Diagnosis and Treatment

Singapore Neurology & Sleep Centre

The Singapore Neurology & Sleep Centre provides diagnosis and treatment for a range of Neurological & Sleep Disorders:

clinical services

Neurological Problems

Sleep Problems

Your Brain & Sleep

Normal brain function and sleep are closely related. Many brain diseases can affect sleep, and poor sleep can affect our well our brain works. The reason why humans need sleep is not well understood although the most probable one appears to be that sleep is needed for rest, repair and restoration of the mind and body. It is also likely that memory and learning are consolidated during sleep. Much of what we do know comes from sleep deprivation experiments. When we do not get enough sleep, we become very sleepy, irritable and our mood is affected. Brain function is particularly disturbed with slowed mentation and difficulty thinking, and impaired performance in tasks requiring close attention.

Neurologists and sleep experts generally agree that good sleep is essential to optimal intellectual performance, besides being an important time for resting the body. Enough good quality sleep on a regular basis helps us to achieve our full brain potential.

brain & sleep

Common Neurological Disorders

Neurological Disorders

Movement Disorders
(including Parkinson's Disease)

Headache (including Migranes) and Nerve Related Pain

Infection & Other Inflammatory Conditions of the Brain, Spine & Nerves

Nerve and Muscle Disease

Dementia
(including Alzheimer's Disease)

Back and Neck Pain

Dizziness and Vertigo

Epilepsy

Multiple Sclerosis

Stroke

sleep disorders

Sleep Disorders

Sleep Medicine is a relatively new field of medicine spanning disciplines. The range of healthcare professionals involved in the management of sleep disorders includes Neurologists, Respiratory physicians, Psychiatrists, Phycologists, ENT surgeons, Sleep Technologists and Respiratory Therapists.

Sleep disorders are conditions occurring around and during sleep which disturb normal sleep. Sleep is an important time for rest and restoration of the mind and body. When sleep is disrupted, out health is impaired. Sleep disorders affect the brain and physical functioning, and often worsen existing conditions such as diabetes, high blood pressure, heart disease, stroke and depression. People who do not get enough sleep are also at risk of more frequent accidents, and poorer performance at school or work.

People at risk for sleep problems include those with irregular work and sleep schedules, poorly managed stress, depression and anxiety, chronic pain, and diseases of the brain such as stroke, Parkinson’s disease and dementia.

The most common problems seen in clinic are insomnia and obstructive sleep apnoea (OSA). Insomnia refers to a difficulty falling or staying asleep or a perception of unfreshning sleep. In OSA there is a blockage to the upper airways during sleep, which causes sleep disruption due to breathing at night. This may present most commonly as snoring, or excessive daytime sleepiness due to the poor quality sleep that results when breathing is interrupted during sleep. All of these conditions are treatable, but unfortunately are often overlooked because many people are not aware of the significant negative impact of these sleep disorders on health. For example, untreated OSA can lead to increased risk of heart attacks, stroke, and worsening blood pressure and blood sugar control.

Treatment for sleep disorders depends on the underlying cause which is established during the Sleep consultation. A sleep study may be needed in some cases for the diagnosis. Treatment options include medication, cognitive-behavioral therapy, continuous positive airway pressure (CPAP), oral appliances and surgery for OSA.

A sleep study involves staying overnight in the sleep laboratory and being hooked up to a machine which is monitored by sleep technologists. Sleep patterns can be studied in the laboratory using machines which record brainwave activity, breathing, heart rate and limb movements during sleep.

The prognosis for sleep disorders is generally very good if diagnosed and treated early. People who have difficulty getting enough sleep without sleeping pills, or who sleepy and tired in spite of sleep 6-8 hours a day are encouraged to seek medical attention. Besides being vital for peak performance, enough good quality sleep on a regular basis is an essential component for optimal mental and physical health.

sleep disorders

sleep problems

Different Types of Sleep Problems

sleep problems

1

Insomnia

2

Excessive Daytime Sleepiness

3

Snoring & Sleep Apnoea

4

Sleep Disturbance Related to Brain Disease
(eg. Parkinson's Disease, Stroke)

5

Sleep Disturbances Related to Other Medical Conditions

6

Insomnia

7

Circadian Rhythm Sleep Disorders

what do to when visiting

During your Visit: What to Bring and What to Expect

Please bring along your referral letter and all old medical records, copies of blood test results, any doctor’s reports and X-Rays, CT Scans, MRI scans etc. Any past medical information you have may provide helpful background to the current medical problem.

