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Sleep Medicine

The Sleep Lab at Kent Hospital

The Sleep Center at Kent Hospital has been in existence since 1991. The lab is located on Health Lane behind the main building. The lab provides sophisticated diagnostic testing and comprehensive treatment options for people struggling with sleep disorders. The Sleep Lab team’s mission is to provide the highest standard of clinical care.

The field of sleep medicine is constantly changing as we learn new information about sleep disorders from scientific research. Because our professional staff is involved in research and patient care, they are well-suited to diagnose and treat a variety of sleep disorders including, but not limited to, obstructive sleep apnea, insomnia, narcolepsy, and restless leg syndrome.

Patients referred to the Sleep Center can also be seen in our outpatient office for a consultation. Follow-up may include further testing or imaging related to your condition.

All test results are interpreted and evaluated by our board-certified sleep specialists, who then send recommendations for treatment to referring physicians.

Contact Information

The Sleep Lab at Kent Hospital
Kent Hospital
455 Toll Gate Road
Warwick, RI 02886
P: (401) 736-3727

Directions

From Toll Gate Road turn into the main visitor's entrance, and take the first right after the Emergency Room parking lot.

The Sleep Lab is located in the tan and green building on the left side of the roadway. Immediately past the building, a sign will direct you to the parking lot. Parking is available in the lot adjacent to the building. Enter the building through the door on the left of the glass enclosure.

Resources 

Learn More About At-Home Sleep Apnea Tests >>

Insomnia: Symptoms and Treatment Options >>

About the Sleep Lab

Enter into the comfortable waiting area where your technologist will be waiting to escort you to your bedroom for the night.

The bedrooms are comfortably appointed with double or queen beds. You will have your own private bathroom/shower and each room has a flat-screen TV for your viewing pleasure. Each room is very private and quiet, opening up into a corridor similar to a hotel.

Your sleep tech will thoroughly explain the testing procedure (sleep study or polysomnogram) to you and answer any questions or concerns you might have.

Signs of Sleep Disorders

The body heals and reenergizes itself while sleeping, and good rest can help protect against other health conditions, including obesity, diabetes, heart conditions, and depression.

A sleep disorder may be present if you experience symptoms such as:

  • Dozing off or feeling sleepy during the day
  • Feeling uncomfortable or restless in your legs
  • Having trouble staying awake while driving
  • Snoring or gasping for air during the night
  • Sweating while sleeping
  • Tossing and turning
  • Waking up with headaches
  • Sleepwalking/talking and night terrors
  • Difficulty initiating and maintaining sleep and nocturnal urination

Take the next step in feeling better

About the Study

During the StudyKENT_Sleep Lab_Room

During the course of the overnight study, sleep techs will monitor these parameters while you sleep. Once the night is over and all of the sleep parameters have been gathered and stored in the computer, the next step is to score the study. A technologist will review the entire night’s study and determines the sleep stages, the number of apneas, and correlates all the data.

All of the information gathered and correlated from the sleep study is now reviewed and interpreted by one of our reading physicians. They will make a final diagnosis and recommendations if needed. The report will be sent directly to your attending physician.

The sleep technologist will apply sensors and electrodes to measure these parameters:
  • Brain waves (surface electrodes on the head)
  • Heartbeats (surface electrodes on the chest)
  • Eye movements (surface electrodes above and below the eyes)
  • Muscle tension (surface electrodes on the chin)
  • Leg movements (surface electrodes on the lower leg)
  • Breathing (sensors attached to the skin near the nose or mouth)
  • Breathing effort and movement (small elastic belt placed around the chest and abdomen)
  • Blood oxygen levels (small sensor attached to the finger – not taken from actual blood samples)
Following the Study

Following a sleep study, if a patient is positive for a condition such as sleep apnea, a recommendation for treatment will be made. The most common treatment is a PAP device. Depending on the patient’s severity, they can get a CPAP, BIPAP, or Auto-PAP device and a wide variety of masks to choose from.  Mask fittings and obtaining PAP devices can be made through Kent Home Medical Equipment, located at 11 Knight Street, Building D-15 in Warwick. 

Learn More

Testing Options
  • In-Center Studies
  • At-Home Testing

In-center studies include baseline evaluations, CPAP and BiPAP titrations, and multiple sleep latency testing (MSLT). We also perform multiple sleep latency testing (MSLT), or daytime nap tests. Our center is fully equipped with state-of-the-art digital technology to record and interpret sleep studies. Our private rooms include a full/queen size bed, television, recliner, and a private bathroom with a shower.

Currently, we offer morning, afternoon, and evening pick-up appointments for patients. A 15 minute appointment is scheduled for patients to sign acknowledgment paperwork and explained in detail how to use their home sleep test device. Every patient is provided with resources to use at home, such as a YouTube link,  picture visuals, and written instructions. We provide the patient with everything needed for this study.

The device is used at home that evening and returned the next day between the hours of 8:00 a.m. to 12:00 p.m. and 1:00 p.m. to 4:00 p.m. 

