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Why Come to an Accredited Sleep center?

The confidence that the highest of care is being demonstrated and most skilled physicians are caring for patients.

A clean, comfortable environment where patient dignity and safety are upheld.

The Center adheres to strict evidence based practice parameters.

The assurance of a knowledgeable and trained staff.

A Diplomat of the American Board of Sleep medicine program.

The staff continually updates their knowledge of sleep medicine by taking part in professional activities with Continuing Medical Education credits.

The facility has relationships with hospitals and appropriate clinical specialties.

The staff educates and informs the local community about sleep disorders .


SLEEP CENTER or SLEEP LAB: What is the Difference?

SLEEP CENTER: Provides comprehensive evaluations and treatment of ALL sleep disorders, including , Sleep Apnea, Other breathing disorders, Periodic Leg Movements, Narcolepsy, Insomnia, Parasomnia and Epilepsy.

SLEEP LAB: Evaluations are limited to only breathing disorders.


What does Accreditation Mean?

Accreditation is the process a Sleep Disorders Center must voluntarily undergo to demonstrate that it has met all requirements that are developed by the American Academy of Sleep Medicine (AASM).

AASM accreditation standards are developed by Diplomats of the American Board of Sleep Medicine.

A Diplomat of the American Board of Sleep Medicine is Medical Director.

When a sleep facility is accredited by the AASM, it must continually maintain performance that meets or exceeds accreditation standards.

The Accredited Sleep Center is among a minority of sleep programs in the nation that comply with the high standards of care required by the AASM.


What is the American Academy of Sleep Medicine?

The AASM is a professional medical association representing practitioners of sleep medicine and sleep research.

AASM is the major accrediting body for sleep disorders centers.

The AASM is dedicated to the assurance of quality care for patients with sleep disorders, advancement of sleep research, and public and professional education.

The AASM’s primary services to sleep disorders facilities are through accreditation.


How is Accreditation Granted?

Center must establish compliance with the AASM-Standards for Accreditation.

AASM-accreditation takes a full year to complete.

The accreditation process consists of the following steps:

1. Submission of detailed application including quality assurance data

2. AASM-Board of Directors decides whether the application qualifies for a site- visit, or rejection

3. Site-Visit conducted by AASM-Board of Directors

4. Site-Visit report reviewed by AASM-Board of Directors

5. Recommendation to grant accreditation, or not

6. Awarding of accreditation by AASM Board of Directors, for 5 years at a time.

Maintaining accredited status requires regular review by the AASM.

The Accreditation Standards are continually revised and updated in order to ensure the highest quality of patient care in sleep facilities.


What is a Sleep Test?

POLYSOMNOGRAM (PSG): This is the most common sleep test. During the PSG, there is continuous monitoring of brain activity, breathing and of leg movements during sleep. This test allows the sleep specialist to diagnose the more common problems of sleep such as apnea and periodic leg movements.

The testing is painless. Small surface electrodes are placed on the head, chest and legs, and monitors over the nose, throat and chest wall. You will be allowed to sleep at your own schedule and routine and the technician will monitor the recordings, including using infrared cameras, from an adjacent area during the entire night. The study will conclude the next morning at about 6 a.m. The technician will be reachable by two-way intercom, and will be readily available should you need any assistance. Typically, one technician monitors two patients at night. However, at times there is only one patient; and should gender selection be a concern, we will reschedule your study.


How do you prepare for the test?

It is recommended that you eat a meal prior to your arrival at the Clinic. You should continue to take all your medications as prescribed. However, all beverages and foods containing caffeine (tea, coffee, soft drinks and chocolate) should be avoided after midday on the day of the study. You should also avoid taking any naps or consuming alcohol on the day of the test.


Shower and shampoo your hair.

Avoid using anything on your hair, including gels.

Avoid jewelry, makeup and body lotions.

Do not wear acrylic nails, at least on one finger.

Pack your sleepwear and toiletries.

Bring your reading glasses, if applicable.

Bring your favorite pillow/blanket, if needed.

Bring reading material or other items that can help you pass time before bedtime.

