Center for Sleep Medicine
The Center for Sleep Medicine, led by Dr. Alan Schaffer, Medical Director and Dr. Ofer Jacobowitz, Associate Medical Director, provides professional consultations and diagnostic services for all types of sleep disorders.
An accredited center of the American Academy of Sleep Medicine, Orange Regional offers treatment to adults and children ages 2 and up.
Sleep Medicine for Children
Sleep problems can negatively affect children's health, performance in school, during extracurricular activities and even with social relationships.
We also perform sleep studies at The Center, which are painless, non-invasive tests conducted by our Board-certified physicians and specially-trained technicians to monitor breathing, heart rate, blood oxygen levels, eye movement, muscle tone and other factors.
What is a Sleep Disorder?
If you suffer from a sleep disorder, the odds are you don't know it unless your bed partner has complained to you. Your bed partner probably will see the symptoms before you do. Symptoms can include:
- Periods observed by your bed partner during which you stop breathing
- Excessive daytime sleepiness
- Loss of concentration
- Morning headaches
- Restless sleep
- Frequent nighttime urination
- Falling asleep at inappropriate times
- Frequent awakening
- Involuntary night time leg movements
If you are suffering from an array of these symptoms together and/or consistently over time could indicate the presence of a sleep disorder.
Nearly one out of every 10 Americans experiences chronic, debilitating and perhaps life-threatening sleep disorders.
Obstructive Sleep Apnea (OSA) is one of the most common sleep disorders. Sleep apnea refers to episodes during which you stop breathing for 10 seconds or longer. You can do this hundreds of times each night without being aware of the episodes.
When you suffer from sleep apnea, oxygen levels in the body fall and sleep may be disrupted by arousals. Loud, irregular snoring is usually the most noticeable sign of this disorder. OSA has been associated with:
- High blood pressure
- Coronary heart disease
- Myocardial infarction (heart attack)
- Chronic fatigue
- Possible death
It can become more severe over time.
What Should I Do?
Diagnosis and treatment of your sleep disorder can be assessed by your physician. He or she can order a sleep study. The sleep study, called a polysomnogram, will help diagnose the severity and type of sleep apnea or other disorder.
What is a Sleep Study?
A polysomnogram, or sleep study, is a painless, non-invasive test. All you have to do is spend one night with us sleeping. While you sleep, specially trained technicians will monitor your:
- Heart rate
- Oxygen levels in your blood
- Eye movement
- Muscle tone
- As well as a host of other factors
The information will be gathered and recorded throughout the night for one evening. The test is performed at the Center for Sleep Medicine at 75 Crystal Run Road in Middletown. This safe, secure, state-of-the-art facility offers the latest technology in diagnosing sleep disorders in a comfortable setting. Most insurances are accepted.
You will be advised by the Sleep Center Coordinator as to your arrival time the evening of the study. Your room resembles a private hotel-style room with a television and private bath. Bathrooms are ADA accessible.
Once you've settled in, the technologist will connect you to monitoring equipment via stick-on electrode patches. In the morning, you may shower in a private bath and enjoy a complimentary continental breakfast before resuming your normal activities.
Frequently Asked Questions
FAQs / Before The Sleep Study
What is the age range of patients you test at the Center for Sleep Medicine?
We can test patients from the age of 2 years old and up.
What is a sleep study?
For most patients, a sleep study is a key diagnostic component of a sleep disorder evaluation. A sleep study, also called a polysomnogram (PSG), measures your brain wave activity, eye movements, muscle contractions, heart activity, breathing and blood oxygenation during sleep.
The information we collect during your study is reviewed and analyzed by our sleep specialists.
Can I visit the center before my study?
Yes, tours of the sleep testing laboratory are provided during the day. Please feel free to call us to schedule a daytime tour before your test. We will be happy to accommodate your visit. You are also welcome to take a tour during your scheduled appointment.
What information will I get ahead of time?
Once you have scheduled your sleep study, you will receive a information package either in the mail or via email containing forms you need to complete, along with directions and phone numbers to the facility. Be sure to bring the directions, phone number, completed forms and your health insurance card on the night of your study.
What if I have special needs?
Please call our office between 8:30 a.m. and 4:30 p.m., Monday through Friday to discuss your special needs requirements. We will try to accommodate your needs and answer any questions you may have about the sleep study procedure. If you do not speak English please let us know so we can make accommodations.
What should I bring?
