Sleep Issues

Sleep is when your body repairs, recharges, and regulates essential systems. When you are not sleeping well, your day-to-day functioning suffers, and over time, your long-term health can be put at risk. You might notice you are becoming more forgetful, snapping at loved ones, struggling to get through the workday, or reaching for caffeine and sugar to stay alert.

When insomnia becomes a regular part of your life, it can alter your mood, slow your cognitive function, and impact your physical and mental health. Chronic insomnia has been linked to a range of health concerns, including:

• High blood pressure and heart disease: Research suggests that insomnia can increase the risk of cardiovascular disease and high blood pressure. 
• Hormonal imbalance: Poor sleep can affect the regulation of hormones that control hunger and metabolism in your body. 
• Weakened immune system: Sleep plays a critical role in supporting your immune system. Sleep deprivation can affect your overall immune system and make your body more vulnerable to infections.
• Mental health conditions: Insomnia is closely intertwined with mental health issues, not only as a symptom but also as a contributing factor. It can often coexist with depression, and the cycle can feed itself. Poor sleep worsens mental health, and mental health struggles, in turn, make restful sleep harder.
• Reduced quality of life: Over time, persistent sleep problems can affect your relationships, work performance, and ability to enjoy everyday life.

At IMPCS, we take a whole-person approach to treating insomnia. Our approach considers your lifestyle, stress levels, and underlying health issues that can affect sleep.

We understand that sleep patterns and their associated challenges are unique to each person. In many cases, insomnia may be connected to other areas of your life and health. 

Here’s what you can expect during your visit.

• A review of your sleep patterns, daily routines, and sleep environment.
• An evaluation of any underlying health conditions that could be contributing to poor sleep, such as: 
  • Thyroid disorders
  • Chronic pain
  • Acid reflux
  • Sleep apnea
  • Mental health issues
• A discussion about your emotional well-being and stress levels.
• A review of your current medications for potential sleep-disrupting side effects.

Based on the evaluation, our provider will create a treatment plan that may include:

• Lifestyle and behavioral changes tailored to your habits and schedule. For example, limiting screen time before bed, setting a consistent sleep routine, and reducing stimulants like caffeine or alcohol.
• Support to address stress, racing thoughts, or anxiety that may keep you awake.
• Targeted medication, when appropriate, to help regulate sleep patterns without over-reliance on sedatives.
• Referrals to trusted mental health providers or sleep specialists if your insomnia is linked to mood disorders, trauma, or other such conditions.

Sleep apnea occurs when your breathing repeatedly stops and starts during sleep. These pauses can last for several seconds to a minute. Each interruption jolts your body out of deep, restorative sleep, often without you realizing it.

The most common type of sleep apnea is Obstructive Sleep Apnea (OSA), which occurs when the muscles in the back of your throat, including the soft palate, tongue, and surrounding tissues, relax excessively during sleep. These relaxed muscles cause your airway to narrow or collapse, making it difficult for air to flow into your lungs.

When airflow is blocked, your oxygen levels begin to drop, and your brain quickly senses this lack of oxygen. In response, it briefly wakes you up just enough to reopen the airway, usually with a choking sound, snort, or gasp. This awakening is typically so brief that you do not even remember it, but it disrupts your sleep cycle.

This pattern of airway collapse, oxygen drop, and sudden awakening can happen many times in a single night. Each episode prevents you from reaching or staying in the deeper, more restorative stages of sleep. Over time, this results in poor sleep quality, daytime fatigue, and increased strain on your body.

Certain factors and conditions that may increase your risk of sleep apnea include:

• Nasal congestion: Difficulty breathing through the nose due to allergies or chronic sinus issues can contribute to airway blockage. Conditions like rhinitis or sinusitis may cause inflammation in the sinuses, leading to congestion and pressure.
• Anatomical issues in the airway: Structural factors, such as enlarged tonsils or a deviated septum, can block airflow and interfere with normal breathing during sleep.
• Large neck circumference: A thicker neck means more soft tissue around the airway. This excess tissue can collapse and block the airway during sleep, increasing the risk of OSA. 
• Excess weight: While it may not always be the root cause, excess body weight can increase the risk of airway narrowing or obstruction. 
• Family history: A family history of sleep apnea or other breathing disorders may increase your risk of developing the condition.

At Internal Medicine & Primary Care of Sebastian, we provide accurate evaluation and personalized treatment for sleep apnea. We work closely with you to uncover the root of your concerns and create a care plan that fits your specific condition.

Your treatment begins with a detailed review of your symptoms, sleep habits, and health history. We conduct a physical exam to look for contributing factors, such as narrowed airways, nasal obstruction, or enlarged tonsils, that might be affecting your breathing during sleep.

If sleep apnea is suspected, we may recommend one of the following sleep studies:

• Home sleep study – A home-based test in which you wear a small device overnight in your own bed to monitor oxygen levels, breathing, and heart rate to detect abnormal breathing patterns.
• In-lab sleep study (Polysomnogram) – If more complex or unclear symptoms are present, we may refer you to a sleep lab for overnight monitoring. This test provides a more detailed view of your brain waves, oxygen levels, heart rate, and body movements throughout the night.

Based on the type and severity of your condition, your health history, lifestyle, and contributing factors we create a treatment plan tailored to your needs.

Lifestyle Modifications

For patients with mild sleep apnea, targeted changes can make a big difference. We work with you on strategies like adjusting sleep positions, avoiding alcohol or sedatives before bed, and establishing a consistent sleep schedule.

Addressing Underlying Conditions

Nasal congestion from allergies or chronic sinus conditions can worsen sleep apnea. We can diagnose and manage these issues using appropriate medications, nasal sprays, or other therapies. If needed, we may refer you to an ENT specialist for advanced care.

CPAP Therapy (Continuous Positive Airway Pressure)

For moderate to severe obstructive sleep apnea, CPAP therapy is often recommended. The device keeps your airway open during sleep by delivering steady air pressure through a mask. If CPAP is appropriate, we will coordinate your setup and follow-up care in collaboration with a sleep specialist.

Specialized, Coordinated, & Ongoing Care

Sleep apnea is often linked with other chronic health issues, such as high blood pressure, diabetes, or fatigue-related concerns. As your primary care provider, Dr. Pierre is in a unique position to manage these overlapping conditions and keep a close eye on how your treatment is working.

If your condition requires further attention, he can also connect you with the appropriate specialists, including:

• Pulmonologists - They can provide advanced evaluation and management for OSA.
• ENT Physicians - They can address structural anatomical issues, such as nasal obstructions or enlarged tonsils, that may be contributing to sleep apnea.
• Cardiologists - They can help address heart-related concerns that may be impacted by or contribute to sleep apnea.