Treating sleep problems improves conditions not typically considered by most physicians.

Over the past decade many Sleep Testing centers have opened throughout the country; most focus on evaluating patients with snoring complaints to determine if they have Obstructive Sleep Apnea (OSA). Once diagnosed these patients are typically placed on CPAP for treatment. Typically a second sleep study is performed to determine the best settings for the CPAP machine, with most centers taking the basic approach  rooted in standards developed when less was known about sleep abnormalities.

As a result, many patients who have abnormalities during sleep are not accurately diagnosed and patients are left without an effective treatment plan. Many patients may have a subtle breathing problem during sleep known as Upper Airway Resistance Syndrome (UARS). Patients with UARS have normal oxygen levels throughout the night and do not stop breathing, but they work harder to breathe and the increased effort causes brief disruptions called micro arousals. Recently accepted minimum standards in the field miss out on the identification of abnormalities such as UARS.

Some centers differentiate themselves in their ability to properly diagnose and treat patients with sleep disturbances by using refined approaches and assessing more sensitive parameters during sleep. Additionally, many conditions not typically thought to be rooted in abnormalities of sleep are now recognized and treated more effectively. In Houston, Jerald H. Simmons, MD, a Triple Board-Certified Neurologist specializing in sleep disorders, directs several sleep centers that clearly stand out from the crowd. His centers use methods beyond what is required by sleep centers for accreditation.

Dr. Simmons points out that "Every path has a starting point and we learn new things along the way. It is great that the field of Sleep Medicine is developing standards but unfortunately the current standards fall short of being able to properly diagnose and treat patients with complicated conditions. By identifying the more subtle abnormalities, we have been successful in providing care to patients who were previously left struggling by the health care system."

In example, a common cause for recurrent morning headaches is OSA or UARS. Many of these patients also have bruxism during sleep (clenching or grinding the teeth at night) and this can lead to TMJ Disorder. Research conducted by Dr. Simmons has shown that bruxism during sleep actually helps keep the airway open by moving the tongue and jaw forward; this is the body's attempt to prevent OSA or UARS. By treating the airway problems during sleep Dr. Simmons and Dental Sleep Specialist Dr.Ron Prehn have demonstrated improvement in both bruxing and TMJ pain.
When appropriate Dr. Simmons treats patients with OSA or UARS by using dental appliances as an alternative to the CPAP machine, and is performing pioneering research on the use of combined treatment approaches using both CPAP with dental appliances.


Additionally, most patients with fibromyalgia have poor sleep. Proper treatment of their sleep problems frequently improves the symptoms of Fibromyalgia. Signals from pain nerve fibers throughout the body constantly send a low level of signals to the brain, but the brain normally filters these out. If the brain is not properly rested it loses the ability to filter these signals which results in common fibromyalgia pain.
Treatments geared to improving sleep continuity restore the brain's pain filter mechanism, and the pain symptoms resolve.

The underlying sleep disturbances causing these symptoms is not always identified by sleep centers, and the treatment opportunities are missed. In many of these patients UARS can be at the root of the problem. Once the sleep disturbance is properly treated, fatigue resolves.

The sleep centers directed by Jerald H. Simmons, MD utilize advanced methods to properly diagnose and treat patients with conditions, such as those described above. Dr.Simmons concludes that "In the future we will look back and see how much we didn't understand, but unless we embrace the knowledge of our experience we will never reach that future perspective."

For more information on sleep disorders and the sleep centers of Dr. Simmons, visit HoustonSleep.net and gain the knowledge you need to obtain a better night's sleep.

TMJ (TMD) and sleep Bruxism associated with OSA. Diagnosis and Treatment...

Temporal Mandibular Joint Dysfuntion (TMJ) causes pain and headaches in millions of people each year. This common problem is caused by clenching and grinding the teeth, typically while asleep.
 Research conducted by Dr. Jerald Simmons and Dr. Ronald Prehn has demonstrated that bruxism during sleep is the body's attempt to open up the airway and improve breathing, particularly for people who suffer from Obstructive Sleep Apnea. When Dr. Simmons has implemented treatments for OSA, such as CPAP or dental appliances (TAP or other mandibular advancing devices), their TMJ symptoms usually resolve.

Many of these patients can not be placed on a mandibular advancing dental appliance initially because of inflammation from the TMJ; once this improves through the use of other methods such as CPAP, then a mandibular advancing appliance can be used successfully. The physiology of this has been demonstrated and is explained by Dr. Simmons in this video.
Visit our web site for more information at http://www.Houstonsleep.net

SLEEP APNEA SUPPORT GROUP IN HOUSTON!

THE SLEEP EDUCATION CONSORTIUM (S.E.C.) is Excited to Announce the Start of the A.W.A.K.E. GREATER HOUSTON Monthly Patient Advocacy Group for Individuals Suffering from Obstructive Sleep Apnea and Other Sleep Disorders.

