Exploring Sleep Apnea with Dr. Anthony Ackerman

According to the American Academy of Sleep Medicine, 26% of adults between the ages of 30 and 70 have sleep apnea. We talked to SIMEDHealth Neurologist and Sleep Physician Anthony Ackerman, MD, about sleep apnea and what is involved in diagnosing someone.

1. We hear the term "sleep apnea" a lot, but what exactly is sleep apnea?

Dr. Ackerman responded, "Sleep apnea is a sleep breathing disorder. There are three different types. The first and most common is Obstructive Sleep Apnea. In this type, the airway is blocked or partially blocked by the relaxed tongue and soft tissues of the pharynx. The obstruction commonly results in snoring or causing the person to wake up gasping or choking during sleep. The next type is Central Sleep Apnea which occurs when there is temporary slowing or stopping of the brain's breathing drive. Central Sleep Apnea is seen in neurologic brain disorders and is no associated with snoring. There's also something called Complex Sleep Apnea which is a combination of both Central and Obstructive Sleep Apnea. All of these types can lead to decreased oxygen delivered to the heart and brain, which cause disruptions of sleep from arousals or micro-arousals, of which the person may or may not be aware. They prevent the brain from going into the deeper, more restorative stages of sleep, such as REM (Rapid Eye Movement Sleep) and Delta sleep. It is during these deeper, restorative sleep in which the brain removes plaques and tangles debris in the brain associated with Alzheimer's type dementia."

2. What symptoms does someone suffering from sleep apnea experience?

"The person can have snoring, wake up gasping or choking, long pauses with little or no air moving during sleep," Dr. Ackerman explained. "There can be frequent nighttime arousals, and trips to the bathroom to urinate occur more often. They wake up unrefreshed and often with a dry mouth and/or morning headaches. They can have daytime sleepiness, increased irritability, and worse control of their chronic health conditions such as diabetes, congestive heart disease, heart arrhythmias, and pain syndromes. It also commonly indirectly disrupts the bed partner's sleep due to loud snoring and frequent moving around in the bed."

3. What causes or contributes to the occurrence of sleep apnea?

"The most common cause is being overweight, although being is not a requirement. Physical conditions associated with sleep apnea include having a narrow airway, a large tongue, uvula, or tonsils, having a large neck, taking certain drugs or medications such as alcohol or opiates. Neurologic diseases such as neuromuscular or motor neuron disease have a high risk, including ALS or Lou Gehrig's disease. And also, the aging process can contribute to the risk for sleep apnea", according to Dr. Ackerman.

4. What are the steps to determine if someone has sleep apnea?

Dr. Ackerman advises, "You'll want to discuss your sleep concerns with your Primary Care Physician and request a referral or call the SIMEDHealth Sleep Center directly to schedule an appointment for an evaluation. During the initial sleep clinic office visit, you'll relay your sleep symptoms and concerns to your doctor, who may end up ordering a sleep study. The study would consist of an in-lab overnight study or possibly a home study. If you're diagnosed with sleep apnea, you would likely be started on something called positive airway pressure or PAP therapy. It consists of a mask that fits under or over the nose or even over the nose and mouth. It delivers a mild air pressure that maintains the open airway. You will then follow up with the Sleep Center clinic approximately one month later to discuss your response to the therapy and address any developed issues. For some, it can take a little while to sleep undisturbed by PAP therapy. If needed, mask and PAP desensitization can be arranged through the Sleep Center. The desensitization is quite successful with many patients."


To schedule an appointment with Dr. Ackerman or any of our Sleep Center physicians, click here. To learn more about the SIMEDHealth Sleep Center, click here.

Sleep Troubles? It May Be Your Sleep Hygiene

We all know what it feels like when you don’t get enough sleep. You’re sluggish, yawning, drowsy and reaching for an extra cup of coffee throughout the day. Although for some of us, the sleep troubles don’t stop there.

According to SIMEDHealth’s medical director for sleep medicine, Dr. Galina Bogorodskaya, it may not be that you’re not getting enough sleep, but rather you’re not getting enough good sleep.

Have you or your partner noticed any of these symptoms?

  • Loud or frequent snoring
  • Not breathing during sleep
  • Choking or gasps sounds
  • Kicking during sleep
  • Violent behavior during sleep
  • Walking or talking during sleep
  • Morning headaches
  • Daytime sleepiness or fatigue
  • Awakening with dry mouth and sore throat

Not only do these symptoms indicate a possible sleep condition, they can prevent you from feeling refreshed and prepared for your day. You may even find you’re more irritable than usual when you aren’t getting proper sleep, Dr. Bogorodskaya said.

 “Most people think you need 8 hours of sleep a night, and while that is the average, some people need 5 [hours], some people need 9. This all depends on your sleep hygiene,” Dr. Bogorodskaya said.

