Sleep Medicine / Disorders
Capital Region Sleep Medicine Disorders Group
- Aaron Sher MD
- Howard Weiss DO
- Barbara Smith BA, MS, FNP.
Capital Region Otolaryngology Sleep Medicine Disorders Group, located at St. Peter’s Sleep Center represents a comprehensive diagnostic, treatment, and research program specializing in the complexity of sleep medicine and surgery.
Dr. Sher is the Medical Director of St. Peter’s Sleep Center, and Dr. Weiss is the Associate Medical Director.
Dr. Sher proposed and helped to establish Capital Region Sleep Wake Disorders Center (Albany Medical Center and St. Peter’s Hospital) in 1990. The program was accredited by the American Academy of Sleep Medicine in 1991. This became St. Peter’s Sleep Center: Capital Region Sleep Wake Disorders Center in 1995. It is the oldest accredited sleep medicine program in the Capital Region.
What Types of Sleep/Wake Disorders Do We Treat?
We treat the full range of disorders that affect sleep and wakefulness. These include, but are not limited to:
Insomnia: repeated difficulty with sleep initiation, maintenance, or quality (despite adequate sleep opportunity) resulting in daytime impairment
Sleep Related Breathing Disorders: sleep related breathing abnormalities (includes snoring and obstructive sleep apnea)
Hypersomnias of Central Origin: excessive daytime sleepiness not due to apparently inadequate or disturbed sleep (includes narcolepsy)
Circadian Rhythm Sleep Disorders: chronic misalignment of the body’s rhythm or “biological clock” and the 24-hour physical or social environment, resulting in insomnia and/or excessive daytime sleepiness (includes advanced or delayed sleep phase, jet lag and shift work disorder)
Parasomnias: undesirable physical events occurring during sleep (includes, among others, sleepwalking, sleep terrors, dream enactment, and bedwetting)
Sleep Related Movement Disorders: stereotyped movements occurring in sleep, resulting in disturbed sleep or excessive daytime sleepiness (includes periodic limb movement disorder and bruxism)
St. Peter's Sleep Center: "Firsts" in the Capital Region
SPSC has brought many firsts to New York's Capital Region. These include the following:
- FIRST comprehensive sleep medicine program dealing with all aspects of sleep medicine
- FIRST sleep medicine program accredited by the American Academy of Sleep Medicine (1991)
- FIRST sleep medicine program to apply computerized digital polysomnographic equipment (Beta site) (1991)
- FIRST multi-disciplinary sleep medicine program:(sleep medicine, otolaryngology-head and neck surgery, pulmonary medicine, clinical psychology, pediatrics, dental medicine and surgery, clinical nutrition, respiratory therapy)
- FIRST regional sleep center, established jointly by St. Peter’s Hospital and Albany Medical Center (1990)
- FIRST sleep medicine program in which all technicians were licensed respiratory therapists as well as registered polysomnographic technicians
- FIRST sleep medicine teaching program, offering clinical elective in sleep medicine to students of Albany Medical College and Albany College of Pharmacy and clinical rotation in polysomnography to respiratory therapy students of Hudson Valley Community College (SUNY)
- FIRST sleep medicine program to routinely diagnose and treat upper airway resistance syndrome (one of the first in the U.S.)
- FIRST sleep medicine program to include an in-house certified dietician
- FIRST (national) conference on sleepiness as a cause of highway crashes , co-sponsored by SPSC and held in Albany (with NYS Traffic Safety Institute, SUNY Rockefeller School of Government, NYS Governor’s Traffic Safety Committee, and National Sleep Foundation), 1993
- FIRST sleep medicine program to affiliate with NYS Institute for Traffic Safety Management and Governor’s Traffic Safety Committee on New York State’s Drive Alert-Arrive Alive campaign
- FIRST sleep medicine program to integrate surgical and non-surgical therapies for sleep apnea
- FIRST sleep medicine program to include radiofrequency tissue ablation as treatment for sleep apnea (national Beta site)
- FIRST sleep medicine program to apply skeletal (jaw) surgery for sleep apnea
- FIRST sleep medicine program to integrate soft tissue and skeletal surgery for sleep apnea
- FIRST sleep medicine program to apply dental devices in the treatment of sleep apnea
- FIRST sleep medicine program to exclusively utilize positive pressure devices that objectively record effectiveness and compliance
- FIRST sleep medicine program to integrate all aspects of positive pressure distribution, teaching, and monitoring into its treatment program (SPDME)
Accreditation of St. Peter's Sleep Center
SPSC was accredited by the national accrediting body, the American Academy of Sleep Medicine (AASM), the year after it opened (1991). It has been re-evaluated and re-accredited every five years.
