Comprehensive Sleep Center
Good Samaritan Hospital Comprehensive Sleep Center provides care for sleep disorders. This includes consultations, testing and ongoing treatment for identified sleep problems. The Sleep Center is located on 1225 Wilshire Boulevard, Los Angeles, CA 90017 in the second floor.
The Good Samaritan Hospital Comprehensive Sleep Center has board certified sleep specialists. The physicians associated with the center are sub specialized in Pulmonary and Neurology Medicine with expertise in diagnosing and treating patients with various types of sleep disorders.
The Comprehensive Sleep Center is fully computerized and equipped with state-of-the-art digital technology to record and interprets sleep studies. The Comprehensive Sleep Center’s private rooms include a twin size bed, television, and a bathroom. Patients can avoid taking time off from work by having their sleep study done overnight and leaving for work the following day.
Good Samaritan Hospital Comprehensive Sleep Center includes sleep studies for adults experiencing ongoing difficulty falling asleep, maintaining sleep, and exhibiting excessive sleepiness during waking hours or undergoing bariatric surgery. The studies, which are conducted in home-like settings with bathrooms, provide essential data on sleep patterns. The data is evaluated by certified sleep technicians and Good Samaritan Hospital physicians.
This hospital-based Sleep Center operates under the direction of Sterling Malish, M.D.
- Studies are conducted 7 days a week with little or no wait to schedule
- Final physician’ reports provided within 3 days after the study
- Knowledgeable staff to answer any questions patients may have about the sleep study
- Comprehensive follow-up care with one our sleep physicians are available.
Good Sleep Habits / Tips
- Avoid excessive daytime napping.
- Have set wake-up times and bedtimes.
- Avoid extended periods of time in bed.
- Avoid alcohol, tobacco, and caffeine in the period prior to bedtime.
- Avoid exercise too close to bedtime.
- Avoid engaging in exciting or emotionally upsetting activities too close to bedtime.
- Avoid use of bed for non-sleep-related activities (e.g., watching television, reading, studying, eating, etc.).
- Make the bed as comfortable as possible (comfortable mattress, adequate blankets).
- Sleep in a comfortable environment (not too bright, too stuffy, too cluttered, too hot, too cold).
- Avoid performing activities demanding high levels of concentration before bed.
- Try to avoid allowing mental activities, such as thinking, planning, reminiscing, etc., to occur in bed.
Weight loss is one treatment option for OSAS in overweight patients. Even a modest 10% weight loss may decrease the number of nighttime apneas. However, this treatment option is usually not successful because only a small percentage of patients can permanently lose weight.
Nasal CPAP and BiPAP
Nasal CPAP (Continuous Positive Airway Pressure) is the most commonly prescribed therapy for patients who have obstructive sleep apnea. It is a particularly important for those patients who have moderate to severe disease or patients who have severe daytime sleepiness. In using this therapy, the patient is fitted with a nasal mask (also referred to as "nasal interface") that is worn during sleep. This mask is attached via tubing to a small generator that sits at the bedside and directs pressure to the nasal interface. When properly fitted and when the pressure is properly adjusted, this therapy alleviates any blockage in the nasal or oral passages that may lead to obstruction of the airway thereby relieving apneas during sleep. This therapy may require an acclimatizing period that may last anywhere from several days to several weeks for the patient to be adequately comfortable with the therapy. The equipment may require adjustments; these adjustments will be coordinated through the physician or the equipment company.
Nasal BiPAP (bilevel positive airway pressure) is a therapy very similar to nasal CPAP (above) with the following exception. Unlike nasal CPAP (during which the pressure is delivered "continuously"), patients on nasal BiPAP will have a certain pressure delivered during inspiration and a lesser pressure during exhalation. This therapy is generally more expensive but in many patients is significantly more comfortable, particularly if high pressures are required via nasal CPAP. This therapy also can prove helpful to patients who have other pulmonary problems by actually assisting breathing during sleep by assisting inspiration by providing extra pressure when the patient is taking in a breath. In general, patients who are able to tolerate nasal CPAP usually do not require BiPAP therapy when treating obstructive sleep apnea.
In patients with sleep apnea, the most common initial therapies utilized are weight loss and nasal CPAP therapy. In carefully selected patients, surgical treatment options are appropriate, particularly in children who have large tonsils or in patients who have nasal obstruction or obstruction of the oral airway (often caused by a markedly enlarged uvula).
A variety of surgical treatment options are available to patients with either obstructive sleep apnea or patients who have snoring without obstructive sleep apnea. In general, surgical therapies are more successful in patients who have snoring without sleep apnea. These surgical treatments are performed by an ear, nose, and throat (ENT) specialist. This physician recommends whether such therapies would be appropriate and discusses specific risks and benefits with each candidate.
Since Tracheostomy (a surgical opening to the trachea created in the front of the neck) is now used much less frequently as treatment for severe sleep apnea, one of the most aggressive surgical treatments for sleep apnea therapy is now the uvulopalatopharyngoplasty. This surgery involves the removal of the tonsils, the uvula, and part of the soft palate.
Laser Assisted Uvuloplasty is a less invasive and more cost-effective resection that is performed in the office, usually on three or four sessions involving laser ablation of the tonsils, the uvula, and part of the soft palate. Generally, this procedure is reserved for patients with snoring in whom apnea has been excluded.
Somnoplasty is a rather new procedure, where radio frequency waves are directed in the deep nasal passages or at the base of the tongue. These radio waves can cause shrinking of tissue in carefully selected areas. This should be clarified with the ENT’s that this is an option
A variety of nasal procedures, including Septoplasty (the repair of a deviated nasal septum), can improve nasal airflow. This may help reduce snoring, improve sleep apnea, or allow a patient better tolerate other therapies such as nasal CPAP.
For more information call (213) 977-2260.