Sleep Medicine

We evaluate, diagnose and treat all types of Sleep Disorders in adults

Chronic Fatigue

EXCESSIVE SLEEPINESS (Hypersomnias)

- Insufficient sleep syndrome
- Narcolepsy
- Idiopathic hypersomnia
INSOMNIA

- Chronic

- Adjustment
PARASOMNIAS
- Sleep walking (somnambulism)
- Restless sleep
- Night terrors
- REM behavior disorder (sleep enacting)
SLEEP RHYTHM DISORDERS
- Advanced sleep phase
- Delayed sleep phase
- Jet lag

 

Sleep-related BREATHING disorders

- Snoring
- Obstructive sleep apnea (OSA)
- Central sleep apnea (CSA)
- Periodic breathing (Cheyne-Stokes)

Sleep-related MOVEMENT disorders
- Restless legs syndrome (RLS)
- Periodic limb movement disorder (PLMS)

SLEEP STUDIES
(American Academy of Sleep Medicine parameters)

Types of studies

- Home study (WatchPAT): Home-based, state-of-the-art diagnostic device with 4-channel data recording.
- Full polysomnography: Comprehensive polysomnograph capable of up to 29 channels, including EEG sleep recording, video monitoring, and technical supervision

POSITIVE AIRWAY PRESSURE TREATMENT
– CPAP
– APAP

– BiPAP
– VPAP

FAQ

What is Sleep Medicine?
Sleep Medicine is the medical specialty dedicated to the diagnosis and treatment of sleep disorders. As a clinical discipline, it began in the 1970s in the United States at Stanford University, based on research into brain wave activity during sleep. Sleep disorders may present in different ways, including insomnia, excessive daytime sleepiness or fatigue, loud snoring, abnormal behaviors, and movements during sleep. A correct diagnosis is essential for successful treatment.

Insomnia is one of the most common sleep disorders. It is defined as difficulty falling asleep or staying asleep, with consequences on daily functioning. In most cases, it is a transient problem. However, it can become persistent due to thoughts and behaviors that reinforce wakefulness. Chronic insomnia lasts more than 3 months, and the treatment of choice is cognitive behavioral therapy (CBT-I). Medication is not the best option for chronic insomnia. Evaluation by a sleep medicine specialist is essential to rule out contributing factors such as medications or underlying medical or psychiatric conditions. Osler Clinic is one of the few centers in the region offering cognitive behavioral therapy for insomnia tailored to your individual needs. 

Pathological sleepiness (as opposed to simple fatigue) may have multiple causes, including: Insufficient sleep duration, medication side effects, medical conditions (e.g., chronic pain), sleep-disrupting disorders such as sleep apnea and rare conditions such as narcolepsy. The Epworth Sleepiness Scale is used as an objective tool to measure sleepiness. Excessive daytime sleepiness requires medical evaluation to rule out treatable and serious conditions.
This may be a symptom of obstructive sleep apnea (OSA). Severe OSA can significantly increase the risk of motor vehicle accidents due to excessive daytime sleepiness and is associated with a number of serious health conditions, including treatment-resistant hypertension, cardiac arrhythmias such as atrial fibrillation, stroke, depression, and other cardiovascular and metabolic disorders.
Each person has different and unique sleep needs. If this individual variation does not negatively affect the person or those close to them, it does not warrant medical evaluation or treatment. For example, some people only need 4 or 5 hours of sleep a day to feel well-rested. This is not a problem if the person feels fine.
Sleep Medicine does not involve interpreting dreams, administering “sleep cures,” or routinely prescribing sleeping pills as a primary treatment. While the function and nature of dreaming remain active areas of scientific research, dream analysis is not part of evidence-based clinical practice. Similarly, so-called “sleep cures” are not used within evidence-based Sleep Medicine. This is a term commonly used in the general population, but its meaning and underlying mechanisms are not clearly defined or standardized in medical science. The use of sleep medications can lead to dependence and may cause undesirable next-day effects. Therefore, prescribing such medications must be done with caution and should always be part of a comprehensive treatment plan, with a strong emphasis on non-pharmacological approaches.
Restless sleep can have several causes, including sleep apnea, insomnia, parasomnias, and restless legs syndrome. In general, these disturbances tend to be more disruptive for the bed partner than for the patient themselves. The term “syndrome” in medicine refers to a group of signs and symptoms that occur together without implying a single specific cause. Restless Legs Syndrome is one cause of restless sleep. It is characterized by an uncomfortable tingling or crawling sensation in the legs that worsens during periods of rest and is relieved by movement. Symptoms are typically more pronounced in the evening or at night and may be associated with excessive leg movements during sleep. In some cases, it may be caused by iron deficiency, folic acid deficiency, or certain medications. Medical evaluation is recommended to establish the diagnosis, identify potential underlying causes, and guide appropriate treatment.
En medicina del sueño diferenciamos a la sensación de FATIGA In sleep medicine, we distinguish between the sensation of FATIGUE and the sensation of SLEEPINESS itself. This distinction is important because their underlying causes may differ. Fatigue refers to a lack of energy to perform everyday tasks during the day. Excessive sleepiness refers to the tendency to fall asleep or doze off during hours of the day when this normally should not occur. Feeling tired during the day can be a symptom of different medical, psychiatric, or sleep-related conditions. If this feeling is persistent or chronic, a thorough medical evaluation is recommended to determine the cause and guide treatment.
One of the most common causes of chronic fatigue or sleepiness is non-restorative sleep, which results from insufficient sleep or poor sleep habits. Sleep hygiene measures are essential for all patients with sleep disorders.
Clinical depression as a psychiatric diagnosis occurs due to an imbalance of neurotransmitters in the brain and requires medical and/or pharmacological treatment. This is different from transient sadness that we may experience for short periods of time. Clinical depression may coexist with several sleep disturbances including insomnia, chronic daytime fatigue, or excessive sleeping. Clinical depression should be ruled out in people with sleep problems.
Asian woman sleeping peacefully in morning light with soft linens.

For more infomation on sleep check:

National Sleep Foundation Academia Americana del Sueño Medline Plus
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Dr. Javier E. Bogarín

Specialist in Pulmonology, Sleep Medicine, and Intensive Care

Manual MSD