We are an independent sleep disorders diagnostic center, evaluating all sleep disorders in adults and children (ages 3-18), established in 1994. We provide initial office visits with a Board Certified Sleep Specialist (with over 24 years experience), follow up visits as needed, diagnostic sleep testing, CPAP testing, CPAP equipment and ongoing support for our patients. Our services are described in detail below, so that you may know what to expect. At the end of the services description is an overview of what makes our center unique and the extra care that we provide to our patients.
If you are wondering whether you or a loved one may have a sleep disorder or want to find out more about sleep disorders, go to the Sleep Disorders Section.
COMPREHENSIVE INITIAL OFFICE VISIT:
The purpose of the Initial Office Visit is to assess for sleep disorders based on presenting complaint and responses to questions about symptoms associated with various sleep disorders, to offer good sleep hygiene recommendations and dispense a daily sleep-symptom log to track your progress. Finally, if sleep testing is indicated, to set-up an appointment for appropriate sleep testing.
The initial office visit with the sleep specialist, allows him
to assess the full range of sleep disorders and takes 45-60 minutes. The sleep
specialist will review your sleep problems and medical history, sleep schedule
and characteristics, life style and will provide an initial expert opinion and
recommendations. A written report is provided to patients and their referring or
family physician, as designated by the patient. Recommendations include good
sleep hygiene information, changes in lifestyle related to sleep, keeping a
sleep-symptoms log for 2-4 weeks, and may include medication recommendations,
and/or sleep testing. The sleep-symptoms log allows the tracking of frequency
and changes in symptoms. Sleep testing is indicated for certain symptoms (for
example, excessive daytime sleepiness, gasping/snoring, frequent arousals,
restless legs, muscle weakness during strong emotions, persistent insomnia,
etc.)
Patients seeking a second opinion also start with the Initial Consultation
visit. All patients are referred back to their primary care physicians for
optimal coordinated care. If a patient does not have a primary care physician,
we will recommend one or more they can see.
FOLLOW UP CONSULTS, AS NEEDED: (All visits produce
written report to patient and their physician)
Follow up visits, as needed, to assess progress in sleep and alertness after implementing recommended changes and to make additional recommendations for any persisting symptoms. Depending on the sleep disorder, some patients may only need the Initial Office Consult, some require an additional follow-up visit, others require testing, and one or more follow-up visits.
For example, insomnia patients sometimes require only 1-2 visits, others may need sleep testing. Patients with excessive sleepiness or snoring or frequent arousals need overnight sleep testing, called a polysomnogram (PSG), and some need a daytime test, called the multiple sleep latency test (MSLT). For sleep apnea patients who use CPAP (continuous positive airway pressure), a follow up schedule of office visits are needed after 1 month, 3 months, then every 3-6 months thereafter), to maximize optimal treatment, check compliance, check equipment for wear and damage, maintenance of equipment, etc. We support our patients with additional appointments as needed, for example, part replacements, equipment adjustment or trouble shooting, changes in health that impact sleep apnea and require additional clinical review.
DIAGNOSTIC TESTING:
All testing conducted on site by Registered Sleep Technologists and supervised by a board certified sleep specialist. All test recordings are scored and interpreted on site. The purpose of diagnostic testing is to provide objective measurement of sleep quality, quantity, type of sleep stages and their order and duration, as well as measurement of breathing, oxygen saturation level, cardiac rhythm, muscle activity, eye movements, and brain wave patterns, in order to discern any patterns associated with sleep disorders and to make an objective diagnosis. Testing is indicated by certain symptoms, such as gasping/snoring, excessive daytime sleepiness, etc.
-PSG: Overnight. Fully attended polysomnogram diagnostic testing, to objectively diagnose and assess certain sleep disorders, such as sleep apnea-hypopnea, periodic limb movements, acting out dreams, sleep walking, frequent arousal’s, excessive sleepiness, persistent insomnia, etc.
-CPAP: Overnight, fully attended Continuous Positive Airway Titration testing for patients diagnosed with sleep apnea, to determine optimal CPAP pressure and equipment type to best treat each patient's apnea needs.
-SPLIT NIGHT: Overnight, fully attended PSG testing the first half of the night, followed by CPAP titration the second half of the night, for patients with severe, life-threatening sleep apnea.
-MSLT: Fully attended Multiple Sleep Latency test, 4-5, 20 minutes naps, spaced 2 hours apart, starting 2-2.5 hours after the PSG test, to objectively assess excessive sleepiness and/or diagnose or rule out narcolepsy.
-MWT: Fully attended Multiple Wakefulness test, to assess alertness by daytime challenge tests, where the patient is instructed to stay awake in a darkened bedroom, while sitting-up in bed. This test is also repeated every 2 hours, starting 2 to 2.5 hours after a PSG, and repeated 4-5 times during the day.
