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Insomnia isn’t just about having trouble falling asleep—it can affect your mood, focus, and overall health. If you find yourself lying awake at night or waking up unrefreshed, it may be more than just a bad week of sleep. Take our short questionnaire to better understand your sleep patterns and learn if insomnia may be impacting your well-being.


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Trouble falling asleep or staying asleep plagues one in three American adults. If you suffer from insomnia, it disturbs your waking hours as well as your sleeping hours, since you’re likely to feel sleepy during the day and have trouble concentrating on tasks after a poor night’s sleep. In this case, insomnia treatment may be an option.
Narcolepsy can be defined as episodes of excessive drowsiness during the day with a tendency to sleep at inappropriate times. Highly stressful situations sometimes bring on the sleep episodes of narcolepsy and are not completely relieved by an amount of sleep. If you are experiencing these episodes, narcolepsy treatment may be an option. Like insomnia treatment, narcolepsy can be treated by maintaining good sleeping habits.
Although narcolepsy is a fairly uncommon condition, its impact on a person’s life can be serious and if not recognized and appropriately managed, disabling. A cure for narcolepsy has not yet been found, but most people with this disorder can lead nearly normal lives if the condition is properly treated.
Loud snoring can be a sign that something is seriously wrong with your breathing during sleep. Snoring indicates that the airway is not fully open, and the distinctive sound of snoring comes from efforts to force air through the narrowed passageway. Sleep can become a time of increased health risk.
An estimated 10-30 percent of adults snore. For the majority of them, snoring has no serious medical consequences. For 5 percent — particularly overweight and middle-aged men — extremely loud nightly snoring is an indication of a potentially life-threatening disorder called Obstructive Sleep Apnea Syndrome (OSA).
A disorder that affects the limbs and affects a person’s ability to sleep at night and function normally during the day is Periodic Limb Movement Disorder (PLMD). While the leg movements of Restless Legs Syndrome (RLS) are a voluntary response to ease the uncomfortable feelings in the limbs when a person is awake, the movements of PLMD occur most often when a person is asleep and are involuntary. People with PLMD are often not aware of these movements, although they may occasionally notice the involuntary movements of PLMD while they are awake. Bed partners can notice the leg movements, often by a slight jerking of the mattress or bed. Most people with RLS have PLMD, but patients with PLMD often do not have RLS.
The paralysis that normally occurs during rapid eye movement (REM) sleep is incomplete or absent in patients with REM Sleep Behavior Disorder (RBD), allowing the person to “act out” his or her dreams and make abnormal vocal sounds while sleeping. RBD is characterized by the acting out of dreams that are vivid, intense, and violent. Dream-enacting behaviors include sleep talking, yelling, punching, kicking, sitting, jumping from bed, arm flailing, and grabbing.
During sleep, the patient appears to act out the content of whatever she or he is dreaming. Normally, the body loses muscle tone during dream (REM) sleep, preventing most of us from physically reacting to our dreams. For reasons that are not yet understood, some patients do not lose muscle power during dream sleep, and thus begin to move about as their dream content dictates. The danger to the patient and bed partner is that these movements can cause injury.
Circadian rhythm refers to the body’s internal clock, which regulates the natural cycle of sleep and wakefulness over a 24-hour period. When this rhythm is disrupted, it can lead to difficulty falling asleep, staying asleep, or feeling rested at the right times of day. People with circadian rhythm disorders may find themselves wide awake late into the night, waking too early, or struggling with excessive sleepiness during the day.
Potential causes include irregular sleep schedules, frequent travel across time zones, shift work, or underlying medical and mental health conditions that interfere with the body’s natural timing. In some cases, the brain’s internal clock does not align with external cues like light and darkness, leading to ongoing challenges with sleep.
Diagnosis typically involves a thorough evaluation of sleep history, daily routines, and symptom patterns. Keeping a sleep diary or undergoing sleep testing may help identify whether disrupted circadian rhythms are contributing to sleep problems.
These treatments focus on habits, behaviors, and daily routines that affect sleep. They are often the first step for conditions like insomnia or mild sleep disturbances.