Accreditation criteria are diverse and stringent. Leadership positions must be filled by board certified diplomates in sleep medicine. These individuals are trained to diagnose and treat the broad array of sleep-wake disorders, including the 90 disorders included in the International Classification of Sleep Disorders, Diagnostic & Coding Manual, Second Edition, 2005. To be accredited, the center must demonstrate a numerically adequate and adequately diverse patient caseload to ensure diagnostic and therapeutic competency.
Technical staff who conduct diagnostic sleep studies must be registered clinical polysomnographers, having successfully completed requisite training and a certification examination. All of SPSC’s technologists meet AASM standards. They also qualify under the New York State Department of Education code, which mandates that such technologists be licensed respiratory therapists.
Diverse physical attributes of the physical plant, designed to maximize patient comfort and safety, are stipulated.
To achieve accreditation or re-accreditation, the center must document compliance with contemporaneous clinical guidelines of the American Academy of Sleep Medicine. These guidelines, comprehensively covering diagnostic and therapeutic procedures in sleep medicine, are built around regularly updated analysis of relevant peer reviewed literature conducted by the Standards of Practice Committee of AASM. Criteria by which patients are evaluated clinically, criteria by which they are assigned to specific testing protocols, the nature of testing equipment utilized, criteria applied in test scoring, and adequacy of treatment protocols are all subject to AASM scrutiny, measured against data-based AASM guidelines.
Review and acceptance by AASM of extensive preliminary documentation of compliance culminates in a day-long site visit by professional members of the AASM Accreditation Committee. The site visit includes in-depth review of the physical plant, testing equipment, and patient charts. Clinical staff must demonstrate scoring techniques of sleep studies. Interviews are conducted with clinical staff, consulting staff, technical staff, and administrative staff. All aspects of the structure and functioning of the sleep center are scrutinized, judged and criticized.
The accreditation process is repeated every five years.
Focus of St. Peter's Sleep Center Leadership
on the Complex Practice of Sleep Medicine
Drs. Sher, Weiss, and Glovinsky practice sleep medicine on a full time basis. In many sleep programs, the sleep laboratory is, in reality, a sideshow of a full-time pulmonary or otolaryngology practice. SPSC’s leadership believes that the nature of sleep medicine requires of them full-time commitment to coordinating a complex diagnostic and treatment team, involving their disciplines with several other consulting disciplines. They view their original specialty training (otolaryngology head and neck surgery, internal medicine, pulmonary disease, critical care, and clinical psychology as the foundation on which their sub-specialization in sleep medicine is based.
Most medical disciplines focus on a body system. However, sleep medicine differs in that it focuses on the entire body, but as it functions during the contrasting sleep and wake states. The discipline of sleep medicine, therefore, cuts across all medical disciplines, and, by its very nature, requires input from a diverse team of health care specialists. For example, many disciplines are involved in the comprehensive treatment of sleep disordered breathing, or sleep apnea. Dr. Sher’s background in otolaryngology-head and neck surgery enabled him to become an authority on the upper airway in sleep apnea, spending many years researching surgical outcomes for sleep apnea. Dr. Weiss, who is a diplomate in internal medicine and pulmonary medicine, brings expertise in aspects of respiratory control and the impact that sleep apnea has on other organ systems, particularly the cardiovascular system. The relationship of jaw structure to breathing brings the dental and oral-maxillofacial surgeon into the picture. Dr. Glovinsky’s background in clinical psychology affords him unique expertise in addressing the behavioral and cognitive difficulties that are part of sleep apnea. Integration of the varied background specialties of the clinical leadership permits an extraordinary range and depth of care to these patients, whose sleep disorder commonly results in an extensive range of consequences. In similar fashion, other sleep disorders affect mind and body in complex ways, best addressed by a team with diverse background and interests.
