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Your
Sleep Studies
During you initial visit, your sleep medicine fellowship
trained board certified sleep medicine physician will
review your clinical history, medications, medical
history, family history, and physical examination and
decide if it is appropriate for you to proceed with
diagnostic testing. This will occur in our sleep
laboratory that is fully accredited by the American
Academy of Sleep Medicine.
Patients generally arrive at the Sleep Center by 8 or 9
p.m. A polysomnographic technologist will greet you and
care for you throughout the night. You may bring your
own pajamas and pillow, and are encouraged to bring
along a book to read. Your room in which your study is
to be conducted will also have a television set. The
test will be complete the following morning by 6 a.m.
Upon arrival, your polysomnographic technologist will
explain what will happen during the study, and will
prepare you for the sleep study. He or she will attach
electrodes on your head. You will also have electrodes
placed on your legs in order to assess for abnormal leg
movements during sleep and two elastic belts will be
placed around your chest and abdomen in order to assess
for respiratory effort. An airflow probe will be placed
under your nose. Although it may not be quite as
comfortable as sleeping in your own bed, you should
experience no pain or discomfort during or after the
tests. During your initial visit your physician may
decide that you may benefit from a sleeping pill during
the study. Many medications can affect the brainwave
patterns and respiratory effort during sleep and so you
should review any sleeping pills that you might be
taking with your sleep medicine physician prior to the
test. During the recording your polysomnographic
technologist gathers data on your brainwave patterns,
eye movements, muscular tone, effort in breathing,
actual airflow to measure your breathing, EKG, blood
oxygen levels, and leg movements.
There are several different sleep studies that are
commonly performed:
Polysomnogram - This is a 7-8 hour recording used to
look for disorders such as obstructive sleep apnea,
central sleep apnea, periodic limb movement disorder,
nocturnal seizures, sleep walking, and acting out
dreams, as well as a number of other sleep disorders.
The most common sleep disorder is obstructive sleep
apnea which is typically characterized by snoring and
stopping breathing during sleep. If you are diagnosed
with this you may require a second overnight sleep
study. If you are a shift worker and normally work
nights, your sleep medicine physician may decide to run
your “overnight” sleep study during the day.
CPAP titration – This is typically an overnight
recording similar to the polysomnogram except that CPAP
therapy will be initiated to treat you for obstructive
sleep apnea. CPAP stands for continuous positive airway
pressure. It is a mask that may go over your nose or in
your nostrils in order to give you normal air at a
higher pressure. This increased pressure provided by the
device keeps your airway open, just as the increased
pressure inside of a balloon keeps it from collapsing.
Once the appropriate pressure for you is reached, this
will allow you to stop snoring and breathe normally
throughout the night. This will also usually normalize
blood oxygen levels and brainwave patterns of sleep.
Many different pressure settings may be attempted
throughout the night of this study. Your sleep medicine
physician will examine your breathing, heart rhythm,
blood oxygen levels, and brainwave patterns at each
pressure setting in order to decide on an optimum
treatment setting for your CPAP machine.
Multiple Sleep Latency Test (MSLT) - The MSLT follows
the overnight sleep study the following day. The purpose
of this test is to objectively measure daytime
sleepiness and to look for REM sleep during daytime
naps. Although REM sleep may sometimes be seen in normal
individuals during the day under special circumstances,
this is the hallmark sign of narcolepsy, a disorder of
REM sleep. This test is a series of five naps every two
hours lasting approximately 20 minutes each. This test
helps the physician differentiate between narcolepsy and
other disorders of excessive somnolence. Maintenance of
Wakefulness Test (MWT) – The MWT is similar to the MSLT
except that it is usually performed after you have been
treated for your sleep disorder. The purpose is to stay
awake during the recording sessions and demonstrate that
you now no longer have excessive daytime sleepiness.
This study is commonly performed for truck drivers,
pilots, or people operating heavy machinery and may be
required on a yearly basis, depending on the
requirements dictated by your employer.
Although there will be other patients sleeping in the
lab on your study night, you will be very safe in a
private room while being carefully monitored throughout
the night with special medical equipment and video
cameras. A polysomnographic technologist will always be
close by to answer questions or provide assistance.
The following morning (usually by 6 a.m.) you will be
awakened by the technologist who conducted your tests.
You will be free to shower and leave as soon as you
wish.
Following a sleep study, polysomnographic technologists
will compile and analyze your recorded sleep study
before it is carefully reviewed by your sleep medicine
physician. Your physician will then decide if you
require any further sleep studies before making
recommendations for treatment options. All information
is forwarded promptly to your physician for follow-up
and treatment.
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