Pack as you would for an overnight hospital stay. For the benefit of your privacy and comfort, please bring appropriate and comfortable 2-piece nightclothes (such as T-shirts and shorts or pajama top and bottoms). Other patients and staff members will be in the general testing area. Review the recommended checklist below to ensure that you have everything you might need.
Recommended Check List:
- Comfortable nightclothes (2-piece pajamas or t-shirt and shorts)
- Bathrobe and slippers
- Change of clothes
- Special pillow or blanket (if desired)
- Reading material
- Hair dryer
- Snack/breakfast if you have special needs (the Center for Sleep Medicine provides snacks/breakfast items (muffins, juice, cereal, milk, and coffee). Snack items and drinks must not contain caffeine.
What about medications?
Please take your medications as usual and bring them to the center, if necessary. Upon arrival at the sleep lab, the technologist will be able to tell you your approximate bedtime so that you may take nighttime medications accordingly. Our staff will not be able to dispense any medication to you.
We also recommend that you discuss with your physician whether your medications will affect the sleep study results.
Can I wear nail polish?
If you wear nail polish we might have to remove it from at least one finger to obtain a good signal from the oxygen sensor.
Should I have dinner?
Please eat dinner before arrival. You may bring a snack if you wish. Dinner will not be provided.
Can I have a nap?
It is important that you avoid napping on the day of the study.
Can I have caffeine?
Avoid caffeine (coffee, colas, chocolates, etc.) after 2:00 p.m. on the day of the study.
Can I smoke?
Our centers are non-smoking facilities.
Should I take a shower before the study?
You may find that a shower before arriving at the sleep center will make you feel more relaxed. Please remove braids, hair weaves, and hair accessories (clips, rubber bands, etc.). Wash and dry your hair and do not apply any sprays, oils, gels, or make-up.
What if I am running late?
Please contact the sleep lab directly call 845-673-4629, if no answer leave a message) and let us know of your approximate time of arrival.
Can I drive myself to the sleep center?
Yes, you can. The only exception may be if you take a sleeping aid. If you generally wake up and are drowsy and take time to function, you may benefit from having someone bring you to the center and pick you up in the morning. Your safety is our primary concern.
Can my significant other stay with me?
Unless you need assistance, we do not encourage another person to be in the room during the study. This can affect the quality of your sleep and the results from the study.
My child is having a sleep study, should I plan to stay?
Yes, any child under the age of 18 years old must have a parent or guardian present. The parent or guardian can sleep on a recliner provided in the sleep room. We do not allow the parent or guardian to sleep in the bed with the patient. This will affect the quality of the patients sleep and results from the study. We also ask that parents/guardians make arrangement for siblings to be cared for, we can’t accommodate having them stay.
Studies on children have earlier start times; please make sure you speak to our staff to get your arrival time.
FAQs / During The Sleep Study
What happens when I arrive at the sleep center?
The study usually begins in the late evening and ends about 6:00 – 6:30 a.m. Once you arrive at the center, a sleep technologist will welcome you and show you to your private bedroom. The technologist will ask you to fill out some forms and answer any questions you may have. As part of your orientation, you may be asked to watch a video that will explain the process.
Will I have a private bedroom?
Yes, sleep study bedrooms are private. The bedrooms have private bathrooms with showers. Each room has an independent control for heating and cooling. Your sleep technologist can help adjust the room temperature to meet you needs.
How do I get ready for the study?
After you change into your sleepwear, the sleep technologist will place a number of non-painful sensors (also called electrodes) on your head, chest area and legs. The areas where the sensors will be attached are cleaned and the electrodes are attached with special gels and paste. (The gels and paste are harmless, however, if you have sensitive skin, please alert your sleep technologist prior to attaching the electrodes.) Elastic belts with sensors will be placed around your chest and abdomen. Airflow sensors will be placed under your nose and a finger clip will be applied to monitor your oxygen levels. All of the sensors will be connected to a small portable box that transmits signals to the sleep monitoring and recording equipment that is in a nearby control room.
Will I be able to sleep with so many things attached to me?
You may find it a bit strange at first, but most people do not find it uncomfortable or an obstacle to falling asleep. We will make every effort to ensure that you are as comfortable as possible. If a problem arises, your sleep technologist will make adjustments. The bedroom has an open intercom that will enable you to communicate with your technologist at any time.
What if I need to go to the bathroom during the study?
If you need to use the bathroom during the night, you can call your sleep technologist on the intercom for assistance. They will temporarily disconnect you from the sleep monitoring equipment.
What happens while I’m sleeping?
The lab is a busy place and there will be other patients being monitored during the same evening. The sleep technologists remain awake in the control room throughout the night analyzing the information being collected while you sleep.