The SPSC leadership team offers an unusual depth of experience in the discipline of sleep medicine, particularly in light of its relative newness as a medical specialty. The combined experience in sleep medicine of the team of Drs. Sher, Glovinsky, and Weiss totals 63 years. SPSC’s respiratory therapists have been working full time at SPSC for an average of 9 years and at SPH for an average of 17 years. The average tenure at SPSC of its two nurse practitioners is 13 years, and its registered nurse has been at SPSC for 20 years.
Philosophy of the St. Peter's Sleep Center Team: Clinical Assessment
SPSC’s patient intake process includes a lengthy initial consultation exploring physical, psychological, and environmental factors which may be contributing to the patient’s sleep or wakefulness complaint. An attempt is made to tease these out, thereby determining therapeutic measures or need for physiological sleep testing. For example, symptoms of sleep apnea may include insomnia, mood disturbance, attention deficit and hyperactivity, nightmares, night terrors, and sleep-walking, all of which may also occur in the absence of sleep apnea. If the latter is not adequately considered, knee-jerk ordering of polysomnographic testing in the face of these symptoms may result in inappropriate and needless testing, with consequent erroneous diagnosis, inadequate or inappropriate therapy, and wasted resources.
On the other hand, when sleep apnea is appropriately diagnosed, it is important to identify other physical, psychological or environmental factors which may interfere with treatment of the sleep apnea. Such factors may include manifestations of behavioral maladaptation indirectly resulting from underlying the sleep apnea. For example, the patient may have become substance dependent (caffeine to fight daytime sleepiness, or alcohol to promote sleep). Continued consumption of these substances interferes with effective treatment of the underlying sleep apnea). Early and continued vigilance for such secondary factors may spell the difference between therapeutic success and failure.
Philosophy of the St. Peter's Cleep Center Team: Testing
Some sleep centers function mainly as testing centers, in some instances applying sleep studies in response to little more than a completed patient questionnaire. In SPSC, physiological testing does not substitute for clinical judgment, based on careful face-to-face interaction with the patient.
Indeed, the emphasis of SPSC is not on testing. The emphasis is, instead, on effective treatment. Indeed, we measure our success in terms of treatment outcomes. Many patients referred to SPSC are never subjected to sleep tests or are tested in deferred fashion, only after a period of clinical evaluation clarifies whether sleep testing is indicated and which type of test is most appropriate. If behavioral or medical issues are likely to interfere with testing or confound the interpretation of test results, testing is deferred until these issues are effectively dealt with.
Once a sleep study is deemed appropriate, the study is performed with specific instructions handed by the ordering clinician to the technologist performing the sleep study. The completed sleep study is analyzed and interpreted by SPSC clinicians working in SPSC, the scoring and interpretive process involving the integrated effort of SPSC clinicians and technologists.
This differs from the practice of many other facilities, whose sleep studies are sent out of state for scoring and interpretation by individuals who are unfamiliar with the patient, the technologist who performed the study, and confounding local matters that may have influenced the outcome. We believe that much is lost when the interpreting team is different and geographically remote from the clinical team.
Philosophy of the St. Peter's Sleep Center Team: Treatment
The diverse armamentarium applied to treat one common sleep disorder, sleep apnea, may include weight reduction (achieved behaviorally or surgically), avoidance of certain medications or substances, use of various types of mechanical devices, and surgery of the upper airway (a host of 30 or more operations on the soft tissue of the head and neck or bones of the maxillofacial skeleton). Each of these therapies may be best suited to some patients, and unsuitable for others. The likelihood of success of these therapies may be diminished or eliminated if unfavorable behavioral practices, such as poor sleep hygiene or inadequate nutritional control are not incorporated. SPSC views this complex, dynamic situation as its domain, and dealing with it as its function. Sleep apnea is but one sleep disorder, but this the general approach of SPSC in dealing with all sleep disorders.
Many sleep disorders, including sleep apnea, are chronic diseases. They require adequate and patient-specific short and long term therapy and adequate long-term follow-up.
