Sleep-disordered breathing is a recognized health risk that effects up to 5 percent of the male and 3 percent of the female population in the United States. If left untreated, sleep-disordered breathing results in higher rates of cardiovascular morbidity and mortality, increased numbers of automobile accidents, and reduced quality of life. Since sleep-disordered breathing becomes more common with increasing age and weight, the prevalence of the disorder is expected to increase in the United States as the population becomes older and more overweight. Although milder forms of sleep-disordered breathing such as snoring and upper airway resistance syndrome do not have the same health consequences as obstructive sleep apnea syndrome, these milder disorders affect up to 30 percent of the adult population and often result in reduced quality of sleep for sufferers and their bed partners. Since snoring is often the first and foremost sign of sleep-disordered breathing, ENT surgeons are often the first specialists consulted for management of the disorder. Therefore, otolaryngologists-head and neck surgeons who are in training require a solid foundation in the diagnosis and management of sleep-disordered breathing.

Physicians and clinics of the MUSC Department of Otolaryngology - Head & Neck Surgery are dedicated to issues related to sleep-disordered breathing. Patients with sleep-disordered breathing are seen in general otolaryngology clinics at Rutledge Tower and the VA, as well as at a multidisplinary sleep clinic at MUSC ENT Associates in East Cooper.

The MUSC Snoring Clinic at East Cooper is a multi-specialty clinic designed to fully address the medical and surgical needs of pediatric and adult patients with snoring and sleep apnea. The clinic provides an opportunity for patients with sleep-disordered breathing to see both a medical sleep specialist and a surgeon at the same time. The physicians then will confer and develop a diagnostic and treatment strategy that is individualized for each patient. East Cooper Regional and MUSC facilities are used for diagnostic and treatment purposes, depending on patient preference.

The Snoring Clinic offers a wide range of services, allowing the clinic to individualize treatment to meet the needs of each patient. Factors that must be assessed when making treatment recommendations include the patient’s weight, comorbidities, sleep apnea severity, upper airway anatomy, and patient motivation. The clinic addresses numerous sleep disorders including:

• Snoring
• Sleep-disordered breathing
• Restless leg syndrome
• Poor sleep hygiene
• Insomnia
• Narcolepsy
• Enuresis
• Poor sleep secondary to allergy, nocturnal reflux, nasal obstruction, tonsil and adenoid hypertrophy

Key Faculty
M. Boyd Gillespie, MD, MS, FACS (Division Director) has had an interest in sleep-disordered breathing since performing research at the Johns Hopkins Sleep Disorders Clinic during the 1990s. Dr. Gillespie has published several papers on sleep-disordered breathing, is a member of the American Academy of Sleep Medicine, is a consultant on sleep-disordered breathing to the American Academy of Anesthesiology, and currently serves on the Sleep Disorders Committee of the American Academy of Otolaryngology - Head & Neck Surgery. In addition, Dr. Gillespie has a master's degree in Clinical Research from MUSC and uses this training to integrate validated measures into clinical practice, which enables him to track patient outcomes.

Judith Skoner, MD - Dr. Skoner is a general otolaryngologist with advanced training in head and neck surgical reconstruction and facial plastic surgery. Her advanced plastics training is beneficial to patients with serious nasal deformities that cause sleep-disordered breathing and prevent the successful use of nasal CPAP. Dr. Skoner will offer an additional day of multidisciplinary sleep care at the East Cooper office with members of the MUSC Division of Pulmonary and Critical Care Medicine.

Lucinda Halstead, MD, Mark Hoy, MD, and David White, MD in the Division of Pediatric ENT provide additional expertise in the management of children with sleep-disordered breathing due to upper airway anomalies, adenotonsillar hypertrophy, gastroesophageal reflux and allergy.

Paola Tumminello, MD, of the MUSC Department of Neurology serves as medical consultant for the East Cooper Clinic. Dr. Tumminello has more than five years clinical experience in the evaluation and diagnosis of sleep-disordered breathing and is board-certified in Sleep Medicine. In addition to sleep-disordered breathing, Dr. Tumminello’s expertise extends to less common disorders such as narcolepsy, insomnia, enuresis and restless leg syndrome. She has additional experience and expertise in the management of pediatric patients with sleep disorders.

Key equipment/resources
MUSC Sleep Lab, 120 Ashley Avenue, Charleston, SC
East Cooper Regional Medical Center Sleep Lab, Johnnie Dodds Blvd., Mt. Pleasant, SC

Research Projects
PI: M. Boyd Gillespie, MD "Pillar palatal implant system additional implant study." January 2006- December 2006. (0.5% effort).