How Is A Sleep Disorder Diagnosed?
Your doctor will do a physical exam and take a medical history that includes asking you and your family questions about how you sleep and how you function during the day. As part of the exam, your doctor will check your mouth, nose, and throat for extra or large tissues: for example, tonsils, uvula (the tissue that hangs from the middle of the back of the mouth), and soft palate (the roof of your mouth in the back of your throat).
Your doctor may order a sleep recording of what happens with your breathing while you sleep. A sleep recording is a test that is often done in a sleep center or sleep laboratory. The most common sleep recording used to find out if you have sleep apnea is called a polysomnogram (poly-SOM-no-gram), or PSG. This test records:
Breathing and heart rate
How much air moves in and out of your lungs while you are sleeping
The percentage of oxygen in your blood
A PSG is painless. You will go to sleep as usual. The staff at the sleep center will monitor your sleep throughout the night. A sleep medicine specialist will analyze the results of your PSG to determine if you have sleep apnea, or some other sleep disorder, how severe it is, and what treatment may be recommended.
Once all your tests are completed, the sleep medicine specialist will review the results and work with you, your health care providers, and your family to develop a treatment plan.
In some cases, you may also need to see another physician for evaluation of:
Lung problems (treated by a pulmonologist)
Problems with the brain or nerves (treated by a neurologist)
Heart or blood pressure problems (treated by a cardiologist)
Ear, nose, or throat problems (treated by an ENT specialist)
Mental health, such as anxiety or depression (treated by a psychologist or psychiatrist)
What is a Sleep Study?
A Sleep Study or Polysomnogram (PSG) is a multiple-component test, which electronically transmits and records specific physical activities while you sleep. The recordings become data, which will be "read" or analyzed by a qualified physician to determine whether or not you have a sleep disorder.
SLEEPWELL Diagnostic and Treatment Center uses these diagnostic tools:
The EEG or electroencephalogram is a major part of a sleep study. It measures and records four forms of brain wave activity - alpha, beta, delta and theta waves. Alpha waves are usually found during relaxed wakefulness, particularly when your eyes are closed. Theta waves are seen during the lighter sleep stages 1 and 2, while delta waves occur chiefly in deep sleep, the so-called "slow wave sleep" found in sleep stages 3 and 4.
EMG or electromyogram: records muscle activity such as face twitches, teeth grinding, and leg movements. It also helps in determining the presence of REM stage sleep. The amount and duration of these activities provides the doctor important information about your sleep.
EOG or electroculogram: records eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep. The electrodes are usually placed on the outer aspect of your right eyebrow and along the outer aspect below or beneath your left eye.
EKG or electrocardiogram: records heart activities, such as rate and rhythm. Electrodes are placed on your chest.
Nasal Airflow Sensor: records breath temperature, airflow, apnea and hypopnea events. A sensor is placed near your nose and mouth.
Chest/Abdomen Belts: record breathing depth, apnea and hypopnea events. Elastic belts are placed around your chest and abdomen.
Oximeter: records blood oxygen saturation. A band-aid like clip is placed on a finger.
Video: records body positioning and movements.
Snore Microphone: records snoring. An electrode is placed over your trachea, on your lower neck.
How Do You Expect Me To Sleep With All Those Wires On?
Typically patients do sleep despite the wires. The rooms are comfortable and relatively quiet with only one patient per room. You might bring a pillow or blanket that you find comfortable. If you wish you may read in bed prior to the study or spend time in the TV room to try and maintain your regular routine. Generally patients are in bed anywhere from 10:30pm to 11:30 pm.
Despite having all these 'wires' you are allowed to roll over and change position. The 'wires' are quite resilient to movements. If anything is uncomfortable, the technologists can usually fix it. None of the wires inflict pain. Bathroom breaks are permitted and not an inconvenience to the technologist. We would rather you went to the washroom than suffer.
It is recognized however that you may not sleep in the laboratory exactly as you would at home. Generally however this does not cause a problem in obtaining a good diagnosis from your sleep study. You can bring with you a pillow, blanket or other items that aide in you in your normal sleep routine.
What is going to happen to me when I come in for my sleep study?
First, a technician will greet you and show you to your private room (Set up much like a hotel). You will then be asked to fill out some forms and sign a consent form. The technician will give you an opportunity to get ready for bed and will then proceed with the hook-up. The hook –up will take approximately 20-40 minutes. You will need to get ready for bed in enough time for the hook-up before you retire for the night. Also be sure to let the technician know if you have any special needs or concerns or specific wake up time to allow for the technician to plan a schedule for your hook-up.
Once hooked up for your study, you will be allowed to watch some television or read till you are ready to attempt falling asleep. The technician will test the equipment to be sure everything is working properly. You will be asked to open and close your eyes as well as perform other tasks like pointing your toes up and down. At no time will you feel any discomfort or pain during the study.
Following your study, your results will be sent to your referring physician. Technicians will NOT be able to give you results immediately following your study. All of the recorded data with be sent to the interpreting physician for interpretation. This can take up to a week for interpretation. An appointment may or may not be scheduled with one of our Sleep Physicians depending on how your study was ordered. This appointment will be made before your departure if appropriate. If an appointment is not made, our staff will contact you upon receiving the interpretation to update you on recommendations and what is to happen next.
If you have any questions always feel free to contact our staff during normal business hours. They will be more than happy to assist and answer all of your questions or concerns.