The nature of sleep disorders medicine is such that it cuts across diverse medical and surgical specialties, particularly when it comes to treatment. This is particularly poignant for sleep apnea, which will serve as an example. Treatments include behavioral weight reduction, surgical weight reduction (gastro-intestinal bariatric surgery), dental devices, positive pressure devices, upper airway soft tissue surgery, and maxillo-mandibular skeletal surgery. What (and who) determines the treatment applied in any given case? While these treatments differ fundamentally and have different expected outcomes in different patients, the treatment selected may most directly be impacted by the nature of the specialist to whom the patient serendipitously presents: pulmonologist, otolaryngologist, dentist, and psychologist. SPSC believes that patients are not well served by this reality. SPSC recognizes the value of each of these specialists in the treatment of sleep apnea and integrates all of them into a logical treatment program, applying what each has to offer in selective and integrated fashion. It attempts to minimize the impact of serendipity!
It is the policy of some facilities to test, treat, and not perform post-treatment testing. SPSC believes that this is not to the patient’s advantage. Applying sleep apnea as the example, it is generally accepted that the outcome of some therapeutic attempts is likely to be poor, particularly if the treatment was not optimally fitted to the patient.
SPSC strives for universal clinical and objective follow-up after a therapeutic attempt. A poor or inadequate outcome, while disappointing, can usually be improved upon if identified in timely fashion. It is with this spirit that SPSC apply only CPAP machines which continue, over the long term, to objectively monitor compliance and effectiveness. Similarly, SPSC strives to objectively re-test all patients for treatment effectiveness after interventions such as weight loss, dental devices, or sleep apnea surgery are applied.
Patients are laboriously informed about the limitations and expected outcomes of each treatment they are asked to consider. They are made to understand that serious effort will be applied to document success or failure of a given treatment modality. A second therapeutic approach will be offered following documentation of failure.
It is not failure that is most unacceptable, but rather failure, lack of recognition of failure, and subsequent loss to follow-up.
The PAP Follow-up Program: SPDME
Well tolerated positive airway pressure (PAP) is almost always effective for patients with OSA, regardless of anatomical variation, body weight and OSA severity. Effectiveness of PAP can be objectively documented in the sleep center before PAP is prescribed. Settings can then be fine tuned utilizing internal sensing equipment while the patient uses PAP at home.
The significant limitation of PAP is its intrusive nature, which may result in intolerance, limited compliance and outright rejection. The likelihood of rejection is increased when patients are not adequately informed about the risks of untreated OSA and about the rate of failure or limited success of many other treatment options. Inadequate attention to detail during PAP titration (lack of attention to different pressure needs in different body positions or sleep stages) is likely to result in ineffectiveness and patient intolerance. Lack of attention to the specific psychological and physical needs of the patient has a similar effect. After commencement of PAP therapy, likelihood of success is increased through fine tuning, guided by objective monitoring of PAP effectiveness. Such monitoring and PAP adjustment resumes importance during periods of physiological change, such as weight gain or weight loss.
OSA is a chronic disease, requiring long term monitoring to detect changes in patient requirements based on psychological and physical change over time. Objective monitoring is readily achieved through application of currently available technology.
Most other OSA treatments, including the wide range of upper airway reconstructive surgical procedures and dental devices, are less effective against the full range of clinical disease than PAP. The degree of improvement brought about by these latter approaches is variable, and ability to predict success or failure is excessively limited. Effectiveness or lack of effectiveness of treatments other than PAP may relate to head and neck anatomy, degree of obesity, and OSA severity, but there is no formula capable of accurate prediction of success and failure. Furthermore, “success” is often defined by limited short term amelioration rather than long term resolution. Indeed, the level of OSA severity commonly used to define “surgical success” is, nonetheless, adequate to justify successful and long term treatment with PAP (1). It is not possible to predict which patients will achieve even this degrees of improvement with high accuracy. For these reasons, objective short term follow-up should be applied to rule out immediate failure, and long term follow-up should be applied to rule out long term reversal of limited short term “success”. In cases of failure, PAP treatment may still be indicated, while seeking out further alternative therapy.
Recognizing the importance of these factors, SPSC developed a program designed to maximize patient PAP tolerance and compliance.
Essential components are:
- A technical team, dedicated full-time to supporting patients accommodating to or using PAP. All are licensed respiratory therapists who are also dual- credentialed as clinical polysomnogaphers (sleep technicians). All have extensive experience evaluating and treating patients with OSA.