Cognitive Behavioral Therapy for Insomnia (CBT-I): Helps retrain the brain and body to develop healthier sleep patterns.
Sleep hygiene education: Guidance on bedtime routines, environment, and lifestyle choices (like caffeine or screen use) that can improve sleep quality.
Behavioral modification and relaxation techniques: Stress management, mindfulness, and breathing exercises that calm the mind before bed.
Some sleep conditions require prescription medications or medical devices to control symptoms and improve sleep.
Medications: Used for conditions such as narcolepsy (to promote wakefulness) or REM sleep behavior disorder (to reduce disruptive nighttime movements).
Positive Airway Pressure (PAP) therapy: The gold standard for obstructive sleep apnea, using a mask and machine to keep airways open.
Other device-based therapies: Oral appliances to reposition the jaw, or newer implantable devices for sleep apnea.
Accurate diagnosis is key to effective treatment. Hoag offers specialized tools to identify the underlying cause of sleep issues.
Sleep studies (polysomnography): Overnight testing that monitors brain waves, breathing, heart rate, and movements during sleep.
Home sleep testing: A convenient option for diagnosing conditions like obstructive sleep apnea.
Ongoing follow-up: Adjustments to treatment plans to ensure lasting improvement.
Sleep problems often overlap with mental health, medical, or lifestyle factors. Hoag’s integrated model connects patients to additional resources when needed.
Psychiatry and psychology: Support for depression, anxiety, or grief that may contribute to poor sleep.
Nutrition and weight management: Lifestyle support for conditions like sleep apnea.
Wellness programs: Stress management, mindfulness, and resilience training to support long-term sleep health.
We are committed to supporting you at every step of your sleep health journey at the Sleep Center. Your comfort, safety, and satisfaction are our highest priorities, and we want to ensure that you understand what to expect during the process. While some factors are beyond our control, we aim to provide clarity regarding our role and the role of your insurance provider.
1. Compassionate, High-Quality Care – We are dedicated to addressing your sleep concerns with professionalism and empathy.
2. Insurance Advocacy – We will promptly submit all necessary documentation to your insurance company on your behalf.
3. Timely Communication – We will respond to your questions and concerns
Our sole focus is on helping you address your sleep concerns to get you back the quality of life you deserve.
1. Approval or Denial of Sleep Studies – Your insurance company will review your medical needs and determine whether the type of sleep study recommended is covered under its policies.
2. Selection of Equipment Providers – Your insurance will determine which company provides your sleep equipment, including machines and prescriptions, as well as how quickly these items are approved.
3. Timelines for Approval – Each insurance provider has its own timelines for processing approvals or denials, which may affect the speed at which your study is scheduled.
Our providers are here to help diagnose and recommend the next steps for your sleep care. Your insurance company will determine what is covered under your insurance so you can make the best choice for your health and financial considerations.
The Hoag Sleep Health Program, an accredited member of the American Academy of Sleep Medicine, was established in 1987 to meet the community’s need for a specialized center to evaluate and treat sleep disorders. The Hoag team of certified physicians and registered polysomnographic technologists are specialists with extensive experience designing individualized treatment programs.
The staff at the Hoag Sleep Health Program diagnose and treat patients with sleep disorders, including insomnia, snoring, sleep apnea, narcolepsy and others.
This uniquely designed facility is equipped with comfortable bedroom labs where patients are monitored and evaluated throughout the night or during the day. The center serves as an outpatient facility utilizing the most advanced technologies and techniques to evaluate sleep disorders.

Snoring is relatively common, particularly in men who are middle-aged or older, but it can occur at all ages and in both sexes. Snoring implies that the upper airway is narrowed, and that the soft tissues are vibrating, making the sound. The treatment of snoring is determined by identifying the cause.
The major concern is whether this snoring is indicative of breathing problems during sleep, such as Obstructive Sleep Apnea, in which the airway collapses during sleep, blocking air from reaching the lungs. This might be noted as pauses in the snoring sound, sometimes associated with choking episodes during sleep. These individuals are often very sleepy during the day because of the poor quality of sleep.
