Most people think a sleep problem looks like one thing: loud snoring and a partner elbowing you in the ribs. But snoring is only one clue, and there are dozens of sleep disorders. Many of them show up in ways you would never connect to sleep. A sleep study is how doctors sort them out. 

Sterling Malish, MD, is a quadruple board-certified specialist in pulmonary disease, critical care and sleep medicine, with sleep medicine fellowship training at the University of Michigan.  

“Patients come in convinced they’re just getting older, and what they really have is a treatable sleep disorder,” Dr. Malish said. “I have seen how much changes once people get an answer. No one should wait months for that. My goal is to get a sleep study scheduled within a week of your first appointment with me.” 

Symptoms that surprise people 

Sleep trouble often hides behind daytime problems. Tell your doctor if you notice: 

• Loud snoring. 

• Waking up gasping or breathing pauses while asleep. 

• Morning headaches, a dry mouth or waking up several times a night to use the bathroom. 

• Trouble focusing or difficulty concentrating. 

• Memory slips or falling behind at work. 

• Mood changes, irritability, anxiety or feeling depressed. 

• Falling asleep at red lights, in meetings or in front of a screen even after a full night in bed. 

• Lying awake for an hour or more or waking in the middle of the night and not getting back to sleep. 

• An aching, crawling or creeping feeling in your legs at night that only walking seems to fix. 

• Sudden muscle weakness when you laugh or get upset or being unable to move for a few seconds as you wake up. 

• Shouting, kicking or punching in your sleep, sometimes acting out a dream you clearly remember. 

What a sleep study can find 

• Obstructive sleep apnea, where breathing stops and starts many times a night. It affects nearly 30 million Americans, and about 80% of them have never been diagnosed according to the American Academy of Sleep Medicine. 

• Insomnia, meaning ongoing trouble falling asleep, staying asleep or getting good-quality sleep even when you have the time and a quiet room. 

• Restless legs syndrome, an urge to move the legs along with uncomfortable sensations that get worse in the evening and ease when you move. 

• Narcolepsy, which brings sudden sleep attacks, sleep paralysis and sometimes cataplexy, a brief loss of muscle control triggered by strong emotion. 

• REM sleep behavior disorder, in which people physically act out vivid dreams. It affects fewer than 1 in 100 people and shows up most often in men after age 50. 

Why the sleep study is worth doing 

Poor sleep is not just an inconvenience. Untreated sleep apnea raises the risk of high blood pressure, heart attack and stroke. It can also increase the risk of diabetes. Sleep apnea is more common among Hispanic, Black and Native American adults. Restless leg syndrome and insomnia impact memory, concentration and mood over time. Sleep disorders can make you less alert and raise your chance of having a car accident. Most of these conditions respond well to treatment once they are correctly identified. 

What to expect during a sleep study 

The vast majority of our sleep studies are done in the convenience of your own home. You’ll be given sensors that measure your airflow, breathing and oxygen levels. It’s as simple as putting on a watch, a belt and an airflow sensor (canula). 

There are no needles and nothing hurts. You can read before bed and you can get up to use the bathroom. In the morning, the sensors come off. Later, you meet with your doctor to review the results and talk about treatment. Occasionally, more information is needed, and we’ll do a sleep lab study. 

Ready for real rest? Ask your primary care provider for a referral to Natividad’s D’Arrigo Family Specialty Services for an appointment with Dr. Malish.