Will I be treated for my sleep disorder while I’m there?
For certain patients with Obstructive Sleep Apnea (OSA), the sleep study may include the beginning of a treatment called CPAP (Continuous Positive Airway Pressure). After you are asleep for a period of time, the sleep technologist will be able to determine if you have evidence of OSA. If you have evidence of OSA, CPAP treatment may be started during the night. During your orientation, this will be thoroughly reviewed, and you will have plenty of time to ask questions.
FAQs / After The Sleep Study
When will l wake up?
If you are not already awake, you will be awakened between 5:30 a.m. and 6:00 a.m..
Does the sleep center provide breakfast?
As mentioned above, the center has a limited supply of breakfast items. Generally, we have muffins, cereal, crackers, milk, coffee and tea. If you have special needs, please let us know.
When can I leave the sleep center?
You should plan to add an additional 30 minutes to your usual morning preparation time to allow us to remove the electrodes. You may take a shower to wash your hair to remove the gels and paste used to attach the electrodes. If you have long or thick hair, it may take longer to remove the paste. If you need to be somewhere at a certain time, please let us know when you arrive in the center so we can accommodate your request.
If you have arranged for a ride, they will need to pick you up by 7:00 AM. If your ride is not going to get here by 7:00 a.m., we ask our patients to wait for their ride in a seating area near the exit door to the building. There are windows in that area so you will be able to see your ride when they arrive.
What happens if I am scheduled for a nap test?
Your doctor may have ordered an additional test called a Multiple Sleep Latency Test (MSLT) or a Maintenance of Wakefulness Test (MWT) as part of your overall evaluation. This means that you will need to stay at the center for most of the following day for a series of brief naps. The naps are scheduled throughout the day. Please bring reading materials, puzzles or other entertainment items that will help you pass the time. The center for sleep medicine provides breakfast and lunch for those having an MSLT. The center staff will have you fill out a menu the night you come for your study and will bring your order to our Café.
Multiple Sleep Latency Test
Also called a “Nap Test”, the multiple sleep latency test (MSLT) is the standard way to quantify sleepiness and diagnose disorders of excessive sleepiness. An overnight diagnostic sleep test called a polysomnogram (PSG) is required the night prior to the daytime MSLT. After the PSG is complete, a series of nap tests are spread out over the following day.
After being asked to try to fall asleep for each nap test, sensors on the head and chest record your brain wave activity, eye movements, muscle contractions and heart activity to accurately detect if you fall asleep.
The information we collect during your study is reviewed and analyzed by our sleep specialists.
What happens after my sleep study?
A large amount of information is collected during your sleep study. A sleep specialist will analyze this information and a formal report with recommendations will be sent to your doctor. On the night of the study, the sleep technologists cannot provide you with any information about your testing results.
When will my doctor receive my results?
It usually takes up to two weeks for your doctor to receive your formal report. Please schedule a follow-up visit with your physician after that time to discuss the findings and recommendations for treatment. If you have seen one of our specialists, you should have a scheduled follow-up appointment made. This appointment will be for about one-week after your scheduled study.
Your physician will receive a written report of your sleep study results. He or she will explain the results and discuss your treatment options. Correcting your sleep disorder may involve weight loss, medications, equipment to help you breathe during sleep, surgery, or a dental appliance.
MEET OUR TEAM
As Administrator of Ancillary Services, Frank Salvatore Jr., RRT, MBA, FAARC oversees the departments of Respiratory Care, Sleep Medicine, Wound Care and Hyperbaric Medicine at Orange Regional Medical Center.
Dr. Jacobowitz is the Associate Medical Director of Orange Regional’s Center for Sleep Medicine. He is a highly experienced clinician in Otolaryngology and maintains board certifications in Head and Neck Surgery, Otolaryngology and Sleep Medicine.
Dr. Alan Schaffer is the Medical Director of The Center for Sleep Medicine at ORMC. He is Board-certified in Critical Care Medicine, Internal Medicine, Pulmonology, and Sleep Medicine.
Samer El Zarif,
Dr. El Zarif holds Board certifications in internal, pulmonary, critical care and sleep medicine. He treats both adults and pediatric patients with complex sleep related medical disorders.
Dr. Krishna is member of the Division of Pulmonary, Critical Care and Sleep Medicine (PCCSM) team at Orange Regional Medical Group and is a Board-certified pulmonary-critical care physician.
Dr. Gilani holds Board certifications in critical care, internal and pulmonary medicine and is board eligible in preventive medicine.