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September 30, 2016
Dr. Juan Mella, pulmonologist at Texas County Memorial Hospital, discusses results from a sleep study with Paula McDaniel, certified sleep therapist at the TCMH Sleep Studies Laboratory.
The Texas County Memorial Hospital Sleep Studies Laboratory has added the latest in sleep study technology and has increased the number of days the lab is open under the oversight of Juan Mella, MD, board certified pulmonologist and sleep studies specialist at TCMH.
“The new equipment is state of the art,” Mella said, describing the new Respironics Alice 6 G3 system.
The new equipment integrates with electronic medical records at TCMH, creating a nearly seamless electronic record of each patient’s study.
“Currently this is the preferred equipment in the business,” Mella explained.
TCMH had funds earmarked in the 2016 capital budget to purchase the new equipment for the sleep lab. Prior to Mella joining the TCMH medical staff in June, sleep lab patients at TCMH consulted with a pulmonologist from CoxHealth in Springfield.
“This equipment really allows us to tailor the sleep study to each patient’s personal needs,” Lauren Toman, TCMH cardiopulmonary department director, said.
Toman noted that the equipment detects brain waves, leg jerks, arousals, and lack of breathing that can occur while the patient is sleeping. Toman described the monitor hook up as “more comfortable” for the patient, too.
“My father has complex sleep apnea issues, and he had a study done on the new equipment,” Toman said. “The study was a very good experience for him.”
There are six certified sleep therapists in the cardiopulmonary department that work in the sleep lab. Some of the therapists are cross-trained and certified to work as respiratory therapists as well as sleep therapists.

Dr. Juan Mella, board certified pulmonologist and sleep studies specialist
“With our therapists and with Dr. Mella, we have a dream team,” Toman said about the sleep lab staff.
The Sleep Studies Laboratory is now open Sunday through Friday each week, offering two sleep studies each evening.
A patient must have a physician’s order for a sleep study. Insurance, including Medicare and Medicaid, will cover a sleep study. Private pay options are also available for patients without insurance that use the TCMH Sleep Studies Laboratory.
Most patients arrive at the sleep lab between 7 and 8 p.m.
“The patients are screened prior to the study, but our therapists spend time with each patient at the lab. The therapist gets to know the patient and helps the patient get comfortable in the new surroundings,” Toman said.
According to Toman, the “human side” of sleep studies is an important part of the study. Therapists ask about daily routines and sleep routines, accommodating the patient as much as possible.
A typical sleep study will begin about 9 p.m. and ends about 5:30 a.m. The patient’s night of sleep is captured electronically and stored in the lab’s computer system.
Results from the night of sleep will be “scored” by a therapist. Scoring involves going through the data recorded electronically to find “stages of sleep” to prepare a summary to give to Mella.
Results from a study are sent to the patient’s referring physician. Sometimes the patient needs a follow-up appointment with Mella. If a patient requires a sleep device, a durable medical equipment company will work with the patient’s physician and Mella when needed.
Sometimes a sleep study doesn’t completely diagnose a patient’s condition, so the patient may be required to come back for more in-depth sleep studies.
“Unlike some medical treatments, patients don’t return for another sleep study until they become symptomatic again,” Toman said.
Weight gains or losses or other physiological changes may determine a patient’s need for future sleep studies.
After many years of working with patients with sleep issues, Mella is a firm believer in using a sleep study to improve a patient’s health.
“A good night of sleep not only helps my patients feel better, but it can actually save the patient’s life,” Mella said.
Additional information about the Sleep Studies Laboratory and appointments can be made by contacting the TCMH cardiopulmonary department at (417) 967-1247.