24-hour technical support is offered to all home sleep study patients. Most home sleep test devices are portable – about the size of a telephone handset.

Process for At-Home Testing

  • Consult with a physician to ensure that a home sleep test is the best option. All at-home kits should be approved by your physician, and this is particularly important if a patient has other medical conditions or taking any medication
  • Equipment will either be delivered to a patient’s residence or will need to be picked up at a designated location. The kit includes belts, a finger probe clip, and a small nasal cannula
  • Sleep with the home sleep test equipment for one night in order to collect data to be assessed
  • Return equipment to the service provider
  • Data will be then processed and interpreted, and a report will be created. The results will be discussed with patients by their physician

Advantages of an At-Home test

  • Convenience
  • Inexpensive
  • Less intrusive

Disadvantages

  • Can be less accurate
  • No additional diagnoses – home sleep tests only test for obstructive sleep apnea

Preparation Tips

  • Avoid caffeine after lunch
  • Do not nap
  • Sleep only on your back or sides

Home sleep Test Instructional Video >>

Program Integration 

A multifaceted team of experts from across the hospital system works with the Sleep Lab to provide the most comprehensive care for participants and provide patient-centered care to meet their needs.

These include:

Patient Self-Referral

Patients have the option of having a sleep study referral directly to the Sleep Lab if they have had a consultation with their provider or they can meet with a board-certified sleep doctor at the sleep clinic for a more thorough assessment of symptoms. The sleep clinic is located at Brigham & Women’s Pulmonary Associates at Care New England at 1407 South County Trail in East Greenwich.

What to Expect

  • Before coming to the hospital
  • Preparing For the sleep study
  • Day of your sleep study
  • During the Night
  • After the Sleep Study
  • Wash and dry hair
  • Pack an overnight bag, like if staying at a hotel
  • If oxygen is being used at home, please notify the center
  • If a CPAP machine is used at home, please bring the mask and headgear – there's no need to bring your machine
  • Do not use any hair spray, oils, or gels – hair should be clean and dry
  • Continue taking regular prescriptions, but the Sleep Lab team needs to be made aware of what they are so that they can determine if a certain medicine is affecting sleep. Please bring these medications to the study
  • Wear loose-fitting sleepwear
  • Blankets and pillows or other comfort items are welcome
  • Bring snacks since food will not be provided
  • When arriving at the Sleep Lab, the technician will show patients to their rooms. As the technician gets the equipment ready, patients can change into any sleepwear and get ready for bed as they would at home. During this downtime, Wi-Fi can be used or the television. There may also be paperwork to be completed at this time
  • Next, technicians will introduce patients to the equipment that will be used, the sleep study is explained in detail, and any questions may be answered
  • The equipment includes:
    • Approximately two dozen sensors that are applied to the skin using conductive paste and adhesive
    • Elastic belts that are placed around the chest and abdomen
    • A probe will also be placed on a finger

    About the sensors

    The sensors allow for the lab team to monitor the activities that are going on in the body during sleep, such as brain waves, muscle, and eye movements, snoring, etc. the elastic belts are used to measure the effort of breathing, and the finger probe monitors the level of oxygen in the blood and heart rate.

    These devices are typically not a barrier to falling asleep and are designed to be as comfortable as possible. Sleep at the lab may not be exactly like sleep at home, but the process usually doesn’t interfere with obtaining the necessary information to make an accurate diagnosis or assessment.

Lights are turned off at 11 p.m. During the night, patients will be able to roll over and change positions. The technician, who is in a separate room, will be available if sensors should need re-adjusting or if a patient needs to use a restroom. Most patients have to get up at least once during the night. Patients are awakened by 6:30 a.m. and are offer a complimentary breakfast in the morning. 

After the sleep study, a sleep technologist will process the data that was recorded and work with a physician who specializes in sleep medicine to interpret the data. Because the study provides extensive amounts of information, the technologist will review the study twice to ensure accuracy. The study provides over 1,000 pages of data so the interpretation process can take up to three weeks.

If a patient had a diagnostic sleep study, the physician will review the study and send the patient a basic letter of results, which will if someone tested “positive” or “negative” for sleep apnea. During the next appointment, this will be discussed further.

If a patient had a titration sleep study, the physician will review the study and a prescription for a PAP machine will be sent to Kent Home Medical Equipment, which will contact patients directly to coordinate the setup of the machine. The Center for Sleep Medicine will then be contacting patients to schedule a follow-up clinic appointment.

Sleep Medicine Resources

Sleep Medicine
Kent Hospital

About one in three adults don't get enough sleep. In some cases, this is due to having too busy a life, young kids, etc. In other cases, people find it difficult to fall asleep and stay asleep or have...

Sleep Medicine
Zulfi Alli RPSGT, RST

Sleep hygiene or good sleep habits can help you get a good night’s sleep and improve your overall mental and physical health. Sleep deprivation can have a major impact on how you feel and function.

Sleep Medicine
Zulfi Alli RPSGT, RST

Restless Legs Syndrome (RLS) is a nervous system disorder that causes an overpowering urge to move your legs. Restless Legs Syndrome is also known as Willis-Ekbom disease. 

