Capitol Sleep Medicine

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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