You may be asked to fill out questionnaires for basic health information (including sleep habits and mood) before being seen by a Neurologist, who specializes in evaluating and managing Neurological & Sleep disorders. After consultation, if necessary, you may be scheduled for various tests.

Patients with nerve and muscle disorders may undergo a Nerve Conduction Study (NCS) with Electromyography (EMG) or needle electrode examination which are electrical which tests of nerve and muscle function. Patients with a seizure disorder may require an electroencephalogram (EEG) which is another electrical test which records brain wave activity and helps to assess if abnormal brain discharges are present. Patients with sleep disorders may be scheduled for a sleep study, so that sleep patterns can be observed and recorded by the sleep technologists. This night-time sleep study, known as a Polysomnogram (PSG), may be followed by a daytime nap study known as the Multiple Sleep Latency Test (MSLT). Upon completion of your tests, your doctor will discuss with you the test results and recommended treatment.

visiting

testing

Test of Brain, Sleep, Nerve & Muscle Function

testing

1

Nerve Conduction Study & Electromyography (EMG): Electrical testing of nerve and muscle function

2

Electroencephalography (EEG) : Recording of brainwave activity to assess if abnormal brain discharges are present

3

Polysomnogram (Sleep Study): Recording of multiple physiological parameters during sleep to determine the cause and/or effects of sleep disturbances

4

Continuous Positive Airway Pressure (CPAP) Titration Study

5

Video-EEG Monitoring

6

Multiple Sleep Latency Test (MSLT)

certifications

certifications

Professional Education &
Qualifications

Dr Lim Li Ling completed medical school at the Faculty of Medicine, National University of Singapore in 1992. She underwent Basic Specialty Training (BST) in the Singapore General Hospital Division of Medicine Internal Medicine programme from 1994-1996. She graduated at the top of her cohort in the National University of Singapore Master of Medicine (Internal Medicine) exit examinations in 1996, and was awarded the Seah Cheng Siang Gold Medal for being the most outstanding candidate in the field of Internal Medicine. In 1997, Dr Lim was selected for entry into the competitive Neurology Residency training programme at the Cleveland Clinic Foundation (CCF) in Cleveland, Ohio, one of the top 5 hospitals in the United States (U.S. News & World Report, 2015-2016) where she spent 6 years in residency and fellowship, training in Neurology and several Neurology subspecialty disciplines: Clinical Neurophysiology, Sleep Medicine, Neuromuscular Diseases and Electrodiagnostic Medicine, inter-related fields dealing with the interpretation of a range of neurodiagnostic tests such as sleep studies, EEG (brain waves) and neuromuscular function studies (nerve conduction studies, electromyography). Dr Lim completed her Neurology Residency at the Cleveland Clinic Foundation (CCF) in June 2001, and 2 consecutive fellowships in Electromyography, Neuromuscular Diseases and Sleep Medicine from 2001-2003. She remained on staff as a Clinical Scholar in the Section of Sleep Disorders of the Department of Neurology at CCF for one year. She returned to Singapore in 2004 to work at the Singapore General Hospital.

Dr Lim is qualified in Internal Medicine (Member, Royal Colleges of Physicians of the United Kingdom, 1996 and Master of Medicine in Internal Medicine, 1996) and American Board Certified in several subspecialty areas: Neurology (American Board of Psychiatry & Neurology, 2002), Sleep Medicine (American Board of Sleep Medicine, 2003), Electrodiagnostic Medicine (American Board of Electrodiagnostic Medicine, 2003) and Clinical Neurophysiology (American Board of Clinical Neurophysiology, 2004). She is the first American Board certified Sleep Medicine specialist in the Register of Specialists of the Singapore Medical Council in Singapore. Dr Lim also has a Master of Public Health (MPH) degree from the Northeastern Ohio Universities & Cleveland State University (2003).