| A
night at the sleep center:
Sleep is a fascinating
and complex process. In order to fully assess your sleep it is sometimes
necessary to measure numerous bodily functions such as brain wave
activity, muscle movements, breathing patterns, and the oxygen level
in your blood - while you sleep! This information is fed
into a computer where it is read by skilled technologists and reviewed
by your physician to determine the cause of your sleep complaint.
Not all sleep disorders require overnight sleep testing. However
if your physician has ordered a sleep study for you this section
of our web-site will guide you through the testing procedure and
discuss how you should prepare for your study.
On the day
of your test:
There are very
few requirements for the day leading up to your sleep study. However,
it is very important to avoid caffeine (coffee, tea, cola, chocolate)
after 12:00 NOON and try not to nap. Before coming to the sleep
center, eat a normal meal, wash and dry your hair, and do not apply
hair sprays, oils or gels. Be sure to bring a change of clothes
for the next day, toiletries and your favorite pillow.
Be sure to inform
your physician about any medications that you may be taking well
before your study night! This includes prescription medications,
over the counter medications and dietary supplements such as melatonin
and diet pills.
Arriving
at the Sleep Center:
The technologist
will greet you when you arrive at the sleep center and show you
to your bedroom. At that time he/she will review the sleep study
procedure with you and you will be given a chance to ask questions
about any element of your study. The technologist will ask you fill
out some forms and questionnaires. Be sure to let us know about
your current health and physical condition. It is very important
to provide us the following information:
- Any medications
you have taken in the 24 hours prior to your arrival.
- Any sleep
difficulties you that have not already been discussed with your
physician
- Any recent
changes in you overall health. Do you have a cold or did you have
trouble sleeping on the previous night?
- Do you need
to be at work at a certain time the next day. You may want to
reschedule other commitments for the morning, but if that is not
possible confirm a wake-up time when you arrive at the sleep center.
After filling
out your papers you'll have time to make yourself comfortable, change
into nightclothes and prepare for bed, just as you would at home.
Your arrival time is scheduled to insure that you have enough time
to complete your bed time tasks prior to the technologist applying
the probes for you sleep study. If there is additional time you
can read, watch TV or relax as you normally would at home.
The Hook-up:
Before bedtime,
the technologist will attach the monitoring devices that will allow
us to assess your sleep patterns. None of these devices are painful.
They are all quite small and designed to be as comfortable as possible.
Typically
we monitor the following signals:
- Brainwave
patterns and eye movements allow us to determine whether you
are asleep or awake and help us determine each stage of sleep.
Each night when you sleep you move through several levels of sleep
called stages. When you dream, you are in a particular stage called
REM sleep (which stands for Rapid Eye Movement sleep). This is
a very important stage because breathing patterns become less
regular in REM sleep and people suffering from Sleep Apnea tend
to have their longest apneas when they are in REM sleep.
- Breathing
patterns allow us to determine when you are breathing and
when you may be fighting for breath. When a person has an apnea
they continue to try to breathe but their airway is blocked. We
monitor both your breathing efforts and the amount of air flowing
out of your nose and mouth. This allows us to determine when you
are breathing and how long you stop breathing if you have an apnea.
- Electrocardiogram
and heart rate are measured to see how hard your heart is
working during sleep. During an apnea the heart will slow down
when you stop breathing and speed up as you struggle to breathe
again.
- Leg movements
and muscle activity in the chin are measured to determine
if you suffer from sleep movement disorders. The chin muscles
help us look for REM sleep because the body relaxes all your muscles
while you are in that stage.
- Oxygen
levels are monitored by an incredible device that looks like
a small bandage. It determines the oxygen content of your blood
by shining an infrared light through your finger or ear lobe.
It is completely painless and is one of the most important aspects
of the sleep study.
These electrodes
and devices may feel strange at first on your skin, but most people
do not find that they are uncomfortable or prevent them from falling
asleep. We recognize that your sleep in the center may not be exactly
like your sleep at home but this rarely interferes with the quality
of the study.
