How should I pick a sleep doctor?
Many physicians are affiliated with and own sleep laboratories. We believe that the most qualified persons to evaluate and treat sleep disorders are doctors with special training to do that.

Board certification in a specialty is obtained only after formal training, demonstration of competence, clinical experience, and successful completion of rigorous academic testing.

All of our physicians are board certified in Internal Medicine and pulmonary medicine. All have many years experience in the practice of pulmonary and critical care medicine. Dr. MacDonald is a board-certified sleep specialist, and has evaluated and treated thousands of people with sleep problems.

Having a sleep study – commonly asked questions:

Can I choose what type of sleep study I want?
During your consultation appointment with Dr. MacDonald, he will thouroughly evaluate your sleeping issues. Sleep disorders vary. Because of that, the type of sleep study needed as well as its treatment vary as well. A determination will be made during your visit as to what type of study is indicated for your sleeping issue.

My doctor ordered a sleep study. What will happen?

If you are having an "in-lab" overnight sleep study:
You will be scheduled to show up about 2 hours before the study. This will give the technician time to attach the monitoring equipment. Sensors (electrodes) will be placed on your face, fingers, legs, abdomen, chest and head. Applying these sensors does not provide any pain or discomfort to the patient. An informational sheet (click here) will be given to you at the time you make your appointment. Any questions you have can be answered at that time by our staff as well as by your sleep technician on the night of your study.

Note: if the patient is under 18 years of age, and adult family member is required to stay for the duration of the testing.

If you are having a home sleep study:
An appointment will be made to pick up your machine. Instructions for using the machine (click here) will be given to you at the time of pick up. The machine will be returned the following morning. A follow-up appointment for your results will be made approximately 7-10 days after your home sleep study.

I have been scheduled for a MSLT (nap study). Do I need to bring something to eat?
Our office has a kitchen area that has a refrigerator as well as a microwave oven. Feel free to bring a lunch and/or snack with you. Your frozen entree can be heated for you in our microwave oven and any items that need refrigeration can be placed in our refrigerator until ready to eat.

Can I eat?
Yes, but we will not provide food. If necessary a clean refrigerator is available for food storage

My family member needs a sleep study but suffers from a medical issue which requires my assistance. Can I stay?
Absolutely! In certain situations, family members can stay with the patient throughout the night. While we do not provide hotel accommodations, one accompanying family member is welcome to sleep in a comfortable reclining lounge chair. Bedding and a pillow are provided.

What should I bring with me?
Wear comfortable, loose fitting clothing such as t shirts, pajamas, or sweat pants.
Each bedroom is equipped with a satellite TV and DVD player, you may bring DVD's from home for viewing before bedtime. All patients may bring their favorite pillow if they desire.
We do not provide medications. We do not administer medications. Please make appropriate arrangements. If you need a referral for the study, you must bring it with you. Unless all “paperwork” is done before the study, it will not be performed. Our staff will help obtain referrals if needed.

When can I leave after my study?
You will be scheduled for an 8 hour sleep study. Plan to be awakened 8 hours after your scheduled bedtime. If you wish you may shower before leaving. If you are scheduled for a daytime study (MSLT, or nap study) the next day, do not plan to leave until late the next afternoon – check with our staff regarding the expected study termination time.

Is sleep testing dangerous? Is there any pain or discomfort involved?
No. sleep testing is safe. No significant pain or discomfort is usually experienced.

My husband snores. I think he might stop breathing during sleep. What should I do?
When a person’s spouse or bed partner complains about loud snoring, the snorer’s doctor should be informed.

Loud snoring may be just a nuisance (as it can disrupt the life and sleep of a bed partner). In some individuals, though, it is one of the signs of obstructive sleep apnea. Individuals who are obese, sleepy during the daytime, or who are witnessed to stop breathing during sleep may need a sleep evaluation.

I can't get my teenaged son out of bed in the morning. He is sleepy during school, but can't go to sleep at night. What should I do?

There are many sleep problems and challenges affecting adolescents and young adults. We have a special interest in caring for such individuals. Our sleep specialists have experience treating patients with Delayed Sleep Phase Syndrome (a circadian rhythm disorder) and would be happy to see such individuals in consultation.Your son may have Delayed Sleep Phase Syndrome. He should be seen by a sleep specialist. Our sleep specialists have experience in treating such a problem.

For more information regarding Delayed Sleep Phase Syndrome, CLICK HERE.

What if I can't go to sleep during the sleep study?

We will almost certainly get enough information even during a short period of sleep to diagnose most sleep problems. Some people actually sleep better in a sleep laboratory than at home! Don’t worry!

Why do I have to see a physician before a sleep study?
We strongly feel that consultation with a sleep specialist is the most important aspect of a sleep evaluation. Information gathered during the consultation is important, often leads to diagnoses not forthcoming during sleep tests, and helps our sleep physicians to ensure that testing is properly performed.