You may also bring a snack.

Finally, pack as you would for an overnight hotel stay.


What is a CPAP Test?

CPAP TITRATION ANALYSIS: If there is evidence for significant sleep apnea, you will be called back for continuous positive airway pressure (CPAP) titration analysis. This involves placing a mask over the nose and blowing in air at pressure to help prevent snoring and apnea. The pressure is gradually titrated upward to ensure that the right settings for the individual are determined.


What is a MSLT Test?

MSLT: The multiple Sleep Latency Test (MSLT) is carried out during the daytime and assesses the rapidity with which an individual falls asleep. This test is useful when studying the reasons for excessive daytime sleepiness, in particular for narcolepsy.


What is a MWT Test?

MWT: Maintenance of Wakefulness Test (MWT) helps to determine how well an individual can resist falling asleep. MWT is helpful in determining whether an individual is safe, from a sleep perspective, to drive or pilot an aircraft.


What is Sleep Apnea?

SLEEP APNEA: In this condition there is an obstruction to the flow of air (and oxygen) during sleep resulting in poor night time sleep and consequent daytime sleepiness. Uncontrolled sleep apnea may contribute to elevated blood pressure, and an increased risk of stroke and heart attack.


What are the health risks of uncontrolled sleep apnea?

Elevated blood pressure.

Increased risk of stroke.

Increased risk of heart attack.

Traffic accidents and death.


What is Periodic Leg Movement Disorder?

PERIODIC LEG MOVEMENTS: Frequent disruptive leg movements during sleep resulting in a fragmented sleep pattern. Oftentimes, periodic leg movements are associated with restless leg syndrome or an inability to sit still.


What is Narcolepsy?

NARCOLEPSY: This manifests with an intense uncontrollable urge to sleep or nap during the daytime, and is typically associated with attacks of cataplexy when there is a sudden loss of muscle tone resulting in falls that are precipitated by intense emotions such as laughter and anger.


What is REM-Behavioral Disorder?

REM BEHAVIORAL DISORDER (RBD): This typically occurs in older people who may describe elaborate and vivid dreams. The dream content often involves attempts to resist an attack or attempts to flee from danger, and there is enactment of dream content. Patients have been known to jump out of windows in an attempt to escape a burning home!

NOCTURNAL EVENTS & EPILEPSY: Unusual events during sleep include sleep walking, terror attacks, nightmares, and seizures.

How do I Register or make an Appointment?

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Electroencephalogram (EEG)

EEG Is used to investigate for abnormal electrical signals arising from the brain. The test is oftentimes needed to evaluate symptoms such as fainting or black out spells, seizures and epilepsy.



For more information visit:

Understanding Epilepsy

Read more about EEG

Forms: EEG Test Preparation


Electromyography/Nerve Conduction Study (EMG/NCS) is a test used to investigate symptoms such as numbness, tingling, weakness and back/neck/limb pains. The test measures the electricial activity in muscles and nerves, and helps determine if there is damage to these structures. EMG/NCS is usually done if there is a suspicion of carpal tunnel syndrome, a pinched nerve in the neck or back, nerve damage in the feet as in neuropathy, or for muscle damage as in myopathy.


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Read more about EMG/NCS

Forms: EMG Test Preparation


Evoked Potentials (EP)

EP studies are used to study disorders such as multiple sclerosis. The test measures the generation and tansit of electrical impulses along the visual, hearing and sensory pathways in the brain and spinal cord.


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Read more about Evoked Potentials


Transcranial Doppler

TRANSCRANIAL DOPPLERS (TCD) TCD studies utilize ultrasound and Doppler techniques to assess for narrowing or stenosis in the arteries carrying blood to the brain. These tests are usually needed during evaluation of stroke and transient ischemic attacks (TIA).


