Advanced Center for Sleep Disorders Established by Dr. Anuj Chandra

(March 29, 2006)–Practicing in his specialty as a Board Certified Sleep Specialist, Dr. Anuj Chandra saw the need for a new kind of sleep diagnostic center. After several months of planning and construction, the dream has come to fruition: the Advanced Center for Sleep Disorders is now up and running. The new facility is a comprehensive sleep diagnostic center built in a former home to give patients a familiar and comfortable environment while they are being tested with state-of-the art technology.

The Center began taking patients in December 2005. Dr. Chandra held a grand opening celebration in March 2006, during National Sleep Awareness Week. During this week, Dr. Chandra began a campaign to raise community awareness of sleep disorders in Chattanooga and surrounding areas.

First, the Center offered free screening for sleep disorders when it hosted two open houses in March at the Center. Then the following month, Dr. Chandra initiated a series of seminars on sleep disorders, beginning with seminars on “Snoring and Sleep Apnea, the Not So Silent Killer.”

“I want to make Chattanooga the best-slept city in the nation,” said Dr. Anuj Chandra, founder of the Center. “There is a growing awareness that sleep disorders are a medical issue that may need to be treated before they cause more serious problems, like stroke and heart disease. But many people are uncomfortable with the idea of trying to sleep when they are hooked up to diagnostic equipment, and then going to work the next day. This facility is designed in a unique way to address that issue.”

The Center is located at 6073 East Brainerd Road in a former three-bedroom house. The building has been renovated extensively for its new life as a comprehensive sleep disorder diagnostic center. Two bedrooms had new interior walls built with several inches of insulation to eliminate light and noise from outside. These rooms are furnished and decorated as bedrooms would be in a home. Each room has an adjustable bed and an attached bathroom. The only visible differences are connections to monitoring equipment located in another room — including electrocardiogram and electro-encephalogram, as well as equipment to monitor breathing and muscle activity — and a video camera for visual monitoring.

“Many people think snoring or daytime sleepiness are just inconveniences that they have to live with,” said Dr. Chandra. “But they could lead to heart disease, stroke, high blood pressure, or other serious disorders. Good sleep is as necessary to life as good nutrition and exercise. When sleep suffers, the entire body pays a price, just as it does when the body is malnourished. If you snore and are tired and sleepy during the day, then you should consider seeing a board certified sleep specialist to see if you have a more serious problem.”

As a Board Certified Sleep Specialist, Dr. Chandra is in a growing but still relatively small medical specialty. There are only about 3,300 board certified sleep specialists in America (American Board of Sleep Medicine), compared to over 16,000 cardiologists (American College of Cardiology) and about 94,000 family physicians (American Academy of Family Physicians).

How Sleep Testing Works

After an initial consultation with a sleep specialist, sleep diagnostic testing is one of many possible tests that can be considered for making a complete diagnosis. Dr. Chandra explained how the testing process works, using the Advanced Center as an example.

Patients usually arrive at about 7:30 or 8 p.m., early enough to relax and unwind so their sleep is as natural as possible. Dr. Chandra will usually visit in the evening to be sure the patient is comfortable. The patient will go to bed at his or her normal time, and the center’s technician will connect the monitoring equipment, explain what everything is for, and be sure the patient is comfortable with the equipment. The technician will also ask the person to do a few movements — snore, kick, and roll over, for example — to be sure the instruments are registering accurately before the patient goes to sleep.

As the patient sleeps, the technician will be watching on the video monitor and scoring the readings from the testing equipment. If the person needs to use the bathroom, he or she can press a buzzer to have the technician come and unhook the equipment. In the morning, patients usually get up and go to work directly from the Center. Each testing room has an attached bath, so the person can go through their morning routine there, rather than going home first.

What Happens After Testing

If test results show that treatment is needed, a second night at the Center may be required to confirm that the prescribed treatment method works for the patient. For a diagnosis of sleep apnea, for example, it is quite common to prescribe treatment by Continuous Positive Air Pressure (CPAP), in which the person sleeps wearing a mask connected to a small machine that pushes fresh air into the mouth and nose continuously.

According to Dr. Chandra, someone with sleep apnea has decreased breathing while they are asleep, and may actually stop breathing very briefly many times during the night. The result is less oxygen to the brain, which in turn can cause other problems. By gently pushing through fresh air, the CPAP treatment keeps the airway open continuously, allowing much needed oxygen to reach the lungs.

“Although sleeping while wearing a mask sounds a little strange, CPAP treatment has proven to be extremely effective in treating sleep apnea,” said Dr. Chandra. “But before prescribing CPAP, it’s very important to be sure that this particular treatment works for each person and that they are treated at the right pressure. That’s what the second night is for.”

“I should also point out that not all snoring is sleep apnea, and everyone with sleep apnea does not stop breathing,” he added. “We need the test results to make a diagnosis and prescribe the right treatment.”

According to Dr. Chandra, other diagnoses that might result from sleep testing include seizures, REM behavior disorder (in which dreams are accompanied by violent behavior), narcolepsy, shift-work sleep disorder, circadian rhythm disorders (in which the wake-sleep cycle is disturbed), and a condition called sleep state misperception (in which people who get adequate sleep feel like they haven’t rested at all).

According to the National Sleep Foundation:

• About 40 million adults suffer from a chronic sleep disorder, and 20-30 million more have intermittent sleep-related problems.
• People with untreated sleep apnea are two to three times more likely to have car accidents than the general population.
• People with high blood pressure may increase their risk of heart attack or stroke if they don’t get adequate sleep.
• Shift workers are 30-50 percent more likely to develop heart disease than day workers in the same industry.

Dr. Anuj Chandra has practiced medicine for 10 years in the north Georgia/Chattanooga area. He is board certified in sleep medicine by the American Board of Sleep Medicine and board certified in internal medicine from the American Board of Internal Medicine. After graduating from the University College of Medical Sciences in New Delhi, India he completed his internship and residency in internal medicine at the University of Connecticut. He also did a fellowship for one year at the University of Utah Medical Center in Salt Lake City. Dr. Chandra has continued his studies in sleep medicine through Stanford School of Sleep Medicine, Atlanta School of Sleep Medicine, and the American Academy of Sleep Medicine.