My husband, 65, has had sleep difficulties throuhout his life. He never reached the point of deep, restorative sleep. However, about 5-6 years ago, the situation became extreme. He would have 2-3 days/nights of no sleep each week for about 3-4 weeks. Then he would have a "normal" sleep of 6 hours per night for a few weeks, not deep, but at least he slept. He was always fatigued and lacked energy. He had a sleep study which indicated moderate apnea. Tried various CTAP devices which did not work for him. In March of this year, he had a heart attack. Of 3 clogged arteries, they put a stent in one, did angioplasty on the second and left the 3rd (70% blockage) as it was. For a week, he felt great. Slept well, had energy, felt more mentally alert. We thought all the sleep/energy problems he had been experiencing for years were probably due to a cardiac problem. Then a week later he crashed. He can now sleep for 3 days, only being up an hour or so. He can also have 2-3 nights with absolutely no sleep. He had another sleep study which didn't change. He has had another stress echo which says his heart is working fine. He is on oxygen during sleep, whatever he gets. Prior to the heart attack, he had various sleep agents, none of which worked and/or caused serious side effects such as hallucinations, periods of amnesia, etc. He has also tried anti-depressants. The sleep difficulties continue.

How do we pursue a diagnosis and treatment? Do I seek out a sleep clinic or a cardiac center? Any guidance or insight would be greatly appreciated.

IKO