Will I need a nap test as well as an overnight sleep study?
Nap testing (multiple sleep latency testing) may be ordered if our sleep specialist physicians suspect that you may have narcolepsy. It may also be indicated to prove that an individual is not pathologically sleepy. However, most individuals who visit our center do not undergo this test.

What insurances are accepted?
We accept most major insurances. If we do not accept your insurance we will be glad to assist you in finding physicians who do.

Why can't I just take sleeping pills?
Our sleep specialists can often treat sleep disorders without the use of medicines. If medicines are needed to promote and maintain healthy sleep we are very willing to provide them. In many instances, however, non-drug therapy is best in the long term. We are glad to assist with both drug therapy and non-drug therapy.

My doctor told me I have an abnormal chest x-ray/CT scan of the chest. Should I be concerned? Does that mean I have cancer?
Chest x-rays and CT scans are useful in determining causes for lung symptoms. Shadows and abnormal findings on chest x-rays and CT scans can cause anxiety for patients. While not all abnormal chest x-rays/CT scans indicate cancer, it is important to follow up with any chest x-rays and/or CT scans in a timely manner so an appropriate diagnosis and treatment can be initiated. Due to the stressful nature that any abnormal finding brings to individuals, patients can be seen at The Center for Respiratory and Sleep Disorders within a week's time of your initial finding.

I need to have a bronchoscopy, what is that?

Bronchoscopy is a procedure that allows your doctor to look at your airway through an instrument called a bronchoscope. During a bronchoscopy , your doctor will examine your throat, larynx , trachea , and lower airways. Bronchoscopies are useful in diagnosing problems with the airway, the lungs, or with the lymph nodes in the chest, or to treat problems such as an object or growth in the airway. Your pulmonologist will determine which type of bronchoscopy is needed for your symptoms.

Specialized Bronchoscopies

Bronchial Thermoplasty
This procedure is used for relief of individuals who suffer from severe asthma. It is effective in providing long term relief in the number of asthma attacks, requiring less need for oral steroid medications. A pulmonologist can determine whether or not you might be a candidate for this procedure.

Procedure: With the aid of a bronchoscope, a small device delivers heat to the smooth muscle airways in your lungs. This reduces the volume of excess smooth-muscle tissue in the airways making the airways constrict less. Asthma attacks are reduced and breathing is improved.

Endobronchial Ultrasound (EBUS)
Endobronchial ultrasound (EBUS) is a specialized form of bronchoscopy which uses ultrasound along with bronchoscope to visualize airway wall and structures adjacent to it. This technique is used to diagnose lung diseases. It is also performed when biopsying of lymph nodes in the chest is needed for staging of tumors. These samples are examined as they are obtain leading to a faster evaluation of the tissue.

Super Dimensional Bronchoscopy
Super Dimensional Navigation System-Electromagnetic navigation bronchoscopy (Super D) which provides a minimally invasive approach to accessing difficult-to-reach areas of the lung, which can aid in the diagnosis of lung disease and thereby lead to earlier, personalized treatment.

What you should expect (and insist upon) from your home care company:

Your doctor may write a prescription for you to have durable medical equipment, devices, and / or supplemental oxygen. You have the right to choose your provider unless it is mandated by your insurance company. If you already have a relationship with a provider (home care company), please notify our staff so that the prescriptions may be sent to them.

Once you have picked a home care company, your sleep physician will arrange for a prescription to be sent there. Sometimes the prescription will not be sent until complete scoring of your sleep study is complete - this may take at least a couple of days. The reason for this possible delay is to ensure that the prescription is correct; sometimes complete scoring (and rescoring by the physician) of records is necessary.

Prompt Service
In most cases, your CPAP unit should be delivered no later than 5 working days after receipt of prescription and appropriate insurance authorization. Special requests may take longer.
Phone calls should be answered the same or next working day

Your home care company should offer free delivery of equipment to the site where you will use it.

Demonstration of Use
Technicians should demonstrate how to use the equipment.

Accurate Equipment Dispensing
Your home care company should dispense the mask and other equipment prescribed by your doctor. Sometimes substitution with other equipment is appropriate; technicians from the home care company may find equipment which suits you even better than that prescribed by your doctor. However, such changes should only be made after consultation with your physician.

Follow Up
Technicians from your home care company should be available to answer questions and service equipment if necessary.

Documentation of Compliance
Documentation that you use the unit prescribed by your doctor is important. It helps to show that you are a compliant patient. It helps your physician from a diagnostic standpoint; in some difficult cases we find this information very helpful. Some insurance companies will not pay for the use of CPAP devices if you can not prove that you actually use it.

Some home care companies help you and your physician by providing information about your compliance with equipment.

Please ask if you have questions regarding these issues. We will be glad to help.


44000 West 12 Mile Road, Suite 113, Novi, MI 48377
248.465.9253 (WAKE) Fax: 248.465.9285
© 2015 The Center for Respiratory and Sleep Disorders