Sleep disorders may cause ADD/ADHD

For more than three decades, there has been a growing recognition that some people have difficulty focusing and maintaining attention; in various instances, they also may have difficulty sitting peacefully in a classroom
or calm setting. These individuals have been labeled with attention deficit disorder - with or without hyperactivity -known as ADD/ADHD.

Traditional treatment for ADD/ADHD has been with stimulant medications, such as Ritalin or Adderall, which provide improvement by stimulating a fatigued, unrested brain. It is now known that problems with sleep can result in difficulties with concentration and the ability to stay focused during the day. The increased physical activity -hyperactivity - displayed by many of those affected is a way of remaining stimulated, thus overcoming the sleepiness. This difficulty is most noted when sitting inactive and under-stimulated.

About 30 percent of these patients have a sleep disturbance as a fundamental cause according to Dr. Simmons, who has treated these types of patients for over 20 years. If a sleep disorder is present, there are other treatment options for improvement of the ADD/ADHD symptoms.
"If there is a concern that a child or adult has ADD/ADHD, then it is imperative to first make a few observations regarding the person's sleep in order to determine whether a sleep disorder center consultation is necessary, prior to starting stimulant drugs," Dr. Simmons continued. "In many cases, those who have been placed on stimulants can be successfully taken off them if a sleep problem has been properly diagnosed and treated. For years now, I have taken this approach and many patients labeled with ADD/ADHD in whom we have diagnosed with a sleep disturbance have demonstrated dramatic improvement after treating the sleep disorder. This treatment has minimized or eliminated their reliance on stimulant medications."

The main causes for the disturbed sleep in the ADD/ADHD population are lack of sleep due to domestic/environmental factors in the home, restless legs syndrome or obstructive sleep apnea, or an associated condition known as the Upper Airway Resistance Syndrome.

UARS is a subtle breathing disorder not properly diagnosed at most sleep centers; but by utilizing extra measures Dr. Simmons' team is able to recognize and treat this disorder properly. "We look at a whole battery of issues when someone complains of ADD/ ADHD, including both psychological and physiological factors," Simmons said. "I've seen many patients improve when we treat their sleep without the need for stimulants."

An example of one such patient is Trey Girlinghouse, a 9-year-old whose teachers became concerned with his difficulties in school. They encouraged his mother to find medical assistance for what they labeled as ADD; he was placed on stimulant medication treatment, but his mother was concerned about medication usage and looked for alternative treatments.
She had Trey evaluated by Dr. Simmons, and after a comprehensive sleep test he was found to have UARS. He then began treatment for this breathing disorder and is no longer on stimulants: he has also markedly improved his performance at school.
"Now that his sleep is better and he does better at school, the teachers agree that he no longer needs to be on medications," his mother said.

Dr. Simmons provides this partial list of signs which should raise concerns when considering whether ADD/ADHD may be associated with a sleep disturbance:

•  Difficulty falling asleep 
• Difficulty staying asleep 
• Snoring or labored breathing 
• Kicking repetitively during the night 
• Excessively grinding or clenching teeth 
• Difficulty awakening in the morning 
• Sleep walking or sleep talking 
•  Noticeable sleepiness during the day when not active

If someone has any of these indicators and appears to suffer with ADD/ADHD symptoms, then a proper sleep evaluation would be warranted. Patients can be evaluated by contacting CSMA's sleep centers throughout Greater Houston at 281-407-6222.
Visit www.HoustonSleep.net for more information and fill out our questionnaire to initiate an evaluation.

"Fitness Trackers" may provide misleading information on your sleep quality.

As wearable fitness trackers have become en vogue, physicians are voicing growing concerns over their actual usefulness in a patient's health regime. These devices count your steps, measure your sleep and some even monitor your heart rate, however most of them rely on simple accelerometers and their methods of interpreting the data may not be as accurate as they lead you to believe.

Experts say that while most trackers can in theory tell when a person is awake versus asleep, they are prone to mistakes. And as far as distinguishing sleep stages, trackers that include only an accelerometer as their sensor, "can't do what they claim," said Hawley Montgomery-Downs, a sleep researcher and associate professor at West Virginia University, who has studied the accuracy of sleep trackers. A persons sleep is usually evaluated through a scientifically structured sleep lab test, known as polysomnography.
In 2011, Montgomery-Downs and colleagues compared data from  trackers to polysomnography tests, looking at adults who wore trackers while also undergoing an overnight sleep test. They found that the tracker overestimated the time participants were asleep by 67 minutes, on average.
"It says you are asleep more often than you accurately are," Montgomery-Downs said. The study also found that an actigraph, another device that also uses an accelerometer to monitor sleep and is sometimes used in sleep studies, overestimated sleep time by 43 minutes. Another study, presented at a sleep researchers' meeting in November 2013, found the opposite effect in children -the tracker underestimated how long the children were asleep by 109 minutes.

