Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep. Breathing pauses can last from a few seconds to minutes. They may occur 30 times or more an hour. Typically, normal breathing then starts again, sometimes with a loud snort or choking sound.
The signs and symptoms that are suggestive of OSA include obesity, loud snoring, excessive daytime sleepiness, erectile dysfunction (impotence), morning headaches, personality changes (depression), high blood pressure and frequent nocturnal urination. A large neck girth in both males and females who snore is also a good predictor of OSA. In general, men with a neck circumference of 17 inches or greater and women with a neck circumference of 16 inches or greater are at a higher risk for sleep apnea.
Symptoms of sleep apnea include:
Sleep apnea can have very detrimental health consequences when it goes untreated. It has been associated with high blood pressure, cardiovascular disease, sexual dysfunction and even increased risk of accidents.
There are several treatment options for sleep apnea.
An in-center sleep test is the most detailed and thorough way to test for sleep disorders like sleep apnea. The patient sleeps in a private room at the sleep center while detailed sensors measure the patient's brainwaves, oxygen saturation, leg motion and other critical benchmarks. A technician oversees the patient throughout the night to ensure the most accurate results possible.
After your doctor refers you for a sleep study, a patient care coordinator will contact you to schedule the test.
NO, only in special cases you can bring another person to the sleep center with you. Children and patients requiring an around-the-clock caregiver MUST have someone stay with them.
IMPORTANT: Discuss any special arrangements with the sleep center BEFORE arriving for your study.
You will receive your results within two weeks (10 business days). Each sleep study is scored by a technician and then reviewed by a sleep specialist. See our video for more information on what happens after your sleep study.
A home sleep test (HST) is a convenient, comfortable way to test for sleep disorders like sleep apnea. It takes place in the comfort and convenience of a patient's own home.
After your doctor refers you for an HST, a patient care coordinator will contact you to schedule your HST.
You will pick up the HST device on the day of your sleep study from a sleep technician who will show you how to use the device.
The HST device is fairly simple to set up. When you pick up the device in person, you will have a live technician walk you through how to use the device and answer any questions you may have.
The PAP machine is a therapeutic device that will assist you in getting a good night's sleep. You will most likely continue using the PAP device as long as your condition/diagnosis remains the same. Some patients find that they do not need to use their device or can reduce their pressure settings after significant weight loss. It is important to talk to your doctor before you stop therapy. You may benefit from a sleep study to determine a lower pressure or to evaluate the severity of your condition.
Daily: Wash the mask system with warm, soapy water. Use soaps without added scents, such as plain Ivory® liquid soap or baby shampoo. Rinse well and allow to air dry out of direct sunlight.
Weekly: Separate and hand-wash the mask components and headgear in warm, soapy water. Use soaps without added scents. Rinse the components well and allow them to air dry out of direct sunlight.
Caution: Do not use solutions containing vinegar, bleach, chlorine, alcohol, aromatics, moisturizers, antibacterial agents or scented oils, as they can damage your mask!
All masks are designed with exhalation ports, or small apertures where the pressurized air is released. If you notice air blowing out of these small ports, this is OK. However, it is important not to have air blowing around your face and into your eyes. Please contact us if you are experiencing excessive air leakage or discomfort with your mask.
If you are using a disposable filter (usually white-colored and thinner than a non-disposable filter) you should change it twice a month. However, keep in mind that you may need to swap out these filters more often depending on the quality of the air in your room.
A heated humidifier specifically designed for your PAP device may help reduce dryness. Please refer to the user manual for operation instructions. If you have not received a heated humidifier along with your PAP device or if you have questions about the operation of your heated humidifier, please contact us.
Most humidifiers come with a water chamber that has a maximum water level mark on them. Do not pour water past this mark. The water used with the humidifier needs to be distilled water and must be changed daily. Please refer to your user manual for more information.
The air pressure on your device is normally based on the results of your sleep diagnostic test. At times, it will take up to eight weeks for you to fully adapt to this pressure However, if you feel like the pressure is causing you excessive difficulty, please contact us so that we can assist you.
Certain supplies need be replaced anywhere from every two weeks to every six months. Many insurance plans follow these Medicare guidelines:
| Every Month: | Nasal Mask Cushion/ Pillows (twice per month) |
| Full Face Mask Cushion (once per month) | |
| Device Filter (twice per month) | |
| Every 3 Months: | Mask and headgear, tubing |
| Every 6 Months: | Chinstrap, humidifier, water chamber |
Your insurance may have a different allowance for replacement supplies.
Most insuranceplans (HMO, PPO and Medicare) cover sleep studies and PAP therapy for the treatment of sleep disorders. Plans may vary in their coverage. It is important to understand your benefits.
Most insurance compliance guidelines require that you show proof of using your device for a minimum of four hours per day at least 22 days out of a consecutive 30-day period within the preceding 90 days (in the past three months).
We accept all PPOs, Medicare, Tricare/TriWest, major HMO plans and Workers' Compensation.
Yes, we require a physician's referral for all HMO plans. However, for Medicare and PPO plans, we have sleep specialists to see you in consultation and recommend any sleep studies that may be required.
We are open five nights a week, closed on Sundays and Wednesdays. We will ensure that you have your sleep study on the night most convenient for you.
No. The sleep lab does not provide any medications. Please make sure you have discussed all of your medication needs with your physician prior to your sleep study.
You should take all of your usual medications on the day and night of your sleep study unless your physician has advised you otherwise.
It is recommended that the following instructions are followed:
Upon arrival, a technician will lead you to your room. Surface electrodes will be applied painlessly to your scalp, chin, legs, chest and near your eyes with conductive paste. This will enable us to evaluate your stages of sleep and pertinent information regarding your sleep pattern and behavior. A sensor will be placed under your nose and belts will be placed around your chest to monitor your breathing. The setup process will take about 45 minutes. A technician will monitor your sleep from a room in close proximity to you where your sleep data is collected and stored on our sleep diagnostic computerized system. If apnea is detected, you will be contacted to be scheduled for a CPAP titration trial or the technician will initiate a CPAP trial only if ordered by your physician on the night of your study.
Find great doctors at Paloma Medical Group. Call 949-443-4303 or use our convenient Request an Appointment form. Our physicians welcome patients from Irvine, Mission Viejo, Laguna Niguel, San Juan Capistrano, San Clemente and nearby areas in South Orange County, CA.
In the world we live today with HMOs and specialists it's hard to find a doctor who really cares. A doctor who takes the time needed to solve your problem. I'm writing this letter to thank you, Dr. Kale, for your help with my CPAP Mask. It has made all the difference. Since my visit with you a few days ago I have slept through the night. It has been a very long time since I have slept this well. Not sleeping was taking away the quality of my life. Not only are you a very pleasant person you are a wonderful doctor.
30230 Rancho Viejo Road, Suite 200
San Juan Capistrano, CA 92675
Phone: 949-443-4303
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16305 Sand Canyon Ave Suite 255
Irvine, CA 92618
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Paloma Medical Group is located in San Juan Capistrano and serves patients of all ages in San Juan Capistrano and the surrounding South Orange County, CA communities, including San Clemente, Irvine, Mission Viejo and Laguna Niguel. Our pulmonary specialists and internal medicine doctors offer patients complete primary care, pulmonary care, sleep disorder testing and treatment.