PROVIDER OF CPAP AND BiLEVEL-PAP EQUIPMENT & SERVICES:
For patients who have been diagnosed with sleep apnea, CPAP is the gold standard
of most effective treatment. Our center provides customized fitting of equipment
prior to CPAP titration. Additionally, we provide CPAP devices, both rental and
purchase, to our patients who choose to obtain equipment from us, along with
full day and evening support and problem-solving. This service saves time for
our patients (who don't need to find a third party home health care company to
fill equipment needs), and assures our patients of coordinated care and quality
services. Our strong patient education and support program is the reason behind
our unusually high patient compliance rates for CPAP. We often are referred
patients who were unable to initiate CPAP treatment or were unable to tolerate
it, until they received the additional problem-solving and support that we
provide. We are very proud of our high rate of CPAP compliance (successful
patient follow through with treatment).
-Expert guidance in selection of CPAP and related accessories: We carefully select equipment that we consider to be the best of current offerings (in terms of comfort, durability, convenience, etc.)
-Customized fitting / sizing for comfort: The equipment must be as comfortable as possible, so we take the time to ensure the most comfortable fit and equipment that best suits the patient's clinical needs and lifestyle.
-Instruction in proper usage: Provided to all CPAP patients who obtain equipment from us.
-Comprehensive expert support: including trouble-shooting/ problem solving in the office and with day and evening telephone support, equipment check, filter changes, pressure check and adjustment, and these equipment services coordinated with clinical follow-up of patient progress, CPAP compliance and with certain equipment CPAP data analysis.
-Regularly scheduled follow up visits (1 month, 3 months, then 2-4 times a year) to ensure continued compliance, good progress, good condition of all equipment and accessory parts, and to make any changes as warranted. Interim visits as needed, in case of equipment problems or recurrence of apnea symptoms due to change in health, medications, weight changes, etc. (For example, significant changes in weight + 20 pounds or more, changes in altitude, and certain changes in health or medications can alter a person's CPAP pressure needs. In some cases the change in pressure needs is significant and requires a CPAP re-titration test. It is also important to note that pressure needs tend to decrease during the first year of regular CPAP, especially if there is significant weight loss, and this is why we recommend a CPAP re-titration within the first year of use.
YEARS OF EXPERIENCE in providing the highest standards of diagnostics and care.
Dr. Lawrence Scrima, the center's Director, is a Ph.D., Diplomate American Board
of Sleep Medicine (ABSM), Diplomate American Board of Forensic Medicine (DABFM),
is a board-certified sleep disorders specialist since 1982, with over 24 years
of clinical and over 27 years research experience to offer his patients. Dr. Scrima
has been serving patients in Colorado since 1990 and is an internationally
acclaimed sleep disorders specialist
and sleep researcher, particularly renowned as an expert in narcolepsy, restless
legs syndrome, insomnia and sleep apnea. He has over 100 publications in the
field of sleep and sleep disorders. He has served on the medical advisory boards
of two national organizations (The Narcolepsy Network 1992- ; The Restless Legs
Syndrome Foundation 1995-1998) and is frequently called upon to speak to
physicians in Colorado and other States, regarding sleep disorders and their
treatment.
Dr. William J. Warkentin M.D., the center's Medical Director, is board certified
in internal medicine, has more than 25 years
experience, is the senior physician of Aurora Internal Medicine Clinic P.C. and
has participated as a sub-investigator on several clinical trials related to new
treatments for sleep disorders. Dr. Warkentin is a highly regarded
physician, well known in
Colorado, serving the greater Aurora community.
We get a number of referrals of difficult cases to our center and have a reputation for expertise in arriving at diagnosis and successful treatment plans. We have patients come to us from all over the United States and even from Canada. We also receive referrals from the airline industry to evaluate pilots with sleep problems.
EXPERT CARE: All of our patients are seen by the a board certified sleep specialist, not a technician or assistant. All testing is carried our by a Sleep Technician, all PSG test recordings are scored and interpreted at our center under the supervision of our board certified sleep specialist. All reports and tests are reviewed by both our Sleep Specialist and Medical Director, who co-sign all reports. Test results are provided in a written report that is reviewed with the patient. The sleep specialist personally meets with each patient to explain the reported results and answer questions.
PATIENT SATISFACTION: Surveys consistently give us high ratings on our services.
PATIENT OUTCOMES: Patient outcomes are our highest priority, that's why we provide a strong emphasis on patient education throughout our diagnostics, and excellent follow-up support to encourage compliance with treatment recommendations. We get many referrals for patients who have had difficulty obtaining a firm diagnosis or successful treatment plan, and who benefit greatly from our center's level of expertise, services and support. Our CPAP compliance rate (the percentage of patients who follow through with treatment and therefore benefit from treatment) is around 80-90%, compared to around 40-50% nationally.
