Sengkang General Hospital’s Sleep Medicine clinic is one of the key clinical sites of SingHealth Duke-NUS Sleep Centre. The department provides specialised diagnosis and management of a wide range of sleep disorders. Our mission is to provide the highest standard of clinical care, to educate future generations of clinicians dedicated to sleep and circadian medicine, and to advance collaborative clinical research in the fields of sleep and circadian medicine.
Each member of our Sleep Medicine clinic provides consultation and care for patients affected by wide-range of sleep disorders such as sleep apnea, snoring, insomnia, narcolepsy, REM sleep behavior disorder, NREM parasomnia, restless leg syndrome and circadian rhythm disorders. The Sleep Medicine team is helmed by a multi-disciplinary team of ENT surgeons, pulmonologists, neurologists, psychiatrists and psychologists dedicated to the specialised diagnosis and management of various sleep disorders. By gathering our physicians together from different departments, we are able to maximise the experience and knowledge of our staff to deliver dedicated specialised management of your specific sleep condition.
Our Sleep Medicine Clinic offers comprehensive evaluation and treatment of sleep such as:
Sleep disordered breathing refers to a spectrum of conditions characterised by abnormal breathing during sleep. This can range from mild simple snoring to
obstructive sleep apneas to other conditions causing abnormal breathing patterns during sleep.
These disturbances in breathing can result in significant disruptions to sleep, resulting in impairment in daytime function and can lead to medical consequences. Sleep disordered breathing conditions managed at our sleep clinic
Insomnia is one of the most common sleep conditions in the general population and can affect people of all age groups. For some, it means difficulty in falling asleep. For others, it can be a struggle to stay asleep with frequent awakenings in the night, problems getting back to sleep or waking up too early in the morning with unrefreshing sleep. This inadequate or poor quality sleep can interfere with normal daytime functioning. There are many causes of insomnia. It can be due to a single trigger or result from a combination of factors. Causes can range from psychological, lifestyle and environmental factors to associations with underlying psychiatric conditions or physical health problems. At our sleep clinic, we have a dedicated specialised team providing a thorough evaluation of the insomnia. Treatment will be individualised to the underlying causes of the insomnia and will involve a holistic combination of cognitive behavioural therapy and medication approaches.
Periodic Limb Movements in Sleep (PLMS) are repetitive involuntary brief twitching movement of the legs (occasionally involves the arms too) during sleep. On its own, this is not a serious condition but it is clinically significant if it causes sleep disturbances leading to insomnia and daytime fatigue.
Restless Leg Syndrome (RLS) is a condition characterised by recurrent irresistible urge to move the legs (sometimes arms and trunk) and is often associated with uncomfortable and unpleasant sensation in the legs. 80% of RLS patients have PLMS.
Both RLS and PLMS can cause sleep initiation insomnia and sleep maintenance insomnia respectively. The exact causes of RLS and PLMS are unknown but they are linked to conditions like iron deficiency, chronic kidney disease and certain medications and neurological conditions. Management involves diagnostic workup to identify and treat the underlying associated conditions, avoiding medications that can aggravate as well as implementing lifestyle measures. Occasionally, symptomatic medication treatment may also be initiated.
Hypersomnolence refers to the inability to stay awake during the major awake period of the day and falling asleep at inappropriate times. Hypersomnolence goes by a number of other names, including
excessive daytime sleepiness, excessive daytime somnolence, and hypersomnia. It is a prevalent condition. Common causes include
sleep deprivation, lifestyle factors, medications, sleep-wake cycle disturbances (such as shift work), medical and psychiatric conditions as well as disorders affecting sleep (obstructive sleep apnea
narcolepsy, restless legs syndrome, periodic limb movement disorder. It is important to identify and treat the underlying causes appropriately. Comprehensive evaluation will be conducted at our sleep clinic to facilitate diagnosis and treatment will be directed to the identified specific causes.
Parasomnias are a broad group of disorders causing abnormal behaviours, movements or experiences that disrupt sleep. They occur in association with sleep, in specific sleep stages or in sleep-wake transition phases. The normal sleep is divided into NREM (Non-Rapid Eye Movement) sleep and REM (Rapid Eye Movement) sleep. Parasomnias can be divided into NREM-related parasomnias and REM-related parasomnias according to the stages of sleep at which the complex abnormal behaviour happens.