Preparing
for Bed:
After the technologist
finishes your hook-up he/she will escort you back to your room.
They will be monitoring your sleep from a nearby room so that your
privacy is insured. Via intercom, they will ask you to perform a
variety of movements to insure the proper operation of the equipment.
If there is extra time before you are ready to fall sleep you may
read or watch TV. When you are ready for bed, you will contact the
technologist via intercom so that they can start the recording.
Reviewing
the use of a CPAP mask:
If you are being
monitored for Sleep Apnea, it may be necessary to place you on CPAP
sometime during the night. If you are to be placed on CPAP, it will
be discussed with you prior to your visit.
The technologist
will select an appropriately sized mask, insure that it is properly
fitted and correct any air leaks. This will give you a chance to
get used to the feel of the CPAP mask and spend a few moments breathing
on the CPAP machine. Your physician will determine if it is necessary
for you to spend time breathing on the machine during the study.
You can find more information on CPAP titration studies by clicking
here.
The Sleep
Study:
After saying
"good night" most patients will quickly fall off to sleep.
Your work has ended, but the night has just begun for your dedicated
sleep technologists. From their control room they will monitor you
throughout the night. Their number one job is to insure your comfort
and safety. If you should need anything during the night the technologists
may be contacted at any time via intercom. Be sure to contact the
tech if you need to get out of bed for any reason.
The monitoring
devices are very sturdy so feel free to sleep in any position that
you find comfortable. Your technologist will assist you if any equipment
becomes dislodged.
Waking up:
After you wake
up, the technologist will remove all the probes. The un-hooking
will only take a few minutes so you will quickly be free to shower
and get ready for your day.
Nap studies
- the MSLT
Sometimes an
additional test, called a Multiple Sleep Latency Test (MSLT) is
needed for a complete sleep evaluation. The MSLT measures how quickly
you fall asleep when taking a nap. Several naps are scheduled at
set intervals throughout the day. During each nap your sleep patterns
will be monitored with the same recording equipment used the night
before. This test requires that you stay at the center for most
of the day following your overnight study. It permits a more objective
measurement of your daytime sleepiness and is also used to diagnose
narcolepsy.
Be sure to clarify
if you will be staying for an MSLT so that you can make arrangements
for the day after your study. You may contact the sleep clinic in
advance to find out about meals and the approximate time you will
be able to leave.
The results
of the study:
In order to
fully understand your sleep problem we will need to look at a great
deal of information about your sleep stages, breathing patterns
and body movements throughout the night. After the study, a sleep
specialist will review and interpret the record to help you understand
your results and specific needs. Treatment recommendations will
be made if evidence of a sleep disorder is found.
It is not possible
to tell you the results of study over the phone. The information
is very complex and is better understood during a face-to-face follow-up
consultation with the doctor.
- If you were
seen at our sleep clinic prior to your study - we will e-mail
you with a time for your follow-up visit with the sleep specialist.
Typically this will be 10-21 days after your study. Please contact
our office of the best times to schedule this appointment.
- If you were
referred for your study directly from your family physician or
another specialist, please contact his/her office for an appointment
2-3 weeks after your study.
- If you are
scheduled for a CPAP titration study, please inform us of your
choice of DME provider when you arrive at the lab for your CPAP
study.
Your follow-up
visit:
After your physician
has a chance to review the data, you will be scheduled for a follow-up
consultation to discuss the results of your study and review recommendations
for treatment. Generally this meeting will take place 2-3 weeks
after your study.
FAQ's
How
will I be able to sleep with all those wires?
This is the
question asked most frequently by patients prior to their sleep
studies. None of the sleep equipment is painful. In fact, the
monitors are all quite small and designed to be as comfortable
as possible. The monitoring wires will be gathered together in
a ponytail behind your head so you can easily roll over and change
positions just as you would at home. The devices may feel strange
on your skin, but most people find that they do not prevent them
from falling asleep.