Although an accelerometer monitors your movement, "you move the same amount whether you're in deep sleep, or lighter stages of sleep," Montgomery-Downs said. Experts worry there may be a danger in consumers putting too much trust in these devices to accurately monitor sleep, especially users who have sleep disorders.
For people without sleep disorders, using a fitness monitor to track sleep isn't going to hurt or help them,
but if someone does present with a sleep disorder, tracking sleep with one of these monitors might give them a false reassurance. And sleep trackers with only an accelerometer cannot provide much insight into the quality of sleep. For instance, a person with sleep apnea may stop breathing 300 times a night, but this wouldn't be detected.

According To Dr. Jerald Simmons, a sleep study provides important information about what occurs during sleep and is designed to identify factors that cause sleep disruption. Typically, a study is done to identify breathing problems or limb movement problems during sleep. Once asleep, being hooked up to the wires does not prevent these types abnormal events from occurring. However, it is important that a person falls asleep during the test.It is important to mention that a sleep study is not designed to identify causes for difficulty falling asleep. If a person’s main sleep problem is difficulty falling asleep, treatment can be initiated without a sleep study, but does require a detailed assessment by a Medical Doctor, Nurse practitioner or Physician Assistant who understands the issues of Sleep Medicine.

CSMA's sleep centers throughout Greater Houston provide treatment to patients sufferering from snoring and obstructive sleep apnea disorders. For more information on how to stop snoring and obtain help for sleep apnea call us today at (281) 407-6222.

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References:
livescience.com: Fitness Trackers & Sleep: How Accurate Are They? -Rachael Rettner, January 20, 2014
huffingtonpost.com: fitness trackers and sleep

TMJ (TMD) and Sleep Bruxism Associated with OSA

Teeth clenching or grinding - known as bruxism - is a common problem that may lead to headaches, facial pain and TMJ disorder.

 Bruxism has puzzled dentists and physicians for years, limiting the successful treatment of these disorders. Research conducted by neurologist and sleep disorder specialist Jerald H. Simmons, M.D. has demonstrated that a main cause of bruxism relates to breathing problems during sleep, such as snoring and obstructive sleep apnea. Years of observation and experience in treating patients with OSA and bruxism led him to recognized the relationship of these conditions; with the assistance of Ron Prehn, DDS, they began studies on more than 700 patients with OSA.
This is the first research in the world to conclusively demonstrate that bruxism during sleep is actually an attempt to bring the jaw and tongue forward. Nocturnal bruxism stops the back of the tongue from blocking the airway and, is the brain's way of preventing this blockage from occurring.

Dr. Simmons treats patients with a variety of methods including CPAP masks that fit over the nose to deliver positive pressure; special dental appliances that bring the jaw forward to open the back of the airway, and in some cases surgical procedures which remove crowded tissue in the back of the throat. In some patients a combination of all these treatments are needed. Dr. Prehn has assisted in designing customized CPAP masks for some patients which are held on the face using a special dental appliance, eliminating the need for straps on the head and chin.

One of Dr. Simmons' patients,  Diane F. states that "... I saw multiple doctors, and none of them were able to take care of my symptoms. As soon as Dr. Simmons' treatment opened up my airway, my clenching stopped... I think Dr. Simmons' research has found that missing link."

Other conditions treated at Dr. Simmons Sleep Center, Comprehensive Sleep Medicine Associates (CSMA) include:
• ADHD, which is now recognized to frequently result from poor, non-restorative sleep;
• Fibromyalgia and Chronic Fatigue, both of which are also recognized as a result of sleep problems; and
• Morning headaches, a condition usually resulting from disturbances in sleep that is not properly diagnosed in many patients.

Doctors Simmons and Prehn have presented their results to dentists and physicians at national medical and dental conferences. This new concept has created a wave of interest within the dental field, as most dentists are challenged by patients with bruxism. They have a new prospective and alternative approach in treating these patients.
"It is amazing how much improvement we can provide in patients by properly treating disturbances in their sleep," Dr. Simmons said.