- A provider team, dedicated full-time to the practice of sleep medicine, and consisting of physicians (including specialists in sleep medicine, otolaryngology-head and neck surgery, pulmonary and critical care), a clinical psychologist certified in behavioral sleep medicine and two nurse practitioners.
- Specialized PAP equipment: including systems and ancillary equipment specifically designed to maximize patient tolerance, with characteristics selected to complement individual physical, physiological, and psychological attributes. All PAP units record and download, on a long-term and continuous basis, detailed information about patient compliance and objectively monitored PAP effectiveness (including measurement of residual breathing disturbance despite PAP).
The technical and provider teams work together, under one roof, to assist patients in selecting PAP equipment, instruct them in its use, and trouble-shoot (over the short and long term) to overcome technical and compliance problems. The teams consult among themselves to solve clinical problems related to PAP therapy. While problems are most frequent early in the course of therapy, others may become apparent long into therapy. Detection and corrective action supports long-term compliance.
Most regional insurance companies participate with this program. For patients who are insured by non-participating third party carriers, or for those who prefer to receive their equipment from community based durable medical equipment companies, SPSC’s technical and provider teams work closely with representatives of those companies and strive to achieve favorable outcomes.
Our analysis of treatment outcomes are positive and have been accepted for national presentation at the 2010 meeting of the American Academy of Sleep Medicine. Preparations for publication of this data are underway.
It is important to note that all patients who prove intolerant of PAP, despite this program, are systematically evaluated for alternative forms of therapy, including mechanical or surgical alternatives, depending on the clinical indications.
Short and long-term subjective and objective monitoring of outcomes for all therapeutic approaches undertaken, coupled with frank disclosure of these outcomes (favorable or unfavorable), are the basis for valid provider advice and informed patient decision.
(1) Sher AE, Weiss HS. PAP Acceptance and Compliance in a Comprehensive Program.AASM, June 2010.
The St. Peter's Sleep Center Weight Reduction Program
Until recently we have concentrated our efforts on treating patients with obstructive sleep apnea (OSA) on strategies to improve their ability to tolerate positive airway pressure (PAP) and maximize the likelihood of adherence with this therapy. We have additionally now begun to focus on management of the most frequent cause of OSA, obesity. While it is well accepted that weight gain contributes to the development of OSA in the vast majority of patients, there is a growing body of literature which also suggests that OSA itself, on the basis of sleep disruption, metabolic derangement and daytime fatigue, may contribute to further weight gain. We believe therefore, that the improvements in nighttime sleep quality and daytime energy levels, derived from use of PAP therapy, provide a unique opportunity for individuals with OSA to successfully achieve weight loss. It is for these reasons that we have incorporated a nutrition program into our multidisciplinary center.
Once patients have adapted to PAP therapy and are receiving the expected beneficial effects, they are offered enrollment in a structured weight loss program. This program, led by a registered dietician, includes an 8 week course involving both individual and group sessions. Patients receive education, support, and learn practical behavioral strategies based on the most up to date principles of nutrition. Distinguishing itself from traditional weight loss programs, a strong emphasis is placed on the role of sleep in weight loss, integrating a crucial factor that is otherwise frequently neglected.
We believe that when weight loss is approached in this fashion, patients can make tremendous progress. In addition to the myriad health benefits that may be derived, patients with OSA specifically may see improvement in the severity of OSA, benefit from lower levels of PAP, become better candidates for alternative OSA therapies, and perhaps cure OSA altogether. Particularly given the frequent coexistence of obesity related conditions such as hypertension, diabetes, and heart disease with OSA, we view addressing the fundamental underlying condition to be of paramount importance and are highly optimistic about the chance for success in this setting.
History of St. Peter's Sleep Center
SPSC opened in 1990, a joint venture of St Peter’s Hospital and Albany Medical Center. It was taken over by St. Peter’s Hospital in 1995 and moved to a brand new, custom-designed facility in Pine West Plaza (off Washington Avenue Extension and five minutes from the junction of Interstate 87 and Interstate 90). SPSC provides comprehensive care for all sleep disorders and functions 24 hours per day. Ten hotel-like testing bedrooms designed for state-of-the-art testing also maximize patient comfort. They complement a suite of offices housing a multi-disciplinary team of specialists who diagnose and treat sleep disorders.