A.W.A.K.E. is a national patient advocacy group sponsored by the American Sleep Apnea Association. Its mission is to increase awareness and education about Obstructive Sleep Apnea.
The A.W.A.K.E. GREATER HOUSTON chapter will meet monthly on a rotating cycle of three locations: the Houston Medical Center, The Woodlands, and Sugar Land. Meetings will start with patient discussion, followed by a brief interactive lecture about varying sleep disorders. These lectures will be given by local sleep specialists and will encourage patient Sleep Disorders. and education about Obstructive Sleep Apnea. involvement in the topics discussed.

The first meeting will be on Tuesday, August 26, 2014
At Comprehensive Sleep Medicine Associates
15423 Creek Bend Drive, Sugar Land, TX 77478

Patient Discussion Begins – 6:30 P.M.
Physician presentations:
Overview of Obstructive Sleep Apnea – 7:00 P.M.
Dental Appliances as an alternative treatment to CPAP – 7:20 P.M.
Discussion will follow the conclusion of the lectures.

RSVP by calling 281-269-7881 or by sending an email to AWAKEGreaterHouston@gmail.com

Commercial Drivers Still at High Risk From "Drowsy Driving"

The issue of sleep-deprived or "drowsy" driving has made the news again following the tragic June 7 accident involving the comedian Tracy Morgan. Prosecutors say that the Walmart truck driver whose tractor-trailer slammed into a van, critically injuring Mr. Morgan and killing another passenger, had not slept in over 24 hours.
Drowsy driving is a leading cause of crashes and highway fatalities, according to federal officials: more than 30,000 people die on highways annually in the United States and crashes involving large trucks are responsible for one in seven of those deaths.
Federal rules introduced last year reduced the maximum workweek for truckers from 82 to 70 hours, after which drivers have a mandatory 34-hour resting period. This “restart” must include two periods between 1 a.m. and 5 a.m. to allow drivers to rest at least two nights a week: they cannot drive for more than 11 hours a day and must have a 30-minute break in their schedule.

But the trucking industry has been battling to get the new nighttime-break regulations repealed. On June 6, Senator Susan Collins, Republican of Maine, pushed an amendment through the Senate Appropriations Committee that would freeze the rules, pending further studies. Ms. Collins said the administration had failed to take into account that the new rules would put more trucks on the roads during peak traffic hours. Trucking officials and executives also said that drivers needed to be afforded maximum flexibility in their work and should not be told when to rest.

Safety investigators said that sleepy or drowsy driving is a far more common problem than most people realize, but how extensive the problem is remains a matter of debate, partly because it is difficult to obtain evidence that drivers fell asleep. In 1990, a National Transportation Safety Board study of 182 heavy-truck accidents in which the truck driver died concluded that fatigue played a role in 31 percent of the cases, more than alcohol or drugs.
But the American Trucking Associations said that a federal database of fatal crashes cited fatigue in less than 2 percent of police reports about accidents involving trucks; a more accurate estimate, they claim, is that driver fatigue plays a role in about 7 percent of truck crashes. “Until we have a blood test for determining fatigue, all estimates are likely going to under-report fatigue, because the dead don’t speak and the living often plead the Fifth, especially if they are facing criminal charges,” said Deborah A. P. Hersman, former chairwoman of the N.T.S.B. and now the president and chief executive of the National Safety Council.

The Transportation Department has proposed that all interstate commercial truck and bus companies be required to use electronic logging devices to increase compliance with driving-hour rules. Paper logs are easier to manipulate and more difficult for law enforcement officials to verify. The comment period for the rule is scheduled to end this month. Some commercial truck fleets already such devices. For instance, Walmart’s trucks have GPS and electronic logging systems, which track where the vehicles are and what they are doing. A Walmart spokeswoman said the truck involved in the accident that injured Mr. Morgan, who remains in a New Jersey hospital, was also outfitted with anti-collision technology, which is supposed to alert drivers if there is a car in a neighboring lane when they activate their turn signal, for example. It is also supposed to slow the truck down automatically if it is approaching slow-moving or stopped traffic. Citing the incomplete investigation, Walmart declined to provide specifics on the accident or the driver’s schedule in the days leading up to the crash.