Conditions

 

Obstructive Sleep Apnea

Millions of Americans experience sleep apnea, a common sleep disorder that is serious and potentially life-threatening. It can occur at any age and any gender. Sleep apnea is a breathing problem in which the soft tissues in the throat close down for about 20-30 seconds at a time during sleep. With each pause in breathing, the brain “wakes up” just enough to start breathing properly, although the person may or may not be aware that these obstructions are occurring.

Types of Sleep Apnea

  • Obstructive sleep apnea – Air can’t flow in or out of the nose or mouth while attempts to breathe continue.
  • Central sleep apnea – Inaccurate signals from the brain prevent the breathing muscles from starting to work.
  • Mixed sleep apnea – Mixed apneas have components of both obstructive and central sleep apnea.

Symptoms

  • Difficulty staying asleep
  • Dry mouth
  • Experiencing trouble staying awake while driving
  • Falling asleep while watching TV
  • Feeling sleepy or tired during the day
  • Hypopneas – Ten seconds or more of shallow breathing where one loses 30% to 90% of normal airflow
  • Legs feel uncomfortable
  • High blood pressure
  • Not feeling rested after sleep
  • Inappropriate sleep times
  • Snoring
  • Sore throat
  • Stopping breathing while asleep
  • Sweating excessively while sleeping
  • Tossing and turning
  • Trouble falling asleep 

Causes

  • Throat muscles and tongue relax during sleep and partially block the opening of the airway
  • When the muscles of the soft palate at the base of the tongue and the uvula relax and sag, the airway becomes blocked, making breathing labored and noisy and even stopping it altogether
  • In overweight people when an excess amount of tissue in the airway causes it to be narrowed
  • With a narrowed airway, the person continues his or her efforts to breathe, but air can’t easily flow into or out of the nose or mouth

Risk Factors

  • Loud snoring
  • Overweight
  • High blood pressure
  • Physical abnormality in the nose, throat, or other parts of the upper airway
  • Alcohol and drug use
  • Sleeping pills

Diagnosis

A primary care provider, pulmonologist, neurologist, or another healthcare provider with specialty training in sleep disorders may make a diagnosis and start treatment. Sleep apnea is diagnosed after five pauses in breathing per hour is counted. The more pauses there are, the more severe the case. Patients who have an overnight sleep study are given a number or index of how many pauses occurred per hour of sleep.

Tests include:

  • Polysomnography -  This records a variety of body functions during sleep. This includes the electrical activity of the brain, eye movement, muscle activity, heart rate, respiratory effort, airflow, and blood oxygen levels.
  • Home sleep apnea test – A portable device can be used to diagnose sleep apnea.

Treatment

Treatment may include:

  • Physical or mechanical therapy - Continuous positive airway pressure (CPAP) is a device to be used nightly. A mask is worn over the nose or mouth and nose during sleep. Pressure from an air blower forces air through the nose and throat.
  • Oxygen
  • Behavioral changes, including not using alcohol or smoking, not use sleeping pills, lose weight, or change sleeping positions.
  • Dental appliances – The lower jaw and tongue are repositioned.
  • Orofacial therapy
  • Surgery, including the removal of adenoids and tonsils, nasal polyps, or other growths or tissue in the airway, or to correct structural deformities, to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate), or to reconstruct deformities of the upper jaw (maxilla) and lower jaw (mandible).
  • Nerve stimulator – An implanted device that triggers the neck muscles to tighten when the device detects that the airway is closing during sleep.
Narcolepsy
Dyssomnias
Insomnia
Parasomnias
Circadian Rhythm Disorders
Other Sleep Disorders

Frequently Asked Questions

How long do I need to wear the home sleep testing device?
We ask that you wear your device for a minimum of 6 continuous hours. This ensures that a sufficient amount of data is recorded and we can provide you with the most accurate results.
Can I use the restroom during my sleep study?
Can I sleep in my usual position?
What time do I have to go to bed?
How many nights do I have to use the home sleep study units?
What do the lights on the device mean?
What if a sensor slips off during the night?
What happens if I take off the device early?
What if another person or pets sleep in the same bed during the test?
Can I take my usual medications?
What if I don't fall asleep?
Do I have to wear a shirt or pajamas?
How do I start and stop the recording?
What happens after the test?

Meet The Team

Tina Wagner, RPSGT

Sleep Lab Manager, Registered Polysomnographic Technologist 

Gregory Caldarone

Lead Secretary, Administrator 

Deborah Dean

Secretary, Administrator 

Kleopatra Goncalves, RST

Lead Registered Sleep Technologist 

Ciara Montes

Sleep Lab Aid

Michelle Pegoraro, RPSGT
Registered Polysomnographic Technologist
Christine Ruzzo, CRT, RPSGT

Registered Polysomnographic Technologist

Jenissa Swanson, RPSGT

Registered Polysomnographic Technologist

Cassie Tabares, RPSGT

Registered Polysomnographic Technologist

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