Sleep Studies

Sleep studies are necessary testing measures doctors take to understand how a person sleeps and to determine if a person has a sleep disorder. These studies include a polysomnogram (PSG), which is electronically-administered. Physical activities are also monitored throughout the night. The official readings are presented to the doctor who requested them.

Severe insomnia may require a sleep study.

A doctor often prescribes sleep studies when they believe there is a sleep disorder. Many people suffering from sleep disorders have a difficult time sleeping outside the home, so the sleep study process can seem very intimidating. Doctors may limit medication use prior to the study.

Sleep studies can happen in private doctor's offices, however most happen in sleep centers. The person is given a private bedroom and bathroom. The center will have a central monitoring area where nurses and technicians monitor the person's sleep behavior.

The monitoring is done through electrodes that are positioned in specific locations on the body. These aren't painful; they simply stick to the skin. Once in place, the person can relax reading or watch television.

Electrodes lead from the body to the monitoring devices give an understanding of what is happening during sleep. They capture electrical signals sent by your brain to your muscles. Technicians and doctors monitor for any activity with the muscles.

There are several types of electrodes used to monitor sleep patterns:

• Electroencephalogram: This device is often used in sleep studies. It measures the four types of brain wave activity including alpha, beta, delta and theta waves. These brain waves are often indicators of which level of sleep the individual is in according to the REM cycle.
• Electromyogram: This activity measures small movements in the muscles including leg movements, facial movements and others which also help technicians to know if you are in REM sleep. Technicians are looking for the length of time the person is in any stage of sleep.
• Electro-oculogram: This lead is monitoring eye movement, another indicator of which level of the sleep cycle the person is in.
• Electrocardiogram: This is a standard heart-monitoring device, effective at monitoring the rate and rhythm of the heart.
• Nasal airflow sensor: This monitoring device monitors breathing patterns and the amount of airflow, a direct indicator of sleep apnea.

The study may also use straps which are loosely positioned around the chest. These specially-designed straps are able to monitor respiration, or breathing, throughout the night.

Sleep studies may use video and microphones. These help determine snore intensity and body positioning.

There are a number of studies that may be performed. Several studies can happen at the same time, while others require several days of testing:

• Diagnostic Overnight Study: In this study, the person sleeps at the facility where general monitoring and evaluation is completed.
• Diagnostic Daytime Multiple Sleep Latency Test: Doctors who believe a person is suffering from narcolepsy may request this test. It determines the extent of daytime sleepiness. This test is performed after a night of monitoring.
• Two Night PSG with CPAP Titration: On the first night of the sleep study, general monitoring and evaluation is completed. A patient diagnosed with sleep apnea during the first night will come back for a second night. During the second night the doctors determine if there is a need for a Continuous Positive Airway Pressure (CPAP) device. This device can alleviate sleep apnea in some patients.
• Split Night PSG with CPAP Titration: In this study, the patient has been diagnosed with severe sleep apnea, or there is belief that they will be. The study tests the origin and depth of the sleep apnea. The second portion, which is usually within the same night, includes the use of a CPAP device.

After a sleep study, the process then moves to understanding the data that has been collected throughout the sleep studies using each of these devices. Technicians and doctors work to determine the underlying problem and what type of sleep disorder the patient is suffering from.

From this point, doctors may provide treatment options for sleep disorders.

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