You Might Have Other Sleep Issues
Not all sleep disorders are caused by breathing trouble. If your symptomspersist, you might not have apnea. Other common sleep issues that dontaffect the airways include movement disorders that cause nighttimerestlessness or narcolepsy, a neurological disorder that affects the bodys sleep-wake cycles andcauses excessive sleepiness. Your physician can work with you to pinpointthe cause.
How can I get accurate results from an at-home sleep test?
For the most accurate home sleep apnea reading, its best to have sleep time on your back and side, Patil says. Sleep apnea is typically worse when sleepers are on their backs, and side sleeping can ease apnea. Knowing what happens when you sleep in different positions can help your doctor pinpoint whether you have apnea or some other sleep issue.
How Do I Prepare For My Sleep Study
You will receive specific instructions about how to prepare for your sleep study. Some general information is as follows:
- Do not drink alcohol or consume caffeine-containing beverages and foods for at least eight hours before your study.
- Tell your doctor about all medications you are taking. You may be asked to temporarily stop taking a medication before your study.
On the day of your study:
- Keep to your normal meal times.
- Do not take any naps.
- Shower and wash your hair but do not apply conditioner, hair spray, gels, or other hair products. Do not apply creams, lotions, powders, perfume, aftershave/cologne, cosmetics or any other products to your face or body. These products can interfere with the recording by electrodes that are placed on your skin.
Typically you do not arrive at your sleep study location until early evening.
What Is Sleep Apnea
Sleep apnea is a condition in which breathing stops for short periods during sleep. These periods last 10 seconds or longer. People with sleep apnea tend to snore loudly and make gasping or choking noises in their sleep.1
Sleep apnea causes low oxygen levels in the blood and poor sleep. Left untreated, this can lead to high blood pressure, heart disease, diabetes, kidney disease, depression, and more.1,2
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How Are Sleep Disorders Diagnosed
Your doctor will first perform a physical exam and gather information about your symptoms and medical history. They may also order various tests, including:
- Polysomnography : This is a lab sleep study that evaluates oxygen levels, body movements, and brain waves to determine how they disrupt sleep vs. home sleep study that is performed in your own and is used to diagnose sleep apnea.
- Electroencephalogram : This is a test that assesses electrical activity in the brain and detects any potential problems associated with this activity. Its part of a polysomnography.
- Multiple sleep latency test : This daytime napping study is used in conjunction with a PSG at night to help diagnose narcolepsy.
These tests can be crucial in determining the right course of treatment for sleep disorders.
Treatment for sleep disorders can vary depending on the type and underlying cause. However, it generally includes a combination of medical treatments and lifestyle changes.
How Is The Multiple Sleep Latency Test Performed
âThe Multiple Sleep Latency Test involves taking a series of 20-minute naps every two hours. The test usually consists of four to five naps. You’ll be monitored to determine when you’re awake, asleep, and in REM sleep. The time it takes you to fall asleep and reach REM sleep is measured. You’ll be woken up after having slept for 15 minutes. If you donât fall asleep, the nap trial will end after 20 minutes. â
A polysomnogram is often done the day before to ensure that you have had an adequate night’s sleep before the test.
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Picking Up Watchpat One At Your Providers Office
STEP 1: Schedule an appointment time with your provider for pickup during regular office hours. Picking up the WatchPAT ONE can take up to 20 minutes.
STEP 2: Once payment has been received by your provider, a staff member will call the sleep center to register your devices serial number along with your personal information.
STEP 3: During check out at your providers office, a staff member will provide you with a detailed letter stating how to use the WatchPAT ONE app along with a four digit code. You will also be given the website information where you can view the video on how to use the WatchPAT ONE.
What Is A Polysomnogram
A PSG is a diagnostic tool used to determine if your patient has a sleep disorder. This test is conducted overnight at the sleep center or hospital.
This test monitors your patient’s sleep cycles and stages to identify any disturbances caused by their sleep disorder. Your patient will be connected to a variety of equipment to help monitor things like their:
- Brain activity
Through a PSG, you document the disorder your patient is suffering from.
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Screenings For Circadian Rhythm Disorders
Circadian Rhythm Disorders are sleep issues that are derived from unnatural sleep/wake patterns.It is actually a pretty common condition, especially among swing shift and third shift workers. These tests focus on what the patients body is naturally trying to do. For example, if you could set your own sleep schedule that feels most natural to you, what hours would that be? Or if you could wake up without an alarm clock, what time would that probably be for you?
What Can I Expect During An In
On the night of your sleep study, you will be assigned to a private bedroom in a sleep laboratory. Near the bedroom will be a central monitoring area, where the technologists monitor sleeping patients.
You will be hooked up to equipment that might look uncomfortable. However, most patients fall asleep with little difficulty.
The equipment used in a sleep test includes:
- Electrodes. Electrodes on your face, scalp and body send electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are then recorded. EEG electrodes measure and record brain wave activity. EOG electrodes record eye movements. These movements are important in determining the different sleep stages, particularly rapid eye movement sleep. EMG electrodes record muscle activity from the chin area and legs to identify abnormal movements in sleep and help in determining the presence of REM sleep.