Excessive daytime sleepiness is a common problem in today's society. It is so common that in some circles people almost consider it a normal aspect of a productive society. The fact is that daytime sleepiness and fatigue are leading causes of accidents, both on the job and on the road. The cost to society is estimated in billions of dollars per year. There are several common causes for increased daytime sleepiness. The simplest cause of daytime sleepiness that can be corrected results from insufficient sleep. The average person requires 7 to 8 hours of sleep per night. If a person routinely gets less than this, it will most likely cause excessive daytime sleepiness. Another common problem can be sleeping in a noisy environment. This can cause many short awakenings, so brief that a person doesn't remember them the next morning. This results in non-restful sleep with resulting excessive daytime sleepiness. If a person gets 8 hours of sleep a night and still feels sleepy during the day, one should consider that they may have a medical problem which hinders their ability to obtain restful sleep.
For more information on the causes of "drowsy driving" and how you can get treatment for the sleep-related issues involved, visit Dr.Simmon's website at houstonsleep.net.

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References:
Truckers Resist Rules on Sleep, Despite Risks of Drowsy Driving (NYT, June 16, 2014

Learn about how your sleeping habits affect your epilepsy and what you can do to improve your health

The Epilepsy Awareness Houston Support Group presents a program on 

"How your sleeping habits affect your epilepsy and what you can do to improve your health."

Tuesday, April 8, 2014 from 6:00 to 8:00 pm., 

at 2401 Fountain View Dr.,Suite 900, (9th Floor),

Houston, Texas 77057

With special guest speaker Dr. Jerald H. Simmons:
Triple board-certified in Neurology, Sleep Medicine and Epilepsy, Dr. Simmons’ main focus has always been the specialty of Sleep Disorders Medicine. He trained in Sleep Medicine at Stanford University, then co-directed the University of California Sleep Disorders Center in Los Angeles. He was recruited to Houston to develop and direct the Sadler Clinic Sleep Disorders Center, which he did for 13 years, while also founding his private practice, Comprehensive Sleep Medicine Associates. Always eager to teach, he is the founding director of the Sleep Education Consortium, a nationally recognized, non-profit organization that provides medical education seminars on sleep disorders to phy- sicians, dentists, health care professionals and the community. He continues to be published by many peer reviewed journals and conducts research studies to improve the field of sleep medicine

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.

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

Poor Sleep is Frequently at the Root of Fibromyalgia

For decades, doctors have been challenged in treating patients with a condition known as fibromyalgia. Patients with fibromyalgia complain of pain in various parts of their body, and evaluation by the doctor does not identify any physical cause. There are no inflammation or arthritic changes in the bones to explain the daily difficulties with pain. More than 12 million Americans have been labeled with this diagnosis and treatment options have been limited; for the most part it has consisted of pain medications or medications that dull the nerve pain transmission from around the body to the brain. These medications frequently cause side effects including drowsiness, and their benefits lessen over time.

A new direction in the management of fibromyalgia stems from our growing knowledge of this mysterious disorder. Dr. Jerald H. Simmons, neurologist and founding director of Comprehensive Sleep Medicine Associates (CSMA), says that fibromyalgia is a condition in which the brain's pain-filtering system is fatigued and does not function correctly: "Our brains constantly filter out signals coming in from the nerve fibers throughout the body. This allows us to function without feeling every little impulse coming from all of the nerves. When we sleep, this filter in our brain restores itself in preparation to function throughout the next day. When we are sleep-deprived or have not gotten proper sleep, the filter system begins to malfunction and signals from the nerves that should have been filtered out instead get into the brain and create the sensation of pain."

Another way to describe this is that our pain threshold is lowered by poor sleep, and this relationship between sleep and pain has become increasingly dear. As it turns out, many patients with sleep disorders who have also been identified as suffering from fibromyalgia experience resolution of their fibromyalgia pain as a result of treatment of their sleep disorder. The link between sleep and other conditions has become increasingly clear. "If we improve sleep in fibromyalgia patients, we have seen that the pain improves as well," Dr. Simmons says. "Common sleep disturbances such as obstructive sleep apnea, restless legs syndrome or upper airway resistance syndrome seem to be underlying causes of patients' fragmented sleep. Many of these patients also complain of chronic fatigue syndrome, further implicating sleep disruption as a contributing factor. I have had excellent results from identifying the root of the disrupted sleep and then treating the sleep disturbance."

Dr. Simmons uses a new approach to treat patients with fibromyalgia that have not been identified as having another sleep disorder; it involves Zyrem, a medication originally used for treating narcolepsy. "Now that I'm on Zyrem, I feel better than I have in 20 years," said Nancy Schweining, one of Dr. Simmons' patients. "My pain is gone and I feel like I have my life back." Dr. Simmons expects more doctors to recognize the proper use of this medication, which he said enhances Sleep Wave sleep in patients with fibromyalgia.

If you or someone you know suffers from fibromyalgia, consider the possibility that poor sleep may be at the root of the condition. Evaluation can be provided by Dr. Simmons and his staff at CSMA's sleep centers throughout Greater Houston by calling 281-407-6222 or by visiting www.HoustonSleep.Net.

 

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.