The SPSC team includes the following health care disciplines: sleep medicine, otolaryngology-head and neck surgery, internal medicine, pulmonary and critical care, clinical psychology, pediatrics, dental medicine, and maxillo-facial surgery. A large group of highly experienced respiratory therapists who sub-specialize in sleep medicine, a certified dietician, family nurse practitioner, adult nurse practitioner, and registered nurse complete the team. The group’s expertise is selectively directed and coordinated by a full-time medical director, a full-time associate medical director, and a clinical director (who specializes in behavioral sleep medicine).
Research into improved understanding and treatment of sleep disorders is actively pursued by the team.
In 1991, SPSC was the first regional sleep center accredited by the American Academy of Sleep Medicine.
In 2005, SPSC opened the capital district’s first comprehensive CPAP treatment center for patients with obstructive sleep apnea. It coordinated (under one roof) patient education, distribution of selective CPAP equipment (capable of objective effectiveness monitoring), and short and long-term follow-up care.
In 2010, a medical nutrition program was folded into the treatment armamentarium for overweight patients being treated for obstructive sleep apnea.
Background of St. Peter's Sleep Center Leadership
Dr. Aaron Sher
Dr. Aaron Sher was awarded his BA in Chemistry (summa cum laude) from Queens College of CUNY (1966) and his MD (with honors in cell biology) from New York University School of Medicine (1970). He completed an internship and residency in Surgery and residency in Otolaryngology-Head and Neck Surgery at Albert Einstein College of Medicine (1970-1975). Dr. Sher served as Lieutenant Commander, U.S. Navy (Chief of Otolaryngology, U.S. Naval Hospital, Japan (1975-1977). He completed a fellowship in Head and Neck surgery at Beth Israel Medical Center (NYC) (1979-1980). Dr. Sher is diplomate of both the American Board of Otolaryngology-Head and Neck Surgery and the American Board of Sleep Medicine.
As Associate Professor of Otolaryngology-Head and Neck Surgery at Albert Einstein College of Medicine (NYC) (1977-1986), his career in sleep medicine began in 1977, when he established a surgical program for sleep apnea patients at the first accredited sleep disorders center in the United States (Montefiore Medical Center, Albert Einstein College of Medicine, NYC). In 1983, Sher was invited to present surgical outcomes to the first national conference on surgery for sleep apnea (sponsored jointly by the American Sleep Disorders Association and the American Academy of Otolaryngology). Published in 1985, Sher’s early work contributed to the evolution of current treatment approaches for sleep apnea.
In 1986, Sher joined Albany’s Capital Region Otolaryngology-Head and Neck Group, of which he is currently senior partner. He serves as Clinical Associate Professor of Surgery (Otolaryngology) at Albany Medical College. Sher proposed that Albany Medical Center and St. Peter’s Hospital jointly establish a regional sleep medicine program for the Capital District. Established in 1990 and accredited by the American Academy of Sleep Medicine in 1991, the product of that effort became St. Peter’s Sleep Center in 1995. Dr. Sher serves as medical director.
Sher served on the Board of Directors of the American Academy of Sleep Medicine and as Chairman of the Sleep Disorders Committee of the American Academy of Otolaryngology-Head and Neck Surgery. He served on the cardiopulmonary sub-committee of the National Commission on Sleep Disorders Research (established by U.S. Congress). His contribution was a treatise on the outcomes of surgery and its role in the treatment of sleep apnea. The efforts of this Commission resulted in establishment of a permanent sleep research center at NIH. Sher authored a meta-analysis on outcomes of surgery for sleep apnea which became the basis for the first national practice standards for sleep apnea surgery of the American Academy of Sleep Medicine.
Sher has served in advisory capacity to the National Heart, Lung and Blood Institute (NIH), American Thoracic Society, and Sleep Disorders Dental Society. He hosted and co-chaired the first national meeting on sleepiness and highway crashes, held in Albany in 1993 (with SUNY Rockefeller School of Government, NYS Governor’s Traffic Safety Committee, and National Sleep Foundation).
