downloads/Sleep Disorders Center Referral Form (201706).pdf

PROVIDER'S QUICK GUIDE
Goshen Sleep Disorders Center

To refer a patient:

(574) 364-2400

2067 Dorchester Ct.
Goshen, IN 46526
Fax: (574) 364-2752
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Goshen Sleep Disorders Clinic

Goshen Sleep Disorders Center offers comprehensive diagnosis and treatment of sleep disorders, including sleep apnea and narcolepsy, movement disorders and insomnia.

Our Services

Specifically, we perform a variety of polysomnographic procedures (sleep studies) to assist in the diagnosis and treatment of more than 80 sleep disorders existing in six categories:

• Insomnia
• Sleep related breathing disorders
• Hypersomnia disorders
• Circadian rhythm sleep-wake disorders
• Parasomnias
• Sleep related movement disorders

Sleep Disorder Symptoms

• Daytime sleepiness in general, or also brief, yet sudden sleepiness during or surrounding activities
• Reduced or failed response to medications and treatment plans for comorbid conditions.
• Reduced or failed response to medications and treatment plans for comorbid conditions.
• Difficulty going to sleep; remaining asleep; sleeping as long as the patient feels they should or need to; or unrefreshing sleep
• Restless sleep
• Snoring and/or breathing cessation noted by bed partner or others
• Waking choking, gasping or short of breath
• Morning headaches
• Depression, moodiness or irritability
• Fatigue or lack of energy despite patient’s belief of adequate sleep or time in bed
• Trouble concentrating and/or memory problems
• Abnormal or unexpected behaviors during sleep, i.e., sleepwalking, night terrors/nightmares, sleep eating, sleep talking
• Nocturnal seizures
• Sexual dysfunction
• Bedwetting

Procedures Include

• Diagnostic polysomnography – Standard sleep study
• Titration studies – The application and adjustment of positive airway pressure therapy to quantify treatment
• Mean sleep latency test (MSLT) – A procedure to help confirm or rule out narcolepsy and clarify other areas to investigate regarding hypersomnia
• Maintenance of wakefulness test (MWT) – Measurement of the patient’s ability to remain alert and awake for a period of time in a quiet, relaxing, stimulation-free environment. Value and need of this test is most often associated with the transportation industry or where public safety is of paramount importance.
• Home sleep apnea test (HSAT) – A procedure narrowly focused on a few indicators of obstructive sleep apnea specifically. Unattended (self-administered), and due to limited data and focus, it is inappropriate in the presence of some comorbidities and in the presence or suspicion of other undiagnosed or untreated sleep disorders. As with all polysomnography, interpretation by a sleep specialist (a provider boarded in sleep medicine) is required by CMS and most, if not all third party payors
• In addition to suspected sleep concerns, we often discover, confirm or quantify comorbid or confounding conditions, e.g., nocturnal seizure activity, cardiac dysrhythmias, and sleep related phenomena not otherwise established
• Treatment recommendations tailored to the patient’s specific needs
• Easy access for referring providers, including prompt communication and collaboration

Treatment Options

• Positive airway pressure (CPAP or continuous positive airway pressure)
• Changes in sleep habits, schedules and conditions
• Dental devices
• Exercise programs
• Medication (over-the-counter and/or prescription)
• Modifications of consumption habits, such as eating, drinking alcohol and smoking
• Stress management
• Weight-loss programs
• Surgical restructuring of airway
• Identification and treatment of comorbid conditions

Referring a Patient

Direct referral to the Sleep Disorders Center for a study

• Download referral form, fax requisition with name of procedure, including ICD-10 code and suspected diagnosis
• History and physical/notes resulting from a face-to-face evaluation
• Preauthorization/certification
• A copy of the patient’s benefits card(s)
• Please include other helpful information regarding special needs or conditions, i.e., caregiver to accompany and assist patient, communication issues, cognitive or emotional concerns, mobility issues

Accreditation

Goshen Sleep Disorders Center lab holds accreditation by the American Academy of Sleep Medicine and is a member of the National Sleep Foundation.