Factors which can contribute to snoring include nasal and/or sinus congestion, use of sedative medications or alcohol near bedtime, and being overweight. Changing these factors can improve snoring in many people, but are sometimes not sufficient to bring satisfactory results. Severe snoring can sometimes benefit from upper airway surgery.
Sleep apnea can have serious effects on cardiac function. warning sound. If you or your bed partner notice any of the above findings, ask your physician about evaluating this at the Voltmer Sleep Center. Effective treatments are available.
First of all, sleeping six (6) hours is not enough for most people. To answer this question of sleep quantity, you should try going to bed 1-2 hours earlier for at least four nights in a row to pay back any “sleep debt” that you may have accumulated. Sleep problems such as sleep apnea and periodic leg movements can result in un-refreshing sleep.
It is normal to awaken several times at night. Many people simply roll over in bed or make a quick trip to the bathroom, and can return to sleep easily. When stresses are occurring in one’s life, thoughts may enter your mind that make it difficult to return to sleep. Addressing those stresses during the day can result in a better quality of sleep.
Alternatively, learning techniques to keep your mind free of those stresses when you awaken at night can also be of help. It is also important to avoid caffeine, nicotine and other stimulants before bedtime.
It is often hard to relax at the end of a busy day. This might be helped by performing relaxation activities prior to bedtime, such as reading or listening to music or meditating. It is also important to avoid caffeine, nicotine and other stimulants within six hours of bedtime. Some people can benefit by writing down their worries, saving them to address the next day. Persistent difficulty in falling asleep (Insomnia) can sometimes be aided by nighttime medications and/or behavior modification techniques.
This might be a symptom of Restless Leg Syndrome , an uncomfortable sensation in the legs that occurs near bedtime, often relieved simply by moving the legs. This is a common problem, and generally is not associated with any medical disorder, except that it sometimes is more common during pregnancy.
Restless Leg Syndrome is often associated with brief involuntary leg movements during sleep, called Periodic Limb Movement Disorder. The person may not be aware that his/her legs are moving during sleep. The movements can disturb the quality of sleep, leading to unrefreshing sleep and daytime sleepiness. This diagnosis generally is determined by conducting an all-night sleep study in a qualified sleep health center.
Sleep apnea is a sleep disorder where breathing repeatedly stops and starts during the night. These pauses in breathing can reduce oxygen levels, disrupt sleep, and increase the risk of serious health conditions like high blood pressure, heart disease, and stroke.
Common symptoms include loud snoring, waking up gasping for air, morning headaches, excessive daytime sleepiness, irritability, and difficulty concentrating. Many people are unaware they have it until a partner notices their breathing pauses.
Diagnosis usually involves a sleep study (polysomnography), either done in a sleep lab or at home, which measures breathing patterns, oxygen levels, and sleep quality. Hoag’s sleep specialists use this information to develop an individualized treatment plan.
Treatment depends on the type and severity of sleep apnea. Options may include lifestyle changes (like weight management or sleeping on your side), CPAP (continuous positive airway pressure) therapy, oral appliances, or in some cases, surgery.
Untreated sleep apnea can lead to serious health issues including heart disease, stroke, type 2 diabetes, memory problems, and reduced quality of life. It can also increase the risk of accidents due to fatigue.
No. While CPAP is highly effective, it’s not the only option. Some patients benefit from oral appliances that reposition the jaw, lifestyle changes, or surgical procedures. Hoag’s sleep specialists tailor treatment to what works best for you.
A polysomnogram (overnight sleep study) is noninvasive, painless test that lasts generally one night. It involves recording vital signs and other physiologic variables during a night of sleep in the bedroom laboratory.
You will be asked to complete sleep questionnaires about your sleeping habits, the day’s events, medications taken, and so on.
A sleep technologist will ask you to change into your night clothes or a hospital gown. Small sensors or electrodes will then be attached to parts of your head and body using a water-soluble paste and tape. Flexible wiring is attached to the sensors, which are then connected to a central unit. If you are allergic to adhesive, please notify your tech so, we may use a skin barrier for your protection. A monitoring area is located close to your room. Once all of the sensors, electrodes, and belts are attached, the technologist will take some initial readings while you are awake. You may then read or watch TV before you are ready to go to sleep.