CSMA's sleep centers, founded and directed by Dr. Simmons, are found throughout the greater Houston area. For more information about his work and the sleep center, visit www.HoustonSleep.net

Don't let Snoring Break Your Heart!

For years people have thought of snoring as nothing more than a simple annoyance during the night: snoring is so common that we do not view it as a medical problem. Recent statistics suggest that this seemingly simple noise problem may in fact increase the risk of high blood pressure, stroke, heart attack, and daytime sleepiness.

Snoring typically occurs when the tongue and throat muscles relax during sleep causing the airway space in the back of the throat to narrow. Breathing through a narrow airway causes a vacuum that pulls on the throat's soft tissue causing it to vibrate, which creates the snoring sound. This vacuum in the throat also spreads to the chest where the heart is located, causing a strain on the heart and the possibility for oxygen in the bloodstream to drop to dangerously low levels. When these factors occur night after night, year after year, they instigate the problems listed above. Additionally, new studies have also shown OSA causes increased insulin resistance resulting in poorly controlled diabetes.
Studies have demonstrated that in many people, snoring can cause an increase in chest pressures which can influence blood flow in the heart and lungs. This may be the cause of some of the medical problems in people who snore.

CSMA's sleep centers throughout Greater Houston provide treatment to patients sufferering from snoring and obstructive sleep apnea disorders. For more information on how to stop snoring and obtain help for sleep apnea call us today at (281) 407-6222.

Many people who snore have another problem known as sleep apnea. Apnea is a Greek word, which means, "want to breathe." People with obstructive sleep apnea have pauses in their breathing while asleep. These pauses in breathing occur when the airway collapses during sleep. After a few seconds the person briefly awakens, frequently producing a grunting, gasping, or snorting sound.
Obstructive sleep apnea is more common in obese people and more common in men, but it is not just obesity that can cause this problem. People with a small jaw, large tongue, or large tonsils are at higher risk of having this problem as well. In fact, any condition which can narrow the opening in the back of the throat or possibly the nasal passages can increase the risk of obstructive sleep apnea.
It is important to know the consequences of this problem if left untreated. Some of the more common problems associated with obstructive sleep apnea are excessive daytime sleepiness and an increased risk of high blood pressure, heart attacks and stroke.

What can someone do if they want to know if they have Sleep Apnea?

See your physician and ask about being referred to a sleep disorders center. This is a special testing facility that evaluates people for sleeping problems. If your doctor does not feel this is necessary, don't be discouraged. Most physicians have not been taught very much about sleep medicine in medical school and therefore may not recognize this problem in their patients. Be persistent. You can be seen by a sleep specialist and, if needed, a sleep study can be performed on you during the night.

What can be done if a person snores or has Sleep Apnea?

The most effective treatment to date for sleep apnea is called nasal CPAP (Continuous Positive Airway Pressure). An individual wears a mask on their nose at night that administers air pressure, keeping the upper airway open. This allows the individual to breathe throughout the night without repetitive awakenings. If a person only snores and does not suffer from excessive daytime sleepiness, then CPAP is not the appropriate treatment.
Dental appliances have been used for snoring. Sometimes these devices can also prevent apnea as well. Studies have demonstrated that dental appliances work for snoring and sleep apnea, but not in all patients. Surgery has been used to treat these problems. The most frequently performed surgery is a procedure where the soft tissue in the back of the throat including the uvula is cut away or reduced in size with a new microwave needle or a laser. Although this may work well for snoring, unfortunately most patients who have sleep apnea are not adequately treated with these procedures. There are other more extensive surgeries that can be performed for sleep apnea.

A sleep specialist who is very familiar with these procedures should explain them to you. If you snore at night and think you might have sleep apnea, contact your doctor. If your doctor is not familiar with this type of problem, have him or her contact us directly.
For more information on Snoring, Sleep Apnea and treatment options in the greater Houston area, visit www.HoustonSleep.net

Comprehensive Sleep Medicine Associates, PA welcomes Dr. Gerard Joseph Meskill as Staff Neurologist and Sleep Disorders Specialist.

Dr. Meskill is a neurologist and sleep disorders specialist. He completed his neurology residency at the Hofstra-North Shore Long Island Jewish School of Medicine. The North Shore Long Island Jewish healthcare system is the largest provider of patient care in New York City, with 16 hospitals serving a population of 7 million people spanning three boroughs of New York City and Long Island. The two flagship hospitals of that system, North Shore University Hospital and Long Island Jewish Medical Center, serve as the tertiary care centers for the entire system. Training almost exclusively in those two hospitals, Dr. Meskill was exposed to the full breadth of neurologic disorders, ranging from critical care to outpatient cases, as well as some of the rarest disease processes to common ailments.