NREM-related parasomnias are disorders of arousals from sleep which include confusional arousals,
sleep terrors, sleep talking and sleep-related eating disorders. These are generally more common in children and adolescents than adults.
REM-Behaviour Disorder (RBD) is an important REM-related parasomnia commonly seen in elderly patients. Violent and dream enacting behaviour are observed during sleep. This can cause injury to self or to the bed partners. RBD can be associated with neurodegenerative conditions and detailed consultations to look out for these associated conditions is required.
Diagnostic polysomnograms will be performed at our sleep unit to evaluate these parasomnias and to rule out other sleep disorders. Identification and avoidance of precipitating medications is important in the management as well as ensuring safety precautions in the sleep environment. NREM parsomnias are often managed with lifestyle modifications of good sleep hygiene, avoiding sleep deprivation, avoiding stimulants and avoidance of precipitating medications. In selected cases, medications may be initiated for treatment of both
NREM and REM-related parasomnias.
The circadian rhythm is commonly known as the “body clock”. It is an innate cyclical rhythm that automatically regulates many bodily functions throughout the day and the sleep-wake cycle is one example. It is important that we keep to a regular sleep schedule to maintain synchrony of the “body clock” with the demands of our social activities. Any situation that causes disruptions to this synchrony will result in problems with sleep and difficulties in maintaining alertness. Common causes are jet lag, shift work and circadian rhythm disorders.
Consultation at our sleep clinic will include detailed evaluation of the underlying cause to provide an individualised treatment plan. Management options include optimising sleep hygiene with lifestyle and behavioural modifications, timed bright light exposure therapy with special phototherapy device and timed melatonin administration.
Our team of sleep specialists are qualified and experienced in a wide range of sleep conditions and will strive to give you personalised and holistic treatment for your sleep problems. To see if we can help you, get in touch with our sleep medicine clinic today.
Our Sleep Laboratory is well equipped with a comprehensive range of both inpatient and ambulatory sleep studies to evaluate your sleep conditions. Sleep studies are performed by our professional team of sleep technologists and include the following:
OSA is a condition when the upper airway is repeatedly obstructed either partially or completely during sleep. This leads to snoring and recurrent pauses or reduction in breathing. This disruption can cause a drop in blood oxygen levels and interfere with sleep. Symptoms of OSA include loud snoring, night-time breathing pauses and excessive daytime sleepiness despite adequate sleep. Sleep studies are necessary for diagnosis of OSA. They are generally divided into inpatient and outpatient studies. An evaluation by doctor is required to determine which sleep study is suitable for you.
A breathing assistance medical device called Continuous Positive Airway Pressure (CPAP) is the gold standard effective treatment for OSA. The CPAP therapy works by quietly delivering gently pressurised air to your airway via a mask. This keeps your airway continuously patent and allows you to breathe easily during sleep. Other treatment strategies include weight loss,
surgery, oral appliance therapy and positional therapy.
Narcolepsy is one of the causes of excessive daytime sleepiness and can greatly affect a person’s quality of life. It is characterised by overwhelming daytime sleepiness despite adequate sleep and sleep attacks, causing patients to fall asleep unexpectedly at inappropriate time and places. Diagnosis requires a detailed medical history and physical examination and this is followed by Polysomnogram (PSG) and Multiple Sleep Latency Test (MSLT). Symptoms can be managed with lifestyle modification and medications.
Insomnia is one of the most common sleep conditions in the general population and can affect people of all age groups. For some, it means difficulty in falling asleep. For others, it can be a struggle to stay asleep with frequent awakenings in the night, problems getting back to sleep or waking up too early in the morning with unrefreshing sleep. This inadequate or poor quality sleep can interfere with normal daytime functioning.
Episodes of insomnia that last a few days to a few weeks at a time are called transient and short-term insomnia respectively. Chronic insomnia lasts for a month or longer.
There are many causes of insomnia. It can be due to a single trigger or result from a combination of factors. Causes can range from psychological (such as stress), lifestyle (such as caffeine, nicotine and alcohol consumption, shift workers) and environmental factors (such as noise, temperature changes, excessive light) to associations with underlying psychiatric conditions (such as depression, anxiety) or physical health problems (wide range of medical conditions such as acid reflux, thyroid conditions, chronic pain, heart failure, respiratory disorders) or medications that interfere with sleep.
You may need to visit our sleep medicine specialist to find out what's causing your insomnia. It will be helpful to bring a record of your sleep patterns.
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