When to seek treatment

Everyone has trouble sleeping at times. Sleep problems can be linked to stress, a physical ailment, diet or other issues. Talk to your doctor about a referral to the OHSU Sleep Medicine Program if:

• Your sleep does not improve with good sleeping habits, such as increasing exercise or reducing caffeine.
• Your partner notices an irregular breathing pattern, loud snoring, snorting or gasping while you’re asleep.
• You fall asleep during conversations or regular activities.
• You feel tired or unrefreshed much of the time.
• You can’t sleep through the night.
• You think an underlying physical or mental health condition is keeping you awake.
• You think your medication is disrupting your sleep.

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What to expect at OHSU

If you come to OHSU, your doctor most likely referred you to our sleep specialists. Or you may have visited a throat specialist who wants to learn more before recommending surgery or other treatments.

Here’s how your visits with our sleep experts might go:

• Our sleep specialists may use a questionnaire called the Epworth Sleepiness Scale to learn more about your sleep patterns.
• We may suggest that you do a sleep study at our sleep lab or at home. Some overnight studies are followed by daytime studies.
• Your care team will develop a treatment plan. It may include home-based therapy, medication, surgery or treatment for other conditions.
• If you need home medical equipment, our sleep experts will demonstrate how to use it. They will also coordinate with your equipment provider to monitor your progress.
• You may be referred to a surgeon who can repair breathing impairments. Our team also offers an implanted device, Inspire, that can monitor and adjust your nighttime breathing.
• You may be referred to a behavior specialist who can address underlying issues.
• Your doctor may prescribe melatonin or other medication for an underlying disorder, such as narcolepsy or a mental health condition.

Diagnosing sleep disorders

Our specialists are skilled at choosing the best tests based on your symptoms.

Treatments for sleep apnea

If you are diagnosed with sleep apnea, your care team will most likely recommend medical devices to provide steady air pressure while you sleep.

Treatments include:

APAP (auto-adjusting positive airway pressure): This therapy is like CPAP but can adjust airway pressure minute by minute. An APAP machine is sometimes used to determine the ideal pressure before switching to a less-expensive CPAP machine.

BiPAP or BPAP (bilevel positive airway pressure): A machine delivers a higher air pressure for inhalation and a lower pressure for exhalation. It is often used to treat central sleep apnea.

ASV (adaptive servo-ventilation): This medical device adjusts positive airway pressure more responsively than BiPAP/BPAP machines. It is used if you have obstructive or central sleep apnea, or a combination.

Surgery: If you have enlarged tonsils, an abnormal jaw structure or other clear physical causes of your sleep apnea, surgery may be recommended.

Other sleep apnea therapies

Sleep apnea can be worse when you sleep on your back. Using a device that keeps you from rolling onto your back can help. Examples include:

• Rematee anti-snore T-shirt and bumpers
• SlumberBUMP
• Night Shift Sleep Positioner
• Philips NightBalance

Treatments for other sleep disorders

• Cognitive therapy: You may discover that depression or excessive anxiety is keeping you awake. If so, you may be referred to cognitive therapy (a type of counseling) to treat it.
• Oral devices: We work with several area dentists who have training in sleep disorders. They offer tools, such as mandibular advancement devices (holding the jaw forward to open the airway), to treat mild to moderate sleep apnea.
• Relaxation techniques: Tools for insomnia may include massage therapy, yoga and mindfulness-based stress reduction.
• Medication: If your sleep issues are linked to shift work or jet lag, your doctor may recommend medication.
• Surgery: A type of surgery called uvulopalatopharyngoplasty (UPPP), in which the soft palate and tissues of the throat are tightened, may be recommended to treat snoring. Your doctor may recommend bariatric surgery for weight loss if your weight affects your sleep patterns.

Learn more

• CPAP (continuous positive airway pressure), National Heart, Lung, and Blood Institute
• Sleep Apnea Treatment Options, American Sleep Apnea Association
• Sleep Studies, National Sleep Foundation
• Treatment and Therapy, American Academy of Sleep Medicine