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Sleep Medicine Center


Why Choose Us?

Directed by Lisa Shives, MD, and the chief of pulmonary and critical care medicine, Atul Malhotra, MD, the Sleep Medicine Center at UC San Diego Health System is a comprehensive evaluation, treatment and research center for sleep disorders.

Our team has been involved in the development of several aggressive therapies for treating sleep disorders that are used worldwide. Published in hundreds of leading medical journals, their ongoing research on sleep-related disorders is helping shape the global understanding of sleep health. 

At UC San Diego, sleep disorders are managed by a multidisciplinary team of experts that include specialists in sleep medicine, behavioral health services, and head and neck surgery (ENT). All of our sleep medicine doctors are board certified in their specialty.

Our sleep medicine team uses leading-edge technology to collect precise information about a person’s sleep movements, behaviors, and breathing patterns. These details help us identify even minor forms of sleep abnormalities. For appropriate candidates, we offer a home sleep study via a portable device that is worn for one night at home.

Our pulmonology program is named sixth best in the nation.
U.S. News & World Report 2014-15

What We Treat

We provide a full spectrum of advanced diagnostic and therapeutic services for people with sleep-related disorders including:
  • Sleep apnea
  • Insomnia
  • Periodic leg movement during sleep syndrome
  • Restless legs syndrome
  • Narcolepsy
  • Sleepwalking
  • Sleep eating
  • Sleep disorders associated with medical or psychiatric conditions
  • Sleep-related neurological disorders
  • Circadian rhythm sleep disorders
  • REM behavior disorder

Why Quality Sleep Is Important

Like exercise and a healthy diet, sleep is an essential component of mental and physical health.

For the average adult, 7-9 hours of sleep is recommended. Fewer than 7 hours of sleep a day can have a negative impact on your immune, cardiovascular, nervous and endocrine systems.

Sleeplessness can increase your risk for conditions such as:

  • High blood pressure
  • Heart attack
  • Stroke
  • Depression
  • Obesity (which can contribute to obstructive sleep apnea)
  • Diabetes (impaired glucose intolerance)

It is estimated that at least 50 to 70 million people in the U.S. have a sleep disorder.

Other consequences of chronic sleep loss include:

  • Decreased performance at work or school
  • Increased risk of an accident or injury
  • Decreased quality of life
  • Poor memory and concentration

Diagnosis

Overnight Sleep Study

The benefit to having your sleep evaluated at our specialized sleep center instead of at home is access to advanced diagnostic testing performed by trained sleep technicians.

A comprehensive overnight sleep study, known as a polysomnogram, is the best way to determine if you have a sleep disorder. We conduct overnight sleep studies in our state-of-the-art patient evaluation center.

The polysomnogram records certain body functions while you sleep such as:

  • Heart rate and rhythm
  • Brain waves (electrical activity)
  • The amount of oxygen in the blood
  • Eye movement
  • Air flow
  • Electrical activity of muscles
  • Body position and limb movements
  • Breathing rate

In addition to evaluating your breathing patterns, the polysomnogram assesses specific body functions using the following diagnostic tests:

  • ECG (electrocardiogram): Measures heart rate and rhythm.
  • EMG (electromyogram): Evaluates the health of the muscles.
  • EEG (electroencephalogram): Measures electrical activity of brain.
  • EOG (electroculogram): Measures brain wave and eye movements that signal different sleep stages.

Home Sleep Study

At-home diagnostic testing is available for individuals who prefer to be monitored remotely.

Multiple Sleep Latency Test (MSLT)

The multiple sleep latency test is a full-day sleep study that measures excessive daytime sleepiness. One of the most important tools for diagnosing narcolepsy, the MLST consists of several naps (usually every 2 hours) over the course of one day.

Maintenance of Wakefulness Test (MWT)

The maintenance of wakefulness test is used to assess a person's ability to stay awake during the day. During several scheduled intervals over the course of one day, our sleep medicine experts monitor the activity of your heart, brain, chin and eyes while you sit in a quiet, dark room.

Treatment

Our sleep medicine experts offer a broad spectrum of treatments for all sleep disorders.

The following treatments are used for people with sleep apnea:

  • CPAP: One of the most common treatments for sleep apnea, the CPAP machine helps keep your airway open by gently blowing air down your throat.
  • Oral appliance therapy: A small plastic device fitted to your mouth (similar to a mouth guard) helps prevent the collapse of the tongue and tissues in the back of your throat. 
  • PAP (positive airway pressure): The most commonly used treatment for OSA, PAP involves small nasal tubes or mask that blow compressed air into your lungs.
  • Provent: An alternative form of CPAP, this small device has two small plugs that create just enough pressure to help keep airways open. Provent therapy does not require a machine, mask, or medications.
  • Weight loss and weight-loss surgery: People who are overweight or obese have extra tissue in the back of their throat that can block their airway while they sleep. Losing weight may help reduce, and in some cases even cure, sleep apnea. 
  • WINX: Used for people with obstructive sleep apnea (OSA) who cannot tolerate CPAP (continuous positive airway pressure), this system enables the user to breathe through their nose without a mask.

Behavioral and Lifestyle Treatments

Behavioral and lifestyle techniques can help eliminate behaviors, environmental disruptions and habits that may be keeping you from quality sleep. 

This may include:

  • Limiting or avoiding alcohol
  • Limiting or avoiding caffeine
  • Relaxation methods (e.g., deep breathing techniques)
  • Limiting time in bed to only when sleeping
  • Wearing earplugs and eliminating extra light in the room
  • Modifying your sleep schedule

Surgery

Surgery is sometimes recommended for people with severe sleep apnea.

Surgical procedures we use:

  • Hypoglossal nerve stimulation (HGNS): An electrode is surgically attached to the nerve that controls the tongue muscle. This electrode is then stimulated with a pacemaker. This helps keep the airway open and the tissue and tongue from collapsing during sleep.
  • Septoplasty and turbinate reduction: During this operation, the cartilage on the interior of the nose is straightened. The turbinates (curved bones along the nasal passage) are then reduced to make the airway bigger.
  • Adenoidectomy: Used for people with swollen adenoids (lymph tissue that sits between your nose and the back of your throat in your upper airway).
  • Tonsillectomy: This procedure involves surgical removal of the tonsils. This is recommended for people with large tonsils who have sleep-disordered breathing. 
  • Removal of the uvula: Removing the uvula, the soft structure that hangs down from your soft palate, can help with snoring.
  • Maxillomandibular advancement (MMA): Almost all sleep apnea can be successfully treated by MMA. This complex operation involves surgically cutting the bones holding the upper teeth and the bones holding the lower teeth (called the mandible) and adjusting them so that the lower part of the face is moved forward.

Did You Know?

  • Increasing age is associated with a decline in motor skills and cognition – factors that can increase risk of developing obstructive sleep apnea (OSA).
  • More than 40 million Americans of all ages suffer from sleep disorders. 
  • Most healthy adults need 7-9 hours of sleep. However, some people can function without sleeplessness with as little as six hours of sleep. (National Sleep Foundation)
  • People who do not get enough sleep are more likely to be hungrier. This is due to a decrease in the appetite-regulating hormone, leptin.

Appointments & Referrals

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Sleep Medicine Locations

La Jolla
Consultations, Home Sleep Testing
& Overnight Sleep Center
Hillcrest
Consultations Only

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