After residency, Dr. Meskill switched coasts to continue his training at Stanford University School of Medicine's Sleep Disorders fellowship program. Founded by Dr. William Dement, Stanford's program is recognized internationally as the birthplace of the field and is considered the world's best academic sleep program. Dr. Meskill trained under many of the most recognized innovators in sleep medicine, such as Dr. Dement, considered the father of sleep medicine; Dr. Emmanuel Mignot, the chairman of the program and the world authority on Narcolepsy; and Dr. Christian Guilleminault, one of the world's most published authors in the field of sleep and a major contributor to the discovery of the physiologic mechanisms behind Obstructive Sleep Apnea. Due to Stanford's international reputation and extensive clinical case diversity, Dr. Meskill routinely evaluated and treated both common and rare sleep disorders, ranging from Obstructive Sleep Apnea to Kleine-Levin Syndrome.

Dr. Meskill treats a wide range of neurologic disorders, but like his colleague and fellow Stanford graduate, Dr. Jerald Simmons, he spends majority of his time evaluating and treating sleep disorders. This includes the full spectrum of sleep-disordered breathing, from Upper Airway Resistance Syndrome to Obstructive Sleep Apnea, as well as nocturnal bruxism (teeth clenching/grinding), pediatric and adult ADD/ADHD, Fibromyalgia, Chronic Fatigue Syndrome, TMJ/TMD, Narcolepsy, Restless Legs Syndrome, Periodic Limb Movement Disorder, Epilepsy, and many other disorders. Many of these disorders are related to or are exacerbated by obstructive respirations during sleep. Like Dr. Simmons, Dr. Meskill is trained in the implementation and interpretation of esophageal manometry, which is considered the gold standard measure for detecting sleep-disordered breathing events.

Dr. Meskill is dedicated to improving the standard of care for sleep and neurologic disorders in the Houston area, as well as promoting better understanding of these fields through community education and collaboration with primary care physicians, subspecialists, and community dentists.
 
 Dr. Meskill has recently published two articles in Huffington Post "Healthy Living": Episodic Excessive Sleepiness in Teens May Represent Kleine-Levin (April 09 2013) and Nocturnal Teeth Grinding May Suggest a Sleep Disorder (October 24 2013).

Houston Neurologist Still Able to Provide Care at Comprehensive Sleep Medicine Associates after Sadler Clinic Quickly Closes

After 53-years in business, the Sadler Clinic suddenly closes its doors cutting off communications with most of its patients, leaving many with no answers of who will provide their medical care. The Sadler Clinic Sleep Disorders Center's, Medical Director, faces challenges and focuses on the positive in the wake of the changes. Written by: Victoria Wright, Operations Director, Comprehensive Sleep Medicine Associates, PA. Our mission is to provide a comprehensive approach for high-quality-care of the most difficult patients, ranging from infants to the elderly. Comprehensive Sleep Medicine Associates, PA (CSMA) sets the Platinum Standard in providing care to our patients with sleep disorders. We utilize diagnostic testing in a variety of settings; from home, hospital or in our clinics, with procedures that are above and beyond industry standards. This is critical in establishing the proper diagnosis in the most difficult patients. We are committed to maintaining excellence, respect, and integrity in all aspects of our operations with patients and health care professionals. Find out more about our team, our services and to follow the latest news at: http://www.houstonsleep.net

