Sleep Medicine

Sleep Tests

Tests available to help in the diagnosis of sleep-related issues include:

Polysomnography

• A non-invasive, all night monitoring of a patient's sleep
• Variables routinely monitored are:
  • Chin EMG (muscle activity)
  • EEG (brain waves)
  • EOG (eye movements)
  • For sleep staging, ECG, nasal and oral airflow, respiratory effort, and oxygen saturation to address sleep-related breathing disorders
  • EMG of the limbs to monitor for abnormal body movements such as periodic limb movements or REM behavior disorders

Multiple sleep latency testing

• Evaluates patients with suspected narcolepsy
• Objectively study patients who complain of daytime hypersomnolence 
• This assesses sleep tendency by measuring the number of minutes it takes the patient to fall asleep.

PAP titration studies

• A non-invasive, all night monitoring of a patient's sleep with the use of positive airway pressure to maintain airway patency
• Beneficial to accurately assess treatment needs, mask fit, and adequacy of therapy

Home sleep apnea testing

The new home sleep test is an alternative to traditional testing in a sleep lab. In healthy subjects, it can be a comfortable option to complete in the home setting. Among other variables, the home sleep test records:

• Oxygen levels
• Heart rate
• Breathing effort
• Snoring decibels

Patients with the following conditions are NOT candidates for a home sleep study:

• Heart failure
• Atrial fibrillation
• Moderate to severe pulmonary disease
• Pediatric patients (under age 18)
• Central sleep apnea
• Periodic limb movement disorder
• Insomnia
• Circadian rhythm disorders
• Narcolepsy

Sleep Management

Management options offered in the clinical setting include:

PAP management

• Hands on evaluation of the machine and mask interface
• Data evaluation for adequacy of therapy
• In-clinic PAP modification to maximize adherence to therapy and comfort of treatment

Alternative OSA treatment strategies

Your sleep medicine provider will discuss all possible options for treatment of sleep apnea, including surgery, upper airway stimulation or oral device therapy.

Insomnia strategies

Basic cognitive strategies are individually emphasized to restructure the sleep environment and encourage proper sleep hygiene.

In specific circumstances, short-term sleeping medications may be provided if cognitive, self-treatment is both adhered to and not effective.

Management of Limb Movements of Sleep, Restless Legs

Management of Narcolepsy and Hypersomnia

A sleep study (polysomnogram) charts your brain waves, heartbeat, and breathing as you sleep. It also records your eye and leg movements as well as muscle tension. Sensors are placed on your head, face, chest, and legs. They send tiny electrical signals to a computer.

The signals show when you are asleep and awake during the night. The brain-wave and eye movement help us determine the stages of sleep. The breathing monitors show the number of times you stop breathing. They can also detect low airflow and minor changes in oxygen level. The leg sensors show both minor twitches and major movements that occur during the night. A clip will also be placed on your finger to note changes in the level of oxygen in your blood.

A polysomnogram is often used in the following cases:

• To look for sleep-related breathing disorders, such as sleep apnea
• To set the correct levels of continuous positive airway pressure (CPAP) in patients with sleep-related breathing disorders
• To go along with a daytime nap study to see if someone has severe excessive daytime sleepiness
• To look for behaviors during sleep that can be violent or could be harmful to the patient or others

Preparing for the Test

During the Test

After the Test

In the morning you will test the sensors again, and then they will be removed. This will complete the study, and you will be free to go. You may be tired if you did not sleep well during the night. Otherwise, you can return to normal activities on the day after a sleep study.

Getting the Results

It usually takes about one week to 10 days to get the results of a sleep study. At times the doctor who takes a look at the study needs to get more information. He or she may talk to the technologist or to the doctor who sent you to the center.