- A nasal-oral airflow sensor records airflow through your nose and mouth.
- Belts placed around your chest and abdomen measure your breathing.
- A bandage-like oximeter probe on your finger measures the amount of oxygen in your blood.
- An ECG records heart rate and rhythm.
- A snore microphone records snoring activity.
- A video recorder records body movements, which will be matched against the electrical signals recorded by the electrodes.
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What Is Cpap Titration
CPAP titration studies are conducted overnight in the sleep laboratory. During the study, you will monitor your patient’s breathing and adjust the CPAP pressure to determine the proper air pressure required to prevent upper airway blockage, eliminating pauses in their breathing while they sleep.
You’ll fit your patient with a nasal mask that connects to a tube on a small pressure generating device. During a CPAP titration you will monitor their sleep just like you would during an in-lab diagnostic sleep study. You’ll measure their:
- Brain waves
- Arm and leg movements
You’ll change your patient’s CPAP pressure remotely as needed during the night. The patient starts at low levels of pressure, which are then gradually increased when events are seen.
A patient may need a CPAP re-titration study if their previous symptoms like snoring, apnea, or daytime sleepiness come back despite their CPAP treatment. This allows for determination of their correct pressure setting.
Can I Do A Sleep Study At Home
Home sleep studies are currently only used to evaluate for obstructive sleep apnea . Home sleep apnea tests are less effective at detecting OSA than polysomnography, so the American Academy of Sleep Medicine recommends that they only be used when moderate or severe OSA is suspected and when other health conditions are not present. The AASM also advises that diagnosis and treatment of sleep apnea should not be based solely on the results of an at-home sleep study.
However, home sleep apnea tests are more convenient, may be more affordable, and you may sleep better in your own bed than at a clinic. If your doctor recommends polysomnography to detect sleep apnea, you can ask whether a home study may be an appropriate alternative.
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History And Physical Examination
An accurate and detailed history from the patient, bed partner, or family member combined with a sleep questionnaire can elicit critical information. Most sleep complaints fall into three categories: insomnia excessive sleepiness or abnormal behaviors during sleep. The procedure is as follows.
Inquire into the chief complaint, when symptom started, the pattern since onset, and associated factors that may have predisposed to or precipitated the illness, perpetuated the condition, and improved or worsened symptoms.
Assess the impact of the sleep complaint on the patient’s life, and inquire about meal and sleep schedules, sleep hygiene, restless legs sensation, snoring, witnessed apneic episodes, sweating, coughing, gasping/ choking/snorting, dryness of the mouth, bruxism, excessive movements during sleep, periodic limb movements, any abnormal behaviors during sleep, daytime sleepiness, presence of cataplexy, sleep paralysis, and hypnagogic or hypnapompic hallucinations.
Ask about caffeine intake, alcohol and nicotine use, as well as use of illicit drugs.
Review the pertinent medical/surgical/psychiatric history and past treatments, and their efficacy or lack thereof.
Determine if there is any family history of sleep disorders .
Tests That Diagnose Insomnia
Your doctor might want you to take some of these tests to find out what’s causing your sleeplessness.
Another name for this is a polysomnogram test. It measures how well you fall asleep and how long you stay asleep. A sleep study can help your doctor learn whether you have a sleep disorder such as sleep apnea, narcolepsy, or restless legs syndrome.
You can have this test at a sleep center. Or you can get a kit from your doctor and do it yourself at home.
During the sleep study, you wear sensors on your face, chest, arms, legs, and finger. While you sleep, these sensors monitor your:
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Diagnostic Tests For Sleep Disorders
Sanja Jelic, MD is board-certified in pulmonary disease, sleep medicine, critical care medicine, and internal medicine. She is an assistant professor and attending physician at Columbia University College of Physicians and Surgeons in New York, NY.
For those who suffer from the ill effects of sleep disorders, many diagnostic tests are available that may lead to a better understanding of what the problem may be. Let’s discuss the options.
What Do You Need To Know For Making A Referral
Anyone with two or more of the symptoms associated with OSAHS, particularly if they score highly on the ESS or STOP-Bang Questionnaire, should be referred to a specialist sleep service.1
However, NICE does not recommend using the ESS alone to determine if referral is needed, as not all people will experience excessive sleepiness.1 When making a referral, it is important to include essential information in the referral letter for example, assessment scores, the effect of symptoms and sleepiness, comorbidities, occupational risk, and oxygen saturation and blood gas values .1
Within the sleep service, certain groups of people should be prioritised for rapid assessment for suspected OSAHS, including those who:1
- have a vocational driving job
- have a job for which vigilance is critical for safety
- have unstable cardiovascular disease, for example, poorly controlled arrhythmia, nocturnal angina, or treatment-resistant hypertension
- are pregnant
- are undergoing preoperative assessment for major surgery
- have non-arteritic anterior ischaemic optic neuropathy.
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Take Care Of Yourself And Get Support
- Eat a healthy diet. Some people who work night shifts gain weight because they eat high-calorie or high-fat meals.
- Don’t have alcohol or caffeine in the hours leading up to bedtime.