Sher promoted the recognition of sleep medicine as a separate medical specialty. Sleep medicine is now formally recognized by the American Board of Medical Specialties and the Accreditation Council for Graduate Medical Education (ACGME). The ACGME establishes national criteria for residency and fellowship programs in medical and surgical specialties. Sher served with the ACGME, helping to establish national criteria for fellowships training physicians to become sleep medicine specialists.
Dr. Sher has published 29 scientific articles and 12 book chapters in his area of expertise. He has served on the editorial board of three peer reviewed journals in sleep medicine and as associate editor of an electronic textbook on sleep medicine. Sher has addressed and chaired academic meetings on sleep medicine around the world.
Dr. Howard Weiss
Dr. Weiss completed his undergraduate studies at Binghamton University earning a B.S. in Psychobiology and went on to receive his medical degree from the Nova Southeastern University- College of Osteopathic Medicine in Florida. He pursued post-graduate residency training in Internal Medicine at Winthrop University Hospital, during which he served as Assistant Chief Resident and received the John F. Aloia Award, recognizing a single exceptional graduate. He remained at Winthrop University Hospital where he undertook fellowship training specializing in Pulmonary, Critical Care, and Sleep Medicine. He garnered additional praise during these years, twice named outstanding fellow of the year among all subspecialty programs.
Having grown up in the capital district, Dr. Weiss returned to the region with his wife and two children in 2006, where he now focuses his practice on the evaluation and management of the entire gamut of sleep disorders. The diversity of his training has allowed him to develop expertise in the approach to conditions ranging from obstructive sleep apnea to narcolepsy and insomnia, integrating both medical and behavioral therapies in the care of his patients. He holds a particular interest in the relationship between sleep disordered breathing and cardiovascular disease and has lectured widely on the topic.
Dr. Weiss serves as the Associate Medical Director of the St. Peter’s Sleep Center and is an adjunct faculty member of the Albany College of Pharmacy and Health Sciences of Union University. He is board certified in Sleep Medicine by both the American Board of Sleep Medicine and American Board of Internal Medicine. Additionally, he is board certified in Internal Medicine, Pulmonary Disease and Critical Care.
Dr. Paul Glovinsky
Paul Glovinsky, Ph.D. specializes in the evaluation and behavioral treatment of insomnia, and has co-authored about two dozen articles and textbook chapters on these topics as well as other aspects of sleep medicine over the past twenty five years. He and Dr. Arthur Spielman formulated one of the major models explaining the genesis of chronic insomnia, and co-authored “The Insomnia Answer,” which presents their findings and treatment recommendations to the general public.
Dr. Glovinsky is a licensed psychologist in the state of New York. He is a Diplomate of the American Board of Sleep Medicine and is also Certified in Behavioral Sleep Medicine. He has been Clinical Director of the St. Peter’s Sleep Center for the past fifteen years, maintains a private practice as a clinical psychologist specializing in the treatment of sleep disorders and anxiety disorders, and is an Adjunct Professor at the City University of New York. Dr. Glovinsky has served as an insomnia specialist for the American Board of Sleep Medicine, including four years as Chair of the Behavioral Sleep Medicine examination committee. He has been featured in numerous print, radio and television stories.
The St. Peter's Sleep Center Research Program
Publications of the SPSC Leadership
The SPSC team has published a total of 36 scientific papers, 27 book chapters, and 1 book on research related to the discipline of sleep medicine
- Research previously reported by SPSC team includes aspects of the following topics:
- The interdependence of sleeping and waking state
- The nature of insomnia
- The management of insomnia
- Psychology and sleep
- Sleepiness and REM recurrence
- Delayed sleep phase in adolescents
- Mechanisms of airway collapse in different craniofacial syndromes
- Selection of favorable patients for surgical treatments of sleep apnea
- Outcomes of many diverse surgical approaches in the treatment of sleep apnea
- The role of surgery for sleep apnea
- Outcomes of radiofrequency palate ablation in the treatment of snoring
- Outcomes of positive airway pressure in the treatment of upper airway resistance syndrome
- Outcomes of positive airway pressure devices in the treatment of sleep apnea
- Nature and treatment of insomnia
New Research Commencing at SPSC in 2010
The combined effect of application of nasal CPAP and a concurrently guided nutrition program on BMI and sleep apnea severity.