After more than five decades of medical service to a thriving community in the northern Houston area, the Sadler Clinic shuttered its doors as a result of severe financial difficulties in spite of numerous successful practices within the clinic. One such flourishing part of the now closed-clinic was the Sadler Clinic Sleep Disorders Center (SCSDC), founded and directed by Jerald H. Simmons, MD, nonetheless the Sadler Clinic consisted of more than 100 doctors and about 700 employees, in the months preceding the closing, and the clinic could not sustain its overhead. The closing of Sadler Clinic was announced May 24th and the remaining doctors were terminated May 31st, ending what started out as a modest family practice and grew into a large multispecialty clinic.
"A series of unfortunate events led to the downward turn for the clinic, however this should not affect our patients' continuity of care," states Dr. Simmons. “I will simply extend my other sleep program, Comprehensive Sleep Medicine Associates (CSMA), into The Woodlands and Conroe areas. I have negotiated a temporary lease and we are looking at the best options to ensure we have a healthy practice."
Dr. Simmons, a neurologist who is triple board-certified in epilepsy and sleep, was recruited, in 1999, by the Sadler Clinic, leaving a faculty position at UCLA in Los Angeles, to develop a state-of-the art sleep disorders center in Montgomery County. “When I was considering the transition from my academic career; moving my family to Houston, and joining the clinic, I knew that I could provide a level of care beyond that of other centers in the Houston area. Which is why I structured my agreement with the Sadler Clinic so I could setup sleep programs outside of Montgomery County, as long as I did so in a fashion that was mutually beneficial and not in competition with the clinic,” said Dr. Simmons. The Sadler Clinic had 11 locations, all in Montgomery County, when it closed.
It didn’t take Dr. Simmons long to venture out. In 2001 he started REST Technologies, which infrastructured the sleep center at Memorial Hermann Fort Bend Hospital which, in 2006, relocated its infrastructure to a new Memorial Hermann, Sugar Land Hospital, where he designed and setup their sleep center. Not one to waste time, that same year he founded a private sleep medicine practice, CSMA, in Houston located in the internationally recognized Texas Medical Center area.
The sudden shut-down of Sadler Clinic is not only devastating to the community but also to all the doctors who now have to quickly figure out how to establish a medical practice and take on new business responsibilities, something that would typically be planned over many months or years, not weeks.
In Dr. Simmons’ case, he has seen professional challenges before; in 2008 the sleep lab at the Memorial Hermann, Sugar Land Hospital gave him a 30-day notice-of-termination, when the hospital eliminated the sub-contractor technical services contract. “Losing a number of my staff to the hospital, and quickly finding new space for a sleep lab and finding office space for all that staff, while continuing to provide care all-the-while holding down my SCSDC practice was an extremely difficult time for me. I suppose, what doesn’t kill you, makes you stronger, and I can say while we didn't enjoy the times it made my company and my staff more resilient and cohesive,” stressed Dr. Simmons.
“Believing that I can provide a higher level of care for patients with sleep disorders than what most patients are receiving these days by most centers, pushes me to enhance my practice. Now four years after being cut off from the hospital sleep center in Sugar Land that I created, this April CSMA opened a free standing Five-star state-of-the-art sleep center in Sugar Land,” states Dr. Simmons. “I want to use this center to reach out to the community, so I have included a 2000 square feet conference room, in the building, that can function as a class room to educate the community on sleep disorders medicine. I came to the Sadler Clinic as a faculty member at UCLA and it’s really important to me to share the knowledge that I have amassed over my career. I know that if we focus on the positive then the negative things around us will be over in time.”
Former SCSDC patients can also focus on the positive changes. “We will now have four locations in the greater Houston area under CSMA. I take things in stride, and know that this difficult time with Sadler Clinic closing will result in CSMA having a stronger more cohesive program. I need my patients to understand the strength of my group and my practice," Dr. Simmons emphasized.
Quick changes are what the previous Sadler patients must deal with now. Some patients show up to see their former Sadler doctor and the offices are closed. Dr. Simmons patients can still come to his clinic in The Woodlands. “When my husband and I showed up to see Dr. Simmons today I hadn’t heard the news that Sadler had closed but I noticed it wasn’t as busy as it usually is. When Dr. Simmons told me about Sadler closing I wanted to cry. I guess we are afraid of the changes, but I’m so happy that he can continue providing care to us under CSMA and we won’t have to find a new doctor,” stated Alicia Gonzalez.
Mark Wilkerson, MD an Ophthalmologist whose father was one of the original founding three physicians of the Sadler Clinic is another of the Gonzalez’s doctors stated, “Dr. Simmons is a renowned expert in Sleep Medicine. He was an integral part of Sadler Clinic for many years and was able to develop a center of excellence. He is an energetic innovator who constantly reexamines how to improve the care for patients who suffer from sleep disorders." Dr. Wilkerson has also worked-out a temporary lease and is trying to stay in the same office to maintain a stable environment for his staff and his patients. Alicia Gonzalez stated that she is happy to learn that two of her doctors will still provide care for her and her husband in The Woodlands and hopefully in the same office space. In fact, Gonzalez and her husband have been with the clinic for years and have created relationships with several doctors over those years. Their primary care doctor, Christopher Robertson, left the clinic two-years ago, and is still their primary-care physician.
With the rapid changes that happened at Sadler Clinic many have been left without answers and to help with this, Dr. Simmons’ staff has set up a web page, http://www.sadlerdoctors.com, because while Sadler Clinic may be gone, the teachings, beliefs and legacy of Sadler Clinic are still at the core of many who worked for decades at this clinic. In fact the following; developed by Dr. Peter Bigler and is from the employee handbook:

•     Sadler Clinic is committed to delivering superior healthcare by partnering with our patients, families, employees, and the community we serve. We will achieve this goal by delivering exceptional care through Service, Accountability, being Dynamic, Leadership, Excellence, and Respect. Our guiding vision is to be the best multi-specialty clinic in the country for patients, employees, and providers.

Always looking for innovative, patient care Dr. Simmons teams with dentists in the assessment and management of patients with sleep apnea as well as those who clench or grind their teeth at night. One such dentist is Ronald Prehn, DDS, Director of the Center of Facial Pain and Sleep Medicine in The Woodlands. Dr’s Prehn and Simmons continue to conduct many research studies. Dr. Prehn states, "Dr. Simmons and his excellent staff at the Sadler Sleep Clinic have been taking care of my patients for years, performing state-of-the-art sleep studies and treatment approaches. I am approached by dentists from around the country who tell me how fortunate I am that I have a sleep physician like Dr. Simmons to work with, who can provide sleep studies that demonstrate abnormalities missed by many centers. So naturally I was a bit concerned with the closing of the Sadler clinic that my patients might be left out in the cold and I would not have him to collaborate with any longer, but instead Dr. Simmons and his staff, stepped-up and assured us that there would be no break in their medical care or collaboration. In fact, just earlier this week we met to discuss how we will actually improve the communication between our offices in order to further enhance the care we deliver as a team. I look forward to working with Dr. Simmons and his staff under the umbrella of CSMA."
As the old adage goes there really is no good time for bad news and the timing for this change presents challenges for most and Dr. Simmons is no exception. He is scheduled to present several significant research studies, next week at the annual national sleep disorders conference (APSS - SLEEP 2012) in Boston. “It’s really important that I still present the findings of our research. The work I have been fortunate to do at both my Sadler and CSMA sleep centers has led to cutting-edge methods that will help patients with sleep disturbances. It would be tragic if these recent events with Sadler prevent me from sharing with colleagues from around the globe what we are finding with our clinical research. I’m proud that my centers use enhanced methods of measuring patients’ sleep that most of my peers have not been able to implement in a similar fashion. One focus of my research that I will be presenting at the conference involves new methods for acclimating patients to treatment devices such as CPAP and another study I am presenting is how many patients with symptoms of fatigue and or sleepiness go untreated because the current guidelines used by most laboratories are not sensitive enough to tabulate the problem. Our study shows that over 80% of the patients we treated, who would have gone untreated based on the standard guidelines, improved with our treatment. I can’t miss this meeting. This data needs to be presented and hopefully the guidelines will change and more patients will get proper treatment," said Dr. Simmons.
As one part of Dr. Simmons professional life comes to a close he is optimistic in the care that he and the great team he has built will now be able to function more cohesively and focused, caring for the patient in ways that most sleep centers can’t. Most sleep labs limit their focus to typical obstructive sleep apnea and snoring, since it is so common. However, CSMA excels in a broader scope of sleep related conditions that include:
ADD / ADHD,
Fibromyalgia,
Chronic Fatigue
Irritability/Daytime Fatigue
Jaw pain and teeth grinding (bruxism),
Seizures during sleep,
Bed wetting,
Morning headaches,
Acid Reflux
Heart Disease
Restless Legs Syndrome
Chronic Migraine
And more.
"I think that by bringing all of my centers under one management system and eliminating the obstacles I was presented by functioning within the Sadler system my clinical research efforts can become enhanced. As a result, we will make more strides on better approaches to treat complicated cases. This will be an exciting time in my career and I look forward to the challenges ahead," states Dr. Simmons.
To contact Comprehensive Sleep Medicine Associates the new number for The Woodlands and Conroe locations, not affiliated with Sadler, is 281-407-6222 in Houston in the Medical Center 713-668-4100 and in Sugar Land 281-240-3773. Another way to find out more is to go to the web at http://www.HoustonSleep.net where an online sleep questionnaire can be filled out for review to determine how to best undergo an evaluation and treatment of difficulties with sleep.