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Internal Medicine

Internal Medicine is a primary specialty that deals with the prevention, diagnosis and treatment of adult diseases. Physicians that practice this specialty are referred to as Internists or Primary Care Physicians (PCP). Internists are trained to solve diagnostic problems, interpret diagnostic tests, handle chronic illnesses and multi-system disease processes. Primary care physicians, coordinate with other subspecialist's to manage patients’ care and any difficult medical problems that are associated with that care. PCPs also counsel and educate patients on safe health behaviors, self-care skills and treatment options, and provide screening tests and immunizations.

Sleep Medicine

Sleep Medicine is the medical subspecialty devoted to the diagnosis and therapy of sleep disturbances and disorders. Many sleep disorders present with similar symptoms such as excessive daytime sleepiness (EDS), which in the absence of sleep deprivation, can be caused by a treatable sleep disorder such as obstructive sleep apnea (OSA), narcolepsy, or circadian rhythm disturbances. EDS is quantified by the use of the Epworth Sleepiness Scale (ESS). Insomnia is also a common problem seen in sleep medicine that can have a variety of causes both physical and mental.

During a consultation, a detailed history is taken from the patient. This includes information about their normal sleep schedule, sleep hygiene habits, environmental factors and social behaviors.  The Epworth Sleepiness Scale (ESS) is completed, which gives an indication of excessive daytime sleepiness and can correlate with the degree of sleep apnea as well as being used as a marker for success of therapy. A sleep diary provides a subjective account of patients sleep.  It is a valuable tool to help gather information on sleep habits, sleep schedules and to track progress though treatment. If appropriate, an order for a nocturnal polysomnography (NPSG), or sleep study, is given to diagnose OSA, narcolepsy or illustrate parasomnias such as Restless Legs Syndrome (RLS) or bruxism.  Management in the varying situations can differ greatly and cannot be undertaken without a correct diagnosis.

You can read more about common sleep disorders on