The attached sensors monitor and record various physical activities, such as heart rhythm and rate, eye movements, muscle activity, breathing, leg movements, and blood oxygen levels. Depending on the symptoms you have described to the sleep specialist, some or all of the following will be monitored:
One or more technologists will observe you the entire night while you sleep using an infra-red video camera. Technologists note if you snore and how loudly, or if you have periodic body movements. They also chart your sleep stages and other measurements. The next step is for you to get comfortable and go to sleep!
Some patients need to spend more than one night in the sleep lab. This will be determined by one of our sleep physicians after the sleep study results are processed and interpreted. These results will be discussed with you at your scheduled follow-up visit.
After you wake up in the morning, the technologist will remove the equipment and adhesive tape. You will also be asked to complete another questionnaire about your night’s sleep.
The best option is to use very warm to hot water and shampoo. There are showers available in the Sleep Center.
No. It is impossible because the electrodes and sensors detect the electrical and physical signals that you produce. There is no electricity being sent through the wires to the sensors on your body.
Don’t worry – disconnecting the wires to the nearby unit is a fairly quick process and a technologist is always awake and available to help you. You only need to call out and the technologist will come in and disconnect your unit.
This is a very common question. Most people doubt their ability to sleep in the lab, especially if they are unable to sleep well at home. Sleep technologists find that most patients sleep better in the lab than at home. It could be due to the fact that some people feel more secure or less distracted in the lab than at home. Some individuals are simply relieved that someone is taking an interest in their problem, it will soon be diagnosed, and they are on the road to better sleep. Even if you do not sleep well in the lab, polysomnographic testing will most likely be able to determine a great deal of information.
If you need to cancel or change the sleep study appointment, please give our office a minimum of 24 hours notice, doing so would allow our office to call another patient in your place.
Most insurance plans, including HMOs and PPOs, offer coverage for sleep studies, but the exact benefits can vary. We encourage you to check with your insurance provider to confirm your coverage. Our team is happy to provide you with the billing codes you’ll need, and if you are an HMO patient, please call our office so we can assist you with the authorization process.

Dr. Puangco is an innovative and forward thinking member of the Judy & Richard Voltmer Sleep Disorders Center. He is recognized as a Diplomate of the American Board of Neurology and the American Board of Sleep Medicine. Dr. Puangco is very active in the medical community and is affiliated with the American Academy of Neurology, the American Academy of Sleep Medicine and is a member of the American Board of Medical Specialties.<br><br>Dr. Puangco brings extensive and well-rounded experience to the Voltmer Sleep Center with expertise in multiple specialties. Dr. Puangco created the Cognitive Behavioral Program for Insomnia at Hoag and has been instrumental in providing complete care to Hoag sleep patients.<br><br>Dr. Puangco obtained his medical degree from the University of Texas at Houston Medical School and completed an internship in Internal Medicine at the University of Southern California (USC) and a residency in Neurology at USC. He completed a fellowship in Electrodiagnostic Medicine and Neurophysiology at USC and a fellowship in Sleep Medicine at University of California Los Angeles.<br><br>While not seeing patients at the Voltmer Sleep Center, Dr. Puangco maintains a private neurology practice in Irvine and is a neurohospitalist for Hoag Hospital Newport Beach and Irvine. Dr. Puangco also dedicates his time educating the community through presentations and educational seminars.<br><br>Dr. Puangco’s goal is to establish Hoag as the gold standard for sleep disorders by providing a comprehensive approach to sleep medicine.

