CHOC Sleep Center Receives American Academy of Sleep Medicine Accreditation

CHOC Children’s Sleep Center has recently received a five-year accreditation from the American Academy of Sleep Medicine (AASM) for both Orange and Mission campuses, demonstrating CHOC’s commitment to the highest quality of patient care.

Accreditation by the AASM is the gold standard by which the medical community and the public evaluate sleep medicine facilities. CHOC joins an elite group of centers nationwide who have met the AASM’s rigorous standards in safety, patient evaluation and care, staffing and education, policies and procedures, quality improvement, facility and equipment, among other standards which incorporate the latest advances in sleep medicine.

“We are thrilled for this distinction. Our entire team is dedicated to the highest standards of care provided in our two state-of-the-art facilities, where patients and their families can have confidence that they are receiving quality diagnostics,” says Teresa O’Sullivan, CHOC’s director diagnostic and rehabilitation services.

CHOC’s sleep center focuses on identifying the physical or behavioral factors that affect sleep, from obstructed airways and breathing issues, to conditions including apnea and narcolepsy. The program’s mission is to help patients and their families understand a child’s sleep disorder and provide specialized treatment, sleep studies and close follow-up care.

The center’s multidisciplinary team includes board-certified pulmonologists, sleep medicine specialists and neurologists, as well as psychologists and specially trained sleep technologists.

CHOC Orange currently performs more than 950 sleep studies a year at its three-bed center, while CHOC Mission, which opened in fall 2014, performs more than 720 sleep studies a year in its three-bed center.

Learn more about CHOC’s pediatric sleep center services.

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In the Spotlight: Neal Nakra, M.D.

Dr. Neal NakraAs medical director of the CHOC Children’s pediatric sleep program, Dr. Neal Nakra is examining sleep study data to further analyze the relationships between sleep and obesity, metabolic syndrome and other pediatric conditions.

Dr. Nakra’s initial interests in sleep medicine deepened during his pulmonary medicine fellowship at Yale-New Haven Hospital, in Connecticut. Already well aware of the respiratory issues associated with obesity, his research found that the presence of obstructive sleep apnea was associated with obesity and markers for metabolic syndrome.

He focused his interests in obesity, sleep apnea and metabolic syndrome, and became board certified in pulmonology, pediatrics and sleep medicine. A few years later, Dr. Nakra was co-director of the Cystic Fibrosis Center and associate director of the pediatric residency program at St. Joseph Children’s Hospital in New Jersey, when he heard about an opportunity at CHOC.

The CHOC Sleep Center had recently doubled in size, becoming one of the largest programs in the state. Dr. Nakra was drawn by the opportunity to grow the program further and to work with CHOC pediatric subspecialties.

“Sleep inherently deserves multidisciplinary treatment with other pediatric subspecialties,” said Dr. Nakra, who is working with CHOC otolaryngologists, plastic surgeons and endocrinologists. “One of the joys of practicing sleep medicine at CHOC is the ability to collaborate on a multidisciplinary platform, pick the brains of the best and brightest in the fields, and work together to help the kids of Orange County.”

Dr. Nakra has quickly become an integral part of that team. At a recent CHOC Grand Rounds presentation, he discussed screening guidelines for obesity, metabolic syndrome and obstructive sleep apnea. The American Academy of Pediatrics recommends during routine office visits for pediatricians to ask families about how the patient sleeps at night and for the presence of multiple nighttime awakenings, difficulty breathing, loud snoring and pauses in breathing. This is especially true for overweight and obese children.

“We’re trying to break the cycle of obstructive sleep apnea and obesity,” he said. “Often, the families do not volunteer this information, but when asked, will confirm symptoms of obstructive sleep apnea. In this case, further evaluation by a sleep physician or referral for an overnight sleep study would be warranted.”

Dr. Nakra advises physicians to ask about sleeping when evaluating other symptoms, such as hyperactivity and behavioral disorders in elementary or middle school-age kids. For teens, improved sleep has been shown to improve academic performance and reduce motor vehicle crashes.

When to Refer

An overnight sleep study is recommended for patients with concerns for:

  • Nighttime snoring
  • Persistent mouth breathing
  • Witnessed pauses in breathing while sleeping at night
  • Frequent nighttime awakenings

Further evaluation in the pediatric sleep clinic is warranted based on the results of the sleep study or prior to the study based on pediatrician or parental concerns.

Dr. Nakra sees patients at CHOC Children’s Hospital; CHOC Children’s Health Center, Mission Viejo; and CHOC Children’s Health Center, Huntington Beach. For more information or to schedule a consultation, call 714-509-8622.

Obesity, Metabolic Syndrome and Obstructive Sleep Apnea in Pediatrics

In this CHOC Children’s grand rounds video, Dr. Neal Nakra, pediatric pulmonologist and medical director of CHOC’s pediatric sleep program, addresses the topic of obstructive sleep apnea (OSA) and obesity in the pediatric population. In addition to discussing the trends in OSA, Dr. Nakra details the relationship between the condition and metabolic syndrome. Data, collected over the past decade, regarding the effects of OSA treatment on components of metabolic syndrome is also highlighted.

After watching this video, viewers should be able to

  • describe the screening process for OSA;
  • determine the possible mechanisms underlying the connection between OSA, obesity and metabolic syndrome; and
  • describe the possible effects of OSA treatment on obesity and metabolic syndrome.

For more information on upcoming clinical events at CHOC, visit www.choc.org/cme.

CHOC Children’s at Mission Hospital Opens State-of-the-Art Sleep Center

CHOC Children's at Mission Hospital Sleep CenterFamilies in South Orange County now have access to a state-of-the-art Sleep Center for children who need overnight monitoring to diagnose problems related to sleep.

The new three-room unit at CHOC Children’s at Mission Hospital offers private, comfortable accommodations and the latest technology for routine polysomnograms. CHOC already performs more than 750 sleep studies a year at its three-bed Sleep Disorder Center in Orange.

Each room includes custom light control, a flat-screen TV, a fold-out bed for mom or dad, and unique artwork that showcases Southern California beaches to promote a soothing, calm environment.

The Sleep Center is equipped with live video monitoring and electroencephalogram (EEG), electrocardiogram (EKG), electrooculogram (EOG), electromyogram (EMG), thermistor, pulse oximeter and piezo crystal monitoring systems, allowing technologists to track every child’s breath, brainwave and movement during sleep.

In addition to registered sleep technologists, CHOC’s multidisciplinary sleep team includes a board-certified pediatric neurologist fellowship trained in sleep medicine, board-certified pediatric pulmonologists and psychologists.

Click here to learn more about the sleep conditions that affect children.