The sleep clinic may see patients who have a wide variety of sleep disorders. There are different classifications of sleep disorders, including:

• Sleep-Related Breathing Disorders, e.g. Obstructive Sleep Apnea, Central Sleep Apnea, Snoring
• Sleep-Related Movement Disorders, e.g. Restless leg syndrome, Periodic Limb Movement Disorder
• Parasomnias, e.g. Sleepwalking, REM sleep behaviour disorder, sleep terrors
• Insomnia
• Central Disorders of Hypersomnolence, e.g. Narcolepsy
• Circadian Rhythm Sleep-Wake Disorders, e.g. Shift work disorder, Jet-lag disorder

Out of all these disorders, one of the most commonly seen in the sleep clinic is Obstructive Sleep Apnea (OSA). OSA occurs when the airway becomes narrowed or blocked by relaxing the anatomy of the upper airway during sleep. This can cause recurrent episodes of stopped breathing in sleep, known as sleep apnea.

Treatments:

The sleep specialist interprets the results of the diagnostic sleep study and recommends an appropriate treatment based on those results as well as their clinical evaluation of the patient.

Obstructive Sleep Apnea Treatment: The treatment of obstructive sleep apnea is PAP (Positive Airway Pressure) therapy.

The main type of treatment that is prescribed to patients is:

CPAP (Continuous Positive Airway Pressure):

A CPAP machine is used to treat obstructive sleep apnea. This machine generates pressurized air and pumps it through a hose into a mask that sits on the patient’s nose while they sleep. The pressure of the air keeps the patient’s airway from collapsing and helps to reduce or eliminate episodes of stopped breathing in sleep. Different pressure settings may be needed to treat the apnea depending on its severity. The patient will have a treatment study in the sleep lab, and the technologist will titrate the pressure until the sleep apnea is reduced to an acceptable level. Using this data, the sleep specialist will prescribe a pressure setting for the machine that the patient will use nightly at home when they sleep.

The Sleep Clinic often receives referrals for sleep studies from the Bariatric Clinic at HRH. “The Sleep Clinic conducts sleep studies on pre-operative Bariatric patients to rule out Obstructive Sleep Apnea (OSA) before they have surgery,” said technician Michelle Pockett. The specialists at the Bariatric Clinic want to ensure the best outcome for their patients, and so those found to have OSA will receive treatment prior to surgery.

Who should visit the Clinic?

Patients who come to this Clinic have to be referred by a family doctor or a specialist. “The most common sleep complaints that people report are excessive daytime sleepiness, frequent awakenings at night, snoring, or their bed partner tells them they are having breathing difficulties or stopping breathing in their sleep,” said Michelle.

“Sometimes, we see patients who complain about insomnia, but a sleep study is not always recommended for insomnia patients. However, sometimes people can misinterpret their poor sleep like insomnia, when in fact it could be caused by another disorder, such as sleep apnea, which is why the sleep study may be helpful,” said Michelle.

The sleep study looks at EEG brain wave activity to determine which stage of sleep the individual is in, such as deep sleep, dream sleep or awakening. “We also look at their breathing, heart rate and rhythm and leg movements as well as oxygen saturation,” said Michelle.

COVID-19’s impact on the Clinic:

The Clinic was temporarily closed due to the Covid-19 pandemic but has now reopened, and sleep studies are taking place. The Clinic’s hours have resumed to seven nights a week. The Clinic is taking necessary precautions to ensure the safety of the patients. “We are testing the patients for COVID-19 within four days before their sleep study appointment,” said Michelle. The HRH Reactivation Care Centre, where the sleep clinic is located, also has screeners at the door, checking for symptoms, and everyone is required to wear a mask. In the Clinic, every patient has their own private room and bathroom, so there is no contact between patients, and the patient is attended only by the technician.

[Pictured: Sleep Study]

Are you interested in going to the Sleep Clinic?

If you are interested in going to the Sleep Clinic, you will need a referral from your family doctor or a specialist.

Location: Reactivation Care Centre – 2111 Finch Avenue West, Toronto, Ontario

Phone: 416-747-3700

Hours: 7:30 p.m. – 7:30 a.m. Monday to Sunday