After graduating in 1994 from Rutgers College in New Jersey with a Bachelor of Science degree, Dr. Gozzo attended medical school at UMDNJ-RWJ University Hospital. She graduated in 1999 with a Doctorate of Medicine and continued her training with an Internal Medicine Residency from 1999 to 2002. Dr. Gozzo furthered her training with a fellowship in Pulmonary and Critical Care with Sleep medicine from 2002 to 2005 at UMDNJ-RWJ University Hospital. <br><br>Since graduation from fellowship, Dr. Gozzo was employed at St. Peter's University Hospital as a faculty physician. During her employment she provided both inpatient consultation service for pulmonary and sleep related diseases, intensive care physician services and ambulatory care services for pulmonary and sleep related diseases. She maintained conscious sedation privileges as well as ACLS certification. <br><br>Dr. Gozzo is board certified in Internal Medicine, Pulmonary Medicine, Critical Care Medicine and Sleep medicine. In 2013, she was appointed the Director of the Sleep Laboratory at St. Peter's University Hospital. <br><br>In 2016, she became part of the Newport Pulmonary Associates practice in Newport Beach, California. The focus of her practice is Pulmonary and Sleep Medicine.

Jason Muir, M.D. received his medical degree from the Keck School of Medicine at the University of Southern California. Prior to medical school, Dr. Muir graduated from Occidental College with a Bachelors’ degree in Biology and a Masters in Neurobiology.<br><br>Dr. Muir is a board-certified neurologist in both Psychiatry and Neurology with additional certification in Clinical Neurophysiology. He enjoys working with people seeking treatment for a range of neurologic issues, especially epilepsy, sports related injuries and neuromuscular disorders. He has investigated multiple experimental drugs to treat epilepsy and was a co-principal investigator on the pivotal Repetitive Neurostimulation (RNS) trial. Dr. Muir strives to achieve seizure freedom for his patients through the use of medications, surgical options and mechanical devices such as the Vagus Nerve Stimulator.<br><br>Dr. Muir completed a Clinical Neurophysiology Fellowship at the Keck School of Medicine at USC, with special emphasis on epilepsy evaluation and management, sleep disorders and neuromuscular disorders. After completing an internal medicine internship at State University New York (SUNY) Downstate in Brooklyn, Dr. Muir returned to Los Angeles County-University of Southern California (LAC-USC) Medical Center, the affiliated hospital for the Keck School of Medicine. During his training he served as Chief Resident for the Department of Neurology.<br><br>Dr. Muir enjoys a collaborative practice at Hoag Hospital, working closely with fellow epilepsy and stroke specialists while serving as Program Director of Hoag Neurophysiology Services. He has initiated and organized a hospital-wide program to provide 24-hour continuous electroencephalogram (EEG) services to critically ill patients within Hoag Hospital’s inpatient facilities. Dr. Muir is a member of the neurohospitalist service and stroke team at Hoag Hospital, and currently serves as the vice chair for the Hoag Hospital Department of Neurology and Psychiatry.<br><br>Dr. Muir is a strong advocate for epilepsy patients in Orange County and is a member of multiple local and national neurological societies, including the American Academy of Neurology. His interests within epilepsy include diagnosis, aggressive drug titration, epilepsy surgery, evaluation and management of epilepsy (and other neurological disorders) during pregnancy.

Meneena Bright, M.D., is a double board-certified physician in family medicine and sleep medicine focused on diagnosing and treating various sleep and circadian rhythm disorders to improve the overall well-being of patients. With a comprehensive understanding of the complexities of sleep and its impact on health, Dr. Bright is committed to providing personalized and effective care. Dr. Bright earned her medical degree from Georgetown University in Washington, D.C. and completed residency at one of Temple University’s community hospitals, Chestnut Hill Hospital, before pursuing additional training in sleep medicine and completing her Fellowship at Harvard University. As a sleep medicine physician in Hoag’s Sleep Health Program, part of the Pickup Family Neurosciences Institute, Dr. Bright evaluates and diagnoses a wide range of sleep disorders including insomnia, sleep apnea, narcolepsy, hypersomnia, somnambulism (sleep walking), REM behavior disorder and restless legs syndrome. She employs cutting-edge research and treatment protocols and collaborates with multidisciplinary teams to develop tailored treatment plans for each patient. With a compassionate and patient-centered approach, Dr. Bright strives to empower individuals to achieve better sleep and, consequently, improved overall health and quality of life.