The McFarland Clinic Sleep Medicine Department is dedicated to providing the highest quality medical care in a compassionate and cost-effective fashion.
Sleep physicians treat disorders affecting the regular sleep periods, which can affect daily work performance, physical and mental health, and can lead to serious accidents that may include injury and death.
Conditions We Treat
The sleep disorders service sees referrals for adult patients with conditions or symptoms that include:
- Obstructive sleep apnea, including positive airway pressure (PAP) management
- Parasomnias (undesired body movements associated with sleep)
- Periodic limb movements in sleep
- Restless legs syndrome
- Rapid Eye Movement Behavior Disorder
Locations & Hours
Medical Arts Building Office
1015 Duff Avenue
Ames, IA 50010
312 East Main Street
Marshalltown, IA 50158
HoursPlease contact the Neurology Department for information regarding hours and scheduling for this outreach clinic.
Tests available to help in the diagnosis of sleep-related issues include:
- A non-invasive, all night monitoring of a patient's sleep
- Variables routinely monitored are:
- Chin EMG (muscle activity)
- EEG (brain waves)
- EOG (eye movements)
- For sleep staging, ECG, nasal and oral airflow, respiratory effort, and oxygen saturation to address sleep-related breathing disorders
- EMG of the limbs to monitor for abnormal body movements such as periodic limb movements or REM behavior disorders
Multiple sleep latency testing
- Evaluates patients with suspected narcolepsy
- Objectively study patients who complain of daytime hypersomnolence
- This assesses sleep tendency by measuring the number of minutes it takes the patient to fall asleep.
PAP titration studies
- A non-invasive, all night monitoring of a patient's sleep with the use of positive airway pressure to maintain airway patency
- Beneficial to accurately assess treatment needs, mask fit, and adequacy of therapy
Home sleep apnea testing
The new home sleep test is an alternative to traditional testing in a sleep lab. In healthy subjects, it can be a comfortable option to complete in the home setting. Among other variables, the home sleep test records:
- Oxygen levels
- Heart rate
- Breathing effort
- Snoring decibels
Patients with the following conditions are NOT candidates for a home sleep study:
- Heart failure
- Atrial fibrillation
- Moderate to severe pulmonary disease
- Pediatric patients (under age 18)
- Central sleep apnea
- Periodic limb movement disorder
- Circadian rhythm disorders
Management options offered in the clinical setting include:
- Hands on evaluation of the machine and mask interface
- Data evaluation for adequacy of therapy
- In-clinic PAP modification to maximize adherence to therapy and comfort of treatment
Alternative OSA treatment strategies
Your sleep medicine provider will discuss all possible options for treatment of sleep apnea, including surgery, upper airway stimulation or oral device therapy.
Basic cognitive strategies are individually emphasized to restructure the sleep environment and encourage proper sleep hygiene.
In specific circumstances, short-term sleeping medications may be provided if cognitive, self-treatment is both adhered to and not effective.
Management of Limb Movements of Sleep, Restless Legs
Management of Narcolepsy and Hypersomnia
Understanding a Sleep Study
A sleep study (polysomnogram) charts your brain waves, heartbeat, and breathing as you sleep. It also records your eye and leg movements as well as muscle tension. Sensors are placed on your head, face, chest, and legs. They send tiny electrical signals to a computer.
The signals show when you are asleep and awake during the night. The brain-wave and eye movement help us determine the stages of sleep. The breathing monitors show the number of times you stop breathing. They can also detect low airflow and minor changes in oxygen level. The leg sensors show both minor twitches and major movements that occur during the night. A clip will also be placed on your finger to note changes in the level of oxygen in your blood.
A polysomnogram is often used in the following cases:
- To look for sleep-related breathing disorders, such as sleep apnea
- To set the correct levels of continuous positive airway pressure (CPAP) in patients with sleep-related breathing disorders
- To go along with a daytime nap study to see if someone has severe excessive daytime sleepiness
- To look for behaviors during sleep that can be violent or could be harmful to the patient or others
Preparing for the Test
You will be asked to come to the center in the evening. Some time will be given for you to make yourself at home in the bedroom. No other patients will be in the room with you. Should you feel you would need it, you will have to ask your ordering physician for a sleep aid as the technicians cannot provide them.
You will not feel any pain during the polysomnogram. The sensors are gently placed on your skin and connected to a computer. The wires are long enough to let you move around and turn over in bed. You will be asked to move your eyes, clench your teeth and move your legs. This will make sure that the sensors are working.
During the Test
You are free to read or watch TV until your normal bedtime. Then the lights are turned out and it is time for you to try to fall asleep. A low-light video camera allows a technologist to see you from a nearby room. He or she will have to enter your room if a sensor comes loose. He or she will also have to detach the wires if you need to go to the bathroom during the night.
The polysomnogram is not a test that you can fail. Nearly everyone falls asleep during the study. Most people do not sleep as well as they do at home. This will not affect the results. In most cases, you do not need to sleep for a full eight hours to find the source of your problem.
After the Test
In the morning you will test the sensors again, and then they will be removed. This will complete the study, and you will be free to go. You may be tired if you did not sleep well during the night. Otherwise, you can return to normal activities on the day after a sleep study.
Getting the Results
It usually takes about one week to 10 days to get the results of a sleep study. At times the doctor who takes a look at the study needs to get more information. He or she may talk to the technologist or to the doctor who sent you to the center.
STOP BANG Questionnaire
The STOP BANG Questionnaire is a tool assess risk of Obstructive Sleep Apenea (OSA). If you score 3 or greater, you should consider consultation with your doctor regarding sleep evaluation.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale is used to measure daytime sleepiness. It can be helpful in diagnosing sleep disorders. A score of greater than 9 is defined as excessive daytime sleepiness.
American Academy of Sleep Medicine
The AASM improves sleep health and promotes high quality, patient-centered care through advocacy, education, strategic research and practice standards.
CDC Sleep and Sleep Disorders
The CDC has information on sleep and sleep disorders including basic information, research and sleep management.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale is used to measure daytime sleepiness. It can be helpful in diagnosing sleep disorders.
Mary Greeley Sleep Disorders Center
Information about medical services for sleep and sleep disorders offered by Mary Greeley Medical Center.
MedlinePlus: Sleep Disorders
MedlinePlus from National Institute of Health is the world's largest medical library and has up-to-date information about sleep and sleep disorders.
National Sleep Foundation
The National Sleep Foundation is dedicated to improving health and well-being through sleep education and advocacy.