Sleep Medicine
The sleep medicine service diagnoses and treats your sleep problems, including trouble sleeping, breathing difficulties while sleeping, snoring, teeth grinding and jaw clenching.
Check out the resources below so you can sleep better with help from the sleep medicine clinic at VA Salt Lake City Health Care System.
Appointments
We are now an appointment only clinic. Please call ahead and schedule an appointment before arriving at the clinic to ensure that you can be seen.
Phone: 801-582-1565, ext. 2841.
If your health care involves supplemental oxygen, please direct oxygen related questions to Home Oxygen at 801-582-1565, ext. 5260.
Clinic Hours
Monday to Friday, 7:30 a.m. to 4:00 p.m.
Sleep Apnea Facts and Figures
What is sleep-disordered breathing (SDB)?
SDB describes a number of nocturnal breathing disorders.
- Obstructive sleep apnea (OSA)
- Central sleep apnea (CSA)
- Nocturnal hypoventilation Cheyne–Stokes respiration (CSR)
What is obstructive sleep apnea (OSA)?
- The most common form of SDB
- A partial or complete collapse of the upper airway caused by relaxation of the muscles controlling the soft palate and tongue
- Person experiences apneas, hypopneas and flow limitation
- Apnea: a cessation of airflow for ≥10 seconds
- Hypopnea: a decrease in airflow lasting ≥10 seconds with a 30% reduction in airflow and at least a 3% oxygen desaturation from baseline
- Flow limitation: narrowing of the upper airway and an indication of an impending upper airway closure
Signs and symptoms of sleep apnea
- Lack of energy
- Morning headaches
- Frequent nocturnal urination
- Depression
- Excessive daytime sleepiness (EDS)
- Nighttime gasping, choking or coughing
- Gastroesophageal reflux (GE reflux)
- Irregular breathing during sleep (e.g., snoring)
Classification of sleep apnea
Apnea–hypopnea index (AHI).
- Number of apneas and/or hypopneas per hour of sleep (or study time)
- Reflects the severity of sleep apnea
- AHI: < 5 Normal range
- AHI: 5 to < 15 Mild sleep apnea
- AHI: 15 to < 30 Moderate sleep apnea
- AHI: ≥ 30 Severe sleep apnea
Prevalence of sleep apnea
- Approximately 42 million American adults have SDB
- An estimated 26% of adults have at least mild SDB
- 9% of middle-aged women and 25% of middle-aged men suffer from OSA
- Prevalence in the US is similar to asthma (20 million) and diabetes (23.6 million)
- 75% of severe SDB cases remain undiagnosed
Increased risk factors for sleep apnea
- Obesity (BMI >30)
- Diagnosis of hypertension
- Large neck circumference (>17” men; >16” women)
- Male gender
- Excessive use of alcohol or sedatives
- Upper airway or facial abnormalities
- Smoking
- Family history of OSA
- Endocrine and metabolic disorders
Cardiovascular links
- 5.1 million people in the US have heart failure
- Approximately 76% of congestive heart failure patients have SDB
- Heart failure is the most expensive disorder to treat
- OSA noted in 49% of atrial fibrillation patients10 and 30% of cardiovascular patients
- OSA presents in 70% of heart attack patients with AHI ≥5 and 52% of heart attack patients with AHI ≥10
Hypertension links
- Studies have shown that sleep apnea is an independent risk factor for hypertension
- 30–83% of patients with hypertension have sleep apnea
- 43% of patients with mild OSA and 69% of patients with severe OSA have hypertension
- AHA guidelines on drug-resistant hypertension have shown that treatment of sleep apnea with CPAP is likely to improve blood pressure control
Type 2 diabetes links
- 48% of type 2 diabetes sufferers have sleep apnea
- OSA may have a causal role in the development of type 2 diabetes
- OSA is associated with insulin resistance (independent of obesity)
- 30% of patients presented to a sleep clinic have impaired glucose intolerance
- Mild forms of SDB may be important in predicting risk of pre-diabetes
- 86% of obese type 2 diabetic patients suffer from sleep apnea
Stroke risk
- 65% of stroke patients have SDB
- Moderate to severe sleep apnea triples stroke risk in men
Mortality links
- SDB is associated with a threefold increase in mortality risk
- There is an independent association of moderate to severe OSA with increased mortality risk
- Severe sleep apnea raises death risk by 46%
Treatment of OSA with CPAP
- CPAP treatment reduces the need for acute hospital admission due to cardiovascular disease in patients with sleep apnea
- CPAP reduces blood glucose levels
- Two nights of CPAP improves insulin sensitivity, sustained at the three-month interval
Ordering CPAP Supplies
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If you receive CPAP supplies from VA, you may be able to reorder items like batteries, parts, and accessories. These supplies must have been prescribed by a VA provider and received within the past 2 years. Each item comes as a 6-month supply and can be reordered every 5 months. You can also reach the VA Denver Logistics Center by email.
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Download VA Form 2346b and mail the completed form to the address listed.
CPAP Education Class
If you are new to CPAP, or your equipment is no longer functional, you will be scheduled for one of our CPAP educational classes. During the class you will receive your new equipment, learn how to use it, meet other veterans also using CPAP, and be able to ask questions. CPAP classes are also offered via TeleHealth.
Call the Sleep Medicine Clinic for details and availability.
Phone: 801-582-1565, ext. 2841.
Cleaning Your Equipment
To ensure that your equipment remains fully functional, please remember that you must keep it clean. If you received cleaning instructions with your CPAP equipment, please follow them.
Additional cleaning suggestions:
- Methods: Baby shampoo, white vinegar, or dish soap: 1 part cleaner to 3 parts water
- Daily: Rinse the cushion of the mask and air dry.
- Weekly: Soak the tube, humidifier tank, mask, and headgear for 20 minutes, then rinse well with water and air dry. Rinse the pollen filter with water.
- Monthly: Replace the HEPA filter.
DMV Forms
If you are in the Stable Telemonitoring Clinic and are contacted yearly you should have the form completed by your Primary Care Provider. Patients regularly evaluated by a sleep provider should submit DMV forms to the sleep clinic. Once the form is complete, it will be sent to the DMV directly.
Non-VA (Community Care)
For questions regarding timing of tests, scheduling of sleep studies or billing through the Non-VA (Community Care). Please contact them directly at 801-584-1259.
Travel Tips
Take your equipment with you when you travel as it may not be safe for you to drive if you are not using your machine every night. If traveling by air, you should take your equipment in a carry-on bag because it can be lost or damaged if checked. The Americans with Disability Act ensures that airlines do not count your CPAP unit and other medical equipment against your carry-on bag limit. Some international flights may require documentation of the medical need for the equipment so please check ahead with the airlines and airports you will use if traveling internationally.
*Always empty your water chamber before traveling with your CPAP.