Sleep Disorders Program

Overview

The Judy & Richard Voltmer Sleep Center of Hoag Neurosciences Institute has been studying and treating more than 5,000 patients with sleep disorders annually since its origins dating 20 years. The now five-yearold Voltmer Sleep Center was custom built with six private bedrooms to conduct sleep studies. Each room has a private bathroom and is designed to feel like a high-quality hotel. The diagnostic equipment is top-of-the-line technology from Care Fusion, which meets and exceeds the American Academy of Sleep Medicine guidelines. Sleep patterns can be evaluated throughout the night or day at the Voltmer Sleep Center. Physicians are sleep medicine specialists that can diagnose and treat various sleep disorders such as insomnia, narcolepsy, obstructive sleep apnea, periodic limb movement disorder/Restless legs syndrome, and REM sleep behavior disorder. The program also offers an outpatient behavioral treatment course for insomnia.

Program achievements include accreditation from the American Academy of Sleep Medicine.

Team

The Sleep Disorders Program is led by our Program Director Jose Puangco, M.D. The program has four additional board-certified sleep physicians giving patients a choice from five physicians with varying backgrounds, including anesthesia, pulmonary, and neurology specialists. Our team of physicians is supported by highly skilled polysomnography technologists.

Outcomes

The Judy & Richard Voltmer Sleep Center offers a six-week insomnia program. This program is designed to break the pattern of insomnia through cognitive behavioral therapy and teach participants coping techniques to alleviate their insomnia and improve quality of life. Participants are assessed through questionnaires in Week 1 and again on Week 6 to show the progress made with the program. The Insomnia Severity Index has seven questions asking the participants to identify how severe they feel their insomnia is in specific areas. Participants are also asked to report changes in average sleep time and rate their quality of sleep. On average, participants experienced an eight-point drop in the Insomnia Severity Index after participation in the program. Seventy-six percent of patients reported an increase in average sleep time per night with 96 percent reporting better sleep quality.

The clinic saw 1,521 new patients in consultation which was an 18% increase from last year and 3,654 returning patients. The clinic performed 508 diagnostic polysomnography studies, 539 polysomnography studies with titration and 473 home sleep studies which is an 11% increase from last year for all types of sleep testing.

In an effort to improve patient compliance with treatment, the sleep center continues the PAP nap program where patients meet one on one with a technologist. They are given a personalized mask fitting, instruction on operating the equipment and desensitization. There were 26 patients who completed a PAP nap with 97% of the patients reporting an increase in comfort using their prescribed equipment.

The sleep center has an average PAP compliance rate of 84.1%, which is a 2.5% increase from last year, and 30% higher than the long-term compliance rate reported by the Canadian Respiratory Journal.

Along with traditional methods of treating sleep disorders, the program has adopted new treatment methods. For the treatment of Obstructive Sleep Apnea, the Judy & Richard Voltmer Sleep Center is working in collaboration with local dentists to provide Matrx titration studies. This allows patients to experience success with oral appliance therapy in the sleep center prior to getting a permanent device. Another advancement is Dr. Puangco’s association with Inspire Medical and Dr. Eric Kezirian from USC giving patients a surgical option for the treatment of Obstructive Sleep Apnea. Additionally, the program has added Relaxis as a treatment option for Restless Legs Syndrome, giving patients the first nonpharmacological solution.

Support & Education:

The Judy & Richard Voltmer Sleep Center offers an Insomnia Support Group that meets on the first Wednesday of the month from 5 to 6 p.m.

As a member of American Sleep Apnea Association, the program offers a monthly AWAKE Sleep Apnea Support Group for CPAP users, which meets the last Tuesday of each month from 2 to 3 p.m.

The program has also hosted an annual sleep medicine symposium for polysomnography technologists to assist the local community with staying current on the latest technologies and research.

The following lectures were presented:

Puangco, J, “Dreams”, March 6, 2015, Hoag Annual Sleep Symposium, Hoag Hospital, Newport Beach, CA
Puangco, J, “Sleep Apnea”, March 2, 2015, Community Lecture Series, Hoag Hospital, Newport Beach, CA
Puangco, J, “Sleep Disorders”, Jan. 22, 2015, Community Lecture Series, Hoag Hospital, Newport Beach, CA
Puangco, J, “Inspire Therapy for OSA”, Sept. 24, 2014, Community Lecture Series, Hoag Hospital, Newport Beach, CA
Puangco, J, “Women and Sleep”, April 11, 2014, Community Lecture Series, Hoag Hospital, Newport Beach, CA
Puangco, J, “Medication effects on Sleep”, March 6, 2014, Hoag Annual Sleep Symposium, Hoag Hospital, Newport Beach, CA
Puangco, J, “Insomnia”, March 15, 2013, Advances in Sleep Medicine, Hoag Hospital, Newport Beach, CA
Puangco, J, “Sleep Apnea”, Jan. 30, 2008, Clinical Neurology News Podcast, UCLA/ West LA VA