- Get plenty of exercise.
- Take a nap during a work break if you can.
- Ask family members not to wake you during your sleep time, except for an emergency.
How Much Sleep Does A Person Need
Individuals vary greatly in their need for sleep there are no established criteria to determine exactly how much sleep a person needs. Eight hours or more may be necessary for some people, while others may consider this to be too much sleep.
The National Institutes of Health suggests that most average adults need about 7 to 9 hours of sleep each night. Newbornbabies, by contrast, sleep from 16 to 18 hours a day. Preschool-aged children typically sleep between 10 and 12 hours a day. Older, school-aged children and teens need at least 9 hours of sleep a night. Women in the first trimester of pregnancy have been observed to need a few more hours’ sleep than is usual for them.
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Periodic Limb Movement Disorder
The primary symptom of periodic limb movement disorder is twitching, jerking, and flexing the legs and arms while sleeping, as often as every 20 to 40 seconds. Daytime drowsiness and workplace performance issues from lack of sleep are other telltale symptoms. While the cause of primary PLMD is unknown, secondary PLMD is typically the result of an underlying medical condition, such as diabetes or anemia. Pharmaceuticals, lifestyle changes, and/or treatment of the underlying condition can usually effectively manage the disorder.
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What Is A Multiple Sleep Latency Test
MSLTs are full-day tests consisting of five scheduled naps scheduled two-hours apart. The patient will lie in a bed quietly during each nap trying to go to sleep. The test measures how long your patient takes to fall asleep once the lights go out. Your patient should be woken up after 15 minutes of sleep. If your patient doesn’t fall asleep within 20 minutes, the nap trial should be ended.
Your patient’s first nap will be scheduled approximately two hours after you wake them from the overnight sleep study. Have them eat a light breakfast around an hour before their first nap trial.
Sensors will be placed on your patient’s face, head, and chin to monitor when they are asleep and awake and identify when they’re in REM sleep.
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What Happens During A Sleep Study
A sleep study may be done at a hospital or a sleep study clinic, or in your own home. A home sleep study, also known as a sleep apnea study, is used to help diagnose sleep apnea. It does not diagnose other types of sleep disorders.
During a study at a hospital or sleep clinic:
During a home sleep study:
- You will pick up sleep study equipment at your provider’s office, or it may be delivered to you
- Your provider will give you thorough instructions on how to use the equipment. Be sure to ask questions if you’re unsure about anything.
- On the night of your study, you will attach the electrodes to your body and connect them to a sleep monitoring device.
- The electrodes will record different body functions including breathing rate, heart rate, blood oxygen levels, and snoring.
- In the morning, you’ll remove the electrodes and return the sleep monitoring device as directed by your provider.
Common Treatment Types For Insomnia
Medications tailored to your own specific needs are prescribed. For instance, if anxiety or depression are the underlying cause of your condition, your physician may prescribe you with antidepressants or anti-anxiety medications. Medications for sleep can be used as well, but are typically prescribed to be used on a short-term or as-needed basis.
Non-medical methods, such as cognitive behavior therapy, hypnosis, sleep restriction, stimulus control, and relaxation techniques, can also be used to treat insomnia. Lifestyle changes, such as avoiding caffeine and alcohol, are also advised.
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Ruling Out Other Conditions
Narcolepsy can be difficult to diagnose because the symptoms can be similar to those of other conditions, such as:
- a previous head injury
Excessive daytime sleepiness can also sometimes be caused by the side effects of certain medicines.
Your GP may carry out several tests to help rule out other conditions that could be causing your symptoms.
For example, you may have a physical examination, blood pressure tests and blood tests.
Will I Need To Do Anything To Prepare For The Test
The preparations are the same whether you are being tested at a hospital or clinic, or in your home. To prepare for your sleep study:
- Avoid alcohol and caffeine during the afternoon and evening before your test.
- Don’t nap during the day.
- Don’t use lotions, hair gels, or makeup before the test. They can affect the way the electrodes work.
If you normally take sleep medicines, talk to your provider about whether or not you should take the medicine before the test.
When Is A Sleep Latency Test Done
âYour doctor will order a sleep latency test if you have symptoms of narcolepsy or idiopathic hypersomnia. The main symptom of these conditions is excessive daytime sleepiness, which is characterized by tiredness and a lack of energy during the day, even after a sufficient nightâs sleep.â
âNarcolepsy and idiopathic hypersomnia are also associated with the following symptoms:
- âCataplexy, or a sudden weakening of your muscles, which is often caused by strong emotions
- âSleep paralysis
- Hallucinations that happen while you are dozing or falling asleep
- âWaking up often during the night
Other Tests For Sleep Apnea
- EEG to measure and record brain wave activity
- EMG to record muscle activity such as face twitches, teeth grinding, and leg movements, and to look for REM stage sleep. During REM sleep, intense dreams often happen as the brain has heightened activity.
- EOG to record eye movements. These movements are important in determining the different sleep stages, particularly REM stage sleep.
- EKG to record heart rate and rhythm
- Nasal airflow sensor to record airflow
- Snore microphone to record snoring activity
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