For more information visit:

The TCD Machine

Read more about TCD

Read about Carotid Doppler Study

Forms: TCD Test Preparation


Computerized Tomography (CT)

The test is carried out to study for abnormalities in the head and spine. The technique utilizes small amounts of x-rays to generate three dimensional pictures of the head, including the skull, brain, spine and spinal cord. CT scans are very helpful to exclude sudden or acute problems, such as bleeding in the brain, or fractures of the skull or spine. Sometimes, an iodine-based contrast dye is administered to enhance the ability of detecting abnormalities. The procedure is relatively quick and is typically done in the emergency room.


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Read more about CT

Read about CT-Angiogram (CTA)


Magnetic Resonance Imaging (MRI)

Like CT, MRI is also used to study the brain and spinal cord. However, MRI provides much more detailed information of the intricate structure of these organs. Unlike CT, the technique of MRI utilizes changes in the body’s own magnetic properties to generate remarkable pictures of the inside of the nervous system. There is no radiation or x-ray involved in MRI studies. Sometimes, a special iron-based contrast dye is administered to enhance the ability of detecting abnormalities. Not all MRI machines are the same. The best results are obtained when the procedure is carried out in a high strength (1.5 Tesla or higher) narrow bore machine. Open MRI studies typically utilize less powerful MRI machines and the quality of the pictures are not as detailed as that obtained from high strength machines.


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View MRI Images

Read more about MRI


Magnetic Resonance Angiogram (MRA)

MRA is carried out to study the blood vessels of the brain. The blood vessels in the neck carrying blood to the brain are called the carotid and vertebral arteries, and the network of arteries inside the brain is referred to as the Circle of Willis. Like MRI, MRA also utilizes changes in the body’s own magnetic properties to generate pictures of the blood vessels. Sometimes, it is necessary to study the blood vessels draining blood from the brain, called veins, using a technique called magnetic resonance venogram (MRV). Typically, MRI and MRA studies are done at the same time.



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Read more about MRA


Myelogram is a procedure carried out to study for changes in the spine and nerve roots. This procedure is typically done in patients with back and neck pain, and is carried out under fluoroscopy or x-ray control. Under local anesthesia, a needle is inserted in the low back between the spinal bones, the sac containing spinal fluid is entered, and contrast dye placed within the sac. Thereafter, x-rays and CT scans of the spine are taken from different angles.


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Read more about Myelogram



Catheter Angiography

Angiography is the gold standard to study the blood vessels supplying the brain. The procedure involves placing a catheter, usually through a small incision in the groin, in the blood vessels leading to the brain. Thereafter, contrast dye is injected into these blood vessels. As the dye flows through the arteries and veins of the brain, sequential x-rays are taken. Typically, this test provides exquisite pictures of the blood vessels going and coming from the brain.


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Read more about Angiogram


Lumbar Puncture (Spinal Tap)




The procedure is carried out to obtain a sample of spinal fluid, also called CSF or cerebro-spinal-fluid, for testing. The CSF is produced by specialized blood vessels in the brain, and it functions to help protect and maybe even partially nourish the brain and spinal cord. The fluid is located in a sac that is closely applied to the entire surface the brain and spinal cord, but within the skull and bony spine. Normally, the fluid is constantly circulating between the brain and the spinal canal, and is then released into the draining blood vessels. It is believed that CSF is continuously being produced and removed, such that it is turned around several times daily.

Often times, diseases of the brain and spinal cord, such as infections and multiple sclerosis, cause changes that can be detected in the CSF. Therefore, study of the spinal fluid provides an opportunity to diagnose such conditions without actually having to take a sample of brain tissue. In some other conditions, such as pseudotumor cerebri, there is excessive production of CSF, and its removal may be necessary to provide relief.

The procedure is carried out under local anesthesia. A needle is carefully inserted between the bones in the low back into the sac that contain the spinal fluid. The fluid trickles, drop by drop, and is collected for testing. In order to help replenish the fluid and to help the wound heal, patient’s are advised to lie flat on their back for several hours after the procedure.

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Read more about Spinal Tap

View Lumbar Puncture Images

Forms: Spinal Tap Part I

Spinal Tap Part II


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Rajiv Joseph MD PA
7920 Preston Road, Suite #100
Plano, TX 75024
Phone: 972-712-4141
Fax: (972) 712-4555

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