Neurologic Disorders and Difficulty Sleeping


of Sleep Apnea Patients
remain Undiagnosed

Are your patients at risk?

Obstructive Sleep Apnea occurs when muscles of the soft palate and throat relax during sleep, obstructing the airway and making breathing difficult and noisy (snoring). Eventually, the airway walls collapse, blocking airflow entirely, which results in a breathing pause or apnea.

Neurological Sleep Disorders

  • Nocturnal seizures
  • Insomnia
  • Parasomnias
  • Movement disorders
  • Poor sleep secondary to other neurological diseases

Stroke and Sleep
Stroke is a risk factor for OSA and vice versa (OSA is a risk factor for stroke). Stroke patients have increased risk for central sleep apnea and hypoventilation (if the brainstem is impacted). Stroke patients often have insomnia and/or excessive daytime sleepiness and altered dreams.

Sleep Complaints in Patients with Neuromuscular diseases

  • Primary
    • Sleep disordered breathing
    • Hypoventilation
    • Hypoxemia
    • Combination of all of the above
    • All of these may lead to sleep fragmentation
  • Secondary
    • Insomnia
    • Nocturnal movements

General Principles of Neuromuscular Patient Management
Diagnostic Tests:

  • Pulmonary function test (PFT)
  • Polysomnogram (PSG)
  • Multiple sleep latency test (MSLT) for excessive daytime sleepiness (EDS)
  • Electromyogram (EMG)
  • Treatment Progression:
  • BIPAP (less work of breathing/weak muscles)
  • Non-Invasive Positive Pressure Ventilation
  • (NPPV) advanced stages
  • Patients undergoing BIPAP and NPPV treatment should be titrated at a sleep center

NPPV treatment potential improvements

  • May improve hypoventilation and minute ventilation
  • May prevent need for tracheostomy
  • May reduce morbidity secondary to pneumonia
  • May reduce hospital length of stay compared with intubation

Helping your patient sleep better

  • Listen for clues about sleep issues such as fatigue, lack of energy, and depression
  • Administer the STOP-Bang screening tool
  • Write a referral for a consult, sleep test or home sleep test
  • Let CSCC help you with one of our board-certified neurologist sleep medicine specialists to manage your more complex patients

Detailed references available upon request.


The STOP-Bang Questionnaire : Answer these Eight questions by yes or no

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Helping your patients sleep better

  • If your patients report sleep complaints, assess for obstructive sleep apnea (STOP-Bang) or other sleep disorders
  • Explain that sleep in combination with moderate physical activity may promote remission and help prevent relapse
  • Keep CSCC brochures and forms in your office to help foster awareness of sleep disorders in your patients
  • If your patient screens positive for OSA and has a supportive clinical history, please refer them to Comprehensive Sleep Care Center for an evaluation

The Smart Choice for your patients

A one-stop sleep health shop = win/win for your patients

  • A seamless process from diagnosis to therapy for you and your patient referrals
  • A sleep medicine practice solely focused on sleep medicine
  • Pre-certification services of your patient’s insurance provided by our billing specialists
  • Collaborative partnership and multidisciplinary approach with our referring providers and their patients
  • An individualized, tailored treatment plan for the entire spectrum of sleep health management
  • Full service sleep health practice providing DME, including our onsite team of dentists for the treatment of mild to moderate sleep apnea by oral appliance therapy. Insurance billed directly on the behalf of your patient
  • Ongoing patient education, long term support and compliance monitoring of CPAP therapy to enhance patient outcomes
  • Home Sleep study program available
  • Quick turnaround on results and updated follow up notes provided