We recognize
that your sleep in the center may not be exactly like your sleep
at home but this rarely interferes with the quality of the study.
How
can I sleep in a strange laboratory environment?
Many people
expect the sleep center to be a cold, impersonal place with flashing
lights, beeping alarms and stiff hospital mattresses. However,
our bedrooms (link to pictures) at the sleep center are quite
homey and look more like a comfortable hotel rather than a dreary
hospital.
The monitoring
equipment (link to pictures) and technologists are in a separate
room from where you will be sleeping so you will enjoy a high
degree of privacy. Your technologist will collect your sleep information
into a specialized computer program. They will be able to tell
when you fall asleep, but cannot read your thoughts or dreams.
What
should I bring on the night of the study?
Before coming
to the center, you should pack an overnight bag, just as if you
were staying overnight at a friend's house or hotel. Bring anything
you need to feel at home. If you have special needs, the sleep
center personnel should be able to accommodate you.
Take a look
at the Sleep Study Check List to see a complete listing of everything
you should bring.
Should
I take my usual medications?
It is important
that we know if you are taking any medications - both prescribed
and over-the-counter. This includes dietary supplements such as,
diet pills melatonin, kava kava, valerian root, etc. Since many
substances affect sleep, certain medications need to be discontinued
prior to a sleep study so that the results can be interpreted
correctly. Do not discontinue any medications without first talking
with your physician.
If you have
any questions please be sure ask. Remember to avoid coffee and
alcohol on the day/evening of the study.
In Summary
We hope that
your experience at the sleep center will be a good one. Understanding
the sleep process and the evaluation of sleep disorders will help
you take an active and positive role in your own care.
Sleep study
Check List What to bring for your study:
- Bed time
clothing
- Change of
clothing for the next day
- Your toiletries
o Shaving
supplies
o Contact lens supplies
o Glasses
o Toothpaste & toothbrush
o Mouthwash
o Shampoo
- Medications
ordered and prescribed by your doctor. The Sleep Center cannot
provide you with your medications. If you have questions about
your medication please consult your physician.
- A comfortable
pillow - Of course we have plenty of extras but you may be more
comfortable bringing one from home.
- Your favorite
book - television sets will also be available for view prior to
bed - time permitting
- Sleep Questionnaires
and forms: Be sure to look for the Forms Section for Sleep Studies
to fill out all form
- Your insurance
information - Be sure to have your insurance card and co-payment
if needed.
Do's and
Don'ts
- Do not consume
caffeinated food/beverages TEA, COFFE, COLA, CHOCOLATE after 12:00
NOON on the day of your study.
- Please eat
a normal dinner meal prior to arriving at the lab.
- Please arrive
ON TIME
- Be sure to
shower and wash hair prior to arriving at the sleep center
- Do not wear
make-up, hairspray, or use additional hair conditioner or hair
products
- If you need
ANY special assistance for getting in and/or out of bed be sure
to inform the sleep center well in advance of your study. You
are responsible to provide care taker assistance if it is required.
- You may sleep
in any position during the night, however we would like you to
spend some time on your back. If you have a medical condition
that prevents you form sleeping on you back be sure to inform
your technologist.
- If you are
unable to make your appointment, be sure to notify us 48 hours
prior to your appointment other wise you will be assessed a cancellation
fee which is not covered by your insurance.
- Do not bring
valuables to the sleep lab.
Sleep Study
Overview:
- Arrive at
the lab Please arrive on time
- Fill out
forms 15 minutes
- Change into
bed clothes 15 minutes
- Hook-up procedure
45-60 minutes
- Hook-up check
with technologist 15 minutes
- Bathroom,
TV, Reading 15-45 minutes
- Bed time,
Lights Out Scheduled time
- Lights On
A good night's Sleep
- Unhooking
15-20 minutes
- Wash up and
start your day
- Follow-up
exam 2-3 weeks after your study
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