CONVENIENT LOCATION: Our center is located less than 1 block west of Interstate I-225 & Mississippi exit, across the street from the Aurora Medical Center, south campus.
We serve both adults and children. We provide a large bedroom for children, so that a parent can sleep in the same room during sleep tests.
Our overnight testing rooms are comfortable, private bedrooms. Patients have access to a bathroom with a shower, a lounge area with magazines, books, video player, a microwave and a refrigerator with complimentary snacks and soft drinks. A continental breakfast is provided to patients who do overnight testing, so they can breakfast and be on their way to work. Patients who stay for daytime testing can store their lunch in the fridge or order out for lunch.
We offer on-site CPAP equipment rental/purchase to our apnea patients, as well as full service support, including evening telephone support. For patients who choose to get CPAP equipment with our center, this represents a considerable time savings and the benefit of expert support services that are coordinated with their clinical follow up.
WE VALUE PATIENTS CONCERNS AND TIME CONSTRAINTS, therefore we ensure that there is minimal waiting time at our center. Sleep tests can usually be scheduled within 1-3 weeks. Preliminary test results are available within 3-7 business days to review with the patient and their physician; written reports are released to the patient within 5 business days. We routinely forward results on to the patient's physician(s), with patient permission, to ensure that the primary care /referring physicians are fully informed and treatment plans can be smoothly coordinated.
WE PROVIDE EXCELLENT VALUE: Since we are an independent center, we can hold our prices down and keep them competitive for the Denver metro area. Most health insurance policies have some coverage for sleep disorders. We offer courtesy review of each patient's health insurance plan coverage (for sleep disorders services at our center) at their request, so there are fewer billing surprises. We file health insurance claims on behalf of our patients, including one level of appeal, if necessary.
We bill set procedure codes for testing , CPAP equipment, and initial office visit. Other office visits are billed by time spent with the sleep specialist. After any necessary testing is completed, the sleep specialist meets with the patient to review results and answer questions; the first 15 minutes of this visit is free of charge. All patients receive an early payment discount for paying the balance due at the time of service.
WE ARE PREFERRED PROVIDERS FOR:
 | Great West HMO and PPO |
| Mountain Medical Affiliates |
However, we can bill to your insurance if you have a PPO Plan or HMO Points of Service.
For patients who have no insurance or are paying out of pocket, we can offer significant discounts.
We offer extended payment plans at no extra charge when necessary, and we accept Visa and MasterCard.
We do not accept Medicaire or Medicaid or other HMO insurance at this time.
OUR REPUTATION STANDS ON OUR RESULTS: By providing full
information to patients and ample opportunity to get their questions answered
directly by the sleep specialist, our patients are fully informed on the various
treatment options and the impact of lifestyle choices on their sleep. Well-informed patients make
better decisions and are more fully committed
to following through for successful treatment outcomes. Satisfied patients and
their physicians are our best source of referral.
PLEASE GIVE OUR CENTER A CALL IF YOU NEED TO SCHEDULE AN
APPOINTMENT.
(303) 671-0977
Lawrence Scrima, Ph.D., Diplomate (ABSM), DABFM, Director, is board certified by the American Board of Sleep Medicine since 1982 (#0064), to evaluate and interpret sleep tests and to diagnose and recommend accepted treatment options for all sleep disorders. He has over 24 years experience in clinical sleep disorders evaluation and more than 24 years experience in research related to the functions of sleep and the causes and treatment of sleep disorders.
Dr. Scrima is an internationally acknowledged sleep disorders specialist. He has directed several successful sleep disorders centers, two of which were in medical schools (University of Miami School of Medicine, Neurology Dept. 1982-84 and the University of Arkansas for Medical Science 1984-90), where he also conducted research on sleep disorders and lectured on sleep physiology and sleep disorders to medical students and physicians (as an Assistant and then as an Associate Professor of Medicine, Psychiatry and Interdisciplinary Toxicology). He has conducted research related to the causes and treatments of narcolepsy, sleep apnea, Restless Legs Syndrome, and Periodic Limb Movement Disorder for the National Institutes of Health, the Veterans Administration Hospital, the Food and Drug Administration, pharmaceutical companies, and in independent research. He has over 100 publications in the field of sleep and sleep disorders.
Dr. Scrima has served on the medical advisory boards of two national organizations: The Narcolepsy Network (1992- ) and The Restless Legs Foundation (1995-98). He was co-founder of the first narcolepsy support group in Canada, in Ontario. He provides consultation on sleep disorders to other sleep disorders centers and private industry, gives continuing education lectures on sleep and its disorders and treatment to physicians and nurses, and occasionally provides expert witness testimony in legal cases with issues pertaining to sleep disorders. Dr. Scrima continues to be active in research and has been the Principal Investigator on 19 and the Sub-Investigator on 4 clinical trials for the treatment of sleep disorders to date.
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