past
6 months
Answer Key
1- Never
2- Rarely
3- Sometimes
4- Usually
5- Always
I have trouble falling asleep
1
2
3
4
5
I wake up often during the night
1
2
3
4
5
At bedtime, thoughts race through my head
1
2
3
4
5
At bedtime, I feel sad and depressed
1
2
3
4
5
When falling asleep, I feel paralyzed (unable to move)
1
2
3
4
5
When falling asleep, I have restless legs
1
2
3
4
5
I wake up suddenly gasping for breath, unable to breath
1
2
3
4
5
At night my heart pounds, beats fast, irregularly
1
2
3
4
5
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I sweat a great deal at night
1
2
3
4
5
I have a lot of nightmares
1
2
3
4
5
I am unable to move after a nap
1
2
3
4
5
I have hallucinations as I wake up in the morning
1
2
3
4
5
I have slept for several days at a time
1
2
3
4
5
I have been unable to sleep for several days
1
2
3
4
5
I think I have insomnia
1
2
3
4
5
I am sleepy during the day and struggle to stay awake
1
2
3
4
5
I have fallen asleep talking to someone, or eating
1
2
3
4
5
I have trouble doing my job due to fatigue
1
2
3
4
5
I often let someone else drive due to my fatigue
1
2
3
4
5
I have high blood pressure
1
2
3
4
5
I have less desire or interest in sex
1
2
3
4
5
I have considered or attempted suicide
1
2
3
4
5
I smoke tobacco within two hours before bed
1
2
3
4
5
I feel my nose is blocked up when I am trying to sleep
1
2
3
4
5
My snoring is worse while I am on my back
1
2
3
4
5
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Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations?
Rate each description according to your normal way of live in recent times. Even if you have not
been in some of these situations recently, try to determine how sleepy you would have been.
Use the following scale to choose the best number for each situation:
0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing
Situation
Chance of dozing
Sitting and reading
________
Watching TV
________
Sitting inactive in a public place
________
Lying down to rest in the afternoon
________
Sitting and talking to someone
________
Sitting quietly after lunch without alcohol
________
Sitting in a car, while stopped for a few minutes in traffic
________
Total: ________
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