Sleep hygiene refers to personal habits and practices which allow you to sleep well on a regular basis. According to Dr. Bogorodskaya, to have proper sleep hygiene you should avoid:

  • Using alcohol before sleep
  • Eating 2-3 hours before sleep
  • Using stimulants or taking any medications with caffeine before sleep
  • Exercising before sleep
  • Sleeping with pets
  • Exposure to bright light before sleep
  • Watching TV or using social media before sleep

As you make adjustments to your sleep routine, Dr. Bogorodskaya said it’s important to make sure your bedroom has enough cool air and very little to no light, and most importantly, to be self-aware.

“Just pay attention to not only how you’re sleeping, but ask yourself how you feel throughout the day. Do you feel refreshed, satisfied, and ready for the day? Are you at your full activity level? Sometimes people think their drowsiness is a lack of vitamins, exercise, or something else, but can be related to sleep,” she said.

Memory and concentration problems may also be aided by improving sleep hygiene and taking power naps, said Dr. Bogorodskaya. A 20-30 minute power nap can leave you feeling refreshed and ready to take on the remainder of your day.

When we sleep, our brains reset, our tissue is repaired, our appetite is regulated and we, in turn, are prepared to take on life to the fullest. If you feel you aren’t getting proper rest, speak with your primary care doctor about a referral to the SIMEDHealth Sleep Center, so that you can get back to feeling like you.


Sleep & Heart Health with Dr. Larissa Lim

Sleep and Heart Health

Sleep and Heart Health | SIMED Health

According to the National Sleep Foundation over 18 million Americans suffer from some type of sleep disorder. SIMED Sleep Medicine’s Dr. Larissa Lim weighed in on how quality of sleep can have serious implications on your overall health.


Sleep and heart health are closely intertwined.  A study has shown that adults who slept less than six hours per night were twice as likely to have heart attacks or strokes as people who slept six to eight hours per night.  Patients with untreated obstructive sleep apnea are at higher risk of developing congestive heart failure.  Obstructive sleep apnea has also been linked to hypertension and cardiovascular disease.

Proper sleep hygiene is important. Many Americans suffer from chronic sleep deficit. Dr. Lim has some tips for proper sleep hygiene:

  • Set a bedtime and wake-up time allowing at least 7-8 hours of sleep with 30 minutes set aside for falling asleep
  • Avoid caffeine after lunch 
  • Sleep in a dark, quiet, and cool room 
  • Avoid alcohol at bedtime 
  • Limit use of electronics at bedtime including computers, TV’s, smartphones, and tablets as they tend to delay bedtime

The warning signs of obstructive sleep apnea include loud snoring, daytime sleepiness, waking up gasping or choking, waking up with morning headaches or dry mouth, getting up to urinate, and frequent awakening.

If you have disturbed sleep, or are waking up tired after a night of sleep, a diagnostic polysomnogram, i.e. sleep study is the gold standard test to evaluate for a sleep disorder. There are a few different options for treatment of sleep apnea. Most patients find continuous positive airway pressure or CPAP provides the best method for returning to a long restful night of sleep.  

Sleep is important not only to your heart but your health in general.  Thankfully, achieving good sleep is something we all can do. Contact your SIMED physician to talk about your risk factors for sleep disorders. Set up an appointment at SIMED Sleep Medicine to discuss your questions and concerns with one of our board certified sleep medicine specialized physicians.


Author: Dr. Lim, ABIM Board Certified in Internal Medicine and Sleep Medicine 

SIMED Sleep Center Celebrates Reaccreditation

National Sleep Awareness Week is underway (March 2-8), and there’s no better time for the SIMED Sleep Center to announce that it has formally received its second 5-year Accreditation from the American Academy of Sleep Medicine.  This is the result of a thorough process including review of physician and technologist credentials, quality of our diagnostic studies and care of the patient during their stay.
SIMED Sleep Center is also now fully accredited for home testing.  This is an “express” version of the overnight sleep study in which some, but not all, measures are taken to screen patients and determine if future testing and treatment is needed. Under the direction of Galina Bogorodskaya, MD and a core of board certified sleep physicians representing NeurologyPulmonology and Internal Medicine, SIMED Sleep Center performs diagnostic testing to uncover such diverse ailments as sleep apnea, insomnia, incomplete REM sleep and other parasomnias including talking, walking and getting up to eat or use the restroom. 

Medical journals and popular magazines like Men’s Health recently stepped forward to remind physicians and patients alike that untreated sleep disorders can worsen blood pressure, heart ailments, metabolic syndrome and obesity.

We test and care for patients upon referrals from physicians throughout the community as well as those whose employment entails a need to be alert and awake. SIMED Sleep Center teams up with First Care and several local trucking/transportation companies to test and treat professional drivers who move freight, both locally and on the interstate.
For more information on SIMED Sleep Center, visit our page or call Van Simmons, Division