Allegheny Health Network: Restoring Sleep

Sleep is much more than a nightly ritual. It’s the foundation of health, impacting everything from cardiovascular function to mental health. Yet for millions of people, quality sleep remains elusive with disorders like sleep apnea, insomnia, restless leg syndrome, and narcolepsy.

The AHN Center for Sleep Medicine doesn’t just help patient sleep better, they address the root cause of their health condition. Through advanced diagnostics, innovative therapies, and personalized care, AHN specialists can give patients relief.

“At our center, we take a multidisciplinary approach to care, combining expertise across specialties to uncover diagnoses and deliver solutions that help our patients achieve restful, restorative sleep,” said Daniel Shade, MD, pulmonologist, sleep medicine specialist, and director of AHN Sleep Medicine.

The team includes specialists from pulmonary medicine; neurology; cardiovascular surgery; psychiatry; ear, nose, and throat surgery; oral maxillofacial surgery; and dental medicine.

Testing options for accurate diagnosis

Abnormal sleep patterns and their causes are identified by sleep studies, conducted at home or at one of AHN’s seven testing locations. Two studies might be required for a proper evaluation and diagnosis of a sleep disorder — from apnea and narcolepsy to parasomnia and insomnia. Testing options include:

Home sleep testing is used to diagnose obstructive sleep apnea in patients who are high risk and don’t have other medical conditions, such as heart disease, pulmonary disease, or neuromuscular disease. It allows patients to sleep at home wearing equipment that collects information about their breathing during sleep.

If results determine the patient has a sleep disorder, they may be scheduled for an in-lab positive airway pressure (PAP) titration study. If a patient tests positive for obstructive sleep apnea, they may be eligible for Auto CPAP therapy, an at-home device that delivers a continuous stream of air at the patient’s optimum pressure level.

In-lab diagnostic sleep study requires an overnight stay at one of our sleep centers. It’s a complete evaluation of a patient’s sleep patterns, including brain wave recording, heart rhythm, eye movements, leg movements, respiratory effort, snoring, and oxygen levels. The patient will be scheduled for an in-lab PAP titration study if the sleep study reveals the patient has a sleep disorder.

In-lab PAP titration study is a follow-up study that determines the level of airway pressure needed to minimize episodes of a sleep disorder. During the night, the technologist will adjust the airflow to the correct level for the patient’s needs.

Answers for apnea

AHN offers several treatments for sleep apnea, including continuous positive airway pressure (CPAP) therapy, medication, dental appliances, behavioral therapy, dietary modifications, respiratory muscle stimulation, and surgery.

“After the treatment has started, we will closely monitor the effectiveness of the therapy,” Dr. Shade said. “We will determine if the methods are successful or if the patient would benefit from additional interventions.”

For patients with obstructive sleep apnea, AHN offers a technology called Inspire® that’s implanted just under the collarbone. The patient controls the device with a remote, turning it on before sleep and off when they wake up. It delivers gentle pulses to the airway muscles to keep the airway open so the patient can breathe regularly and sleep soundly.

AHN physicians offer another implantable device called remedē® System, which treats central sleep apnea. The battery-powered system, positioned under the skin in the upper chest area, employs a thin lead to sense breathing patterns and administer stimulation therapy. During sleep, the device stimulates the phrenic nerve, which sends signals to the diaphragm.

“These therapies have been proven to improve a patient’s quality of life, reduce daytime sleepiness, and minimize the overall number of disrupted breathing events,” said Dr. Shade.

Insomnia solution

AHN provides cognitive behavior therapy for insomnia (CBT-I), an evidence-based approach to treating chronic insomnia by addressing the thoughts and behaviors that disrupt sleep. It focuses on identifying and changing negative beliefs and habits surrounding sleep and replacing them with healthier ones.

AHN has CBT-I trained specialists at several of its primary care offices. Patients can participate in these appointments in person, over the phone, or through a video visit.

“CBT-I focuses on treating the root cause of the insomnia, not just the symptoms,” Dr. Shade said. “It’s drug-free and has lasting results compared to sleep medications.”

To refer a patient, call 412-359-8644.

The Remedē system is registered trademark of ZOLL® and used with permission. Inspire® is registered trademark of Inspire Medical Systems, Inc., and used with permission.