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What Happens During A Sleep Apnea Study

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What Are The Effects Of Sleep Apnea

What to Expect During a Sleep Apnea Study

If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.

Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

This is because sleep apnea can cause:

  • Repeated episodes of oxygen lowering .
  • Changes in carbon dioxide levels.
  • Direct effects on the heart due to pressure changes within the chest.
  • Increased levels of markers of inflammation.

With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.

References

What Do The Results Mean

Your results may include measurements of the following:

  • Apnea Hypopnea Index . This looks at how many episodes of sleep apnea happen in a night. If you have more than five episodes, it probably means you have sleep apnea.
  • Sleep efficiency. This is a calculation based on the total number of minutes you sleep during the night compared with the amount of time you spend in bed. So if you spend a long time in bed without being able to sleep, you would have low sleep efficiency.
  • Oxygen Desaturation Index . This measures the number of times your oxygen level drops during sleep. Lower than 90 percent oxygen is considered abnormal.
  • Heart rate. A normal heart rate is between 60 and 100 beats per minute. This result will show if your heart is beating faster or slower than normal.

Your provider will review all the results and provide a treatment plan if appropriate. If you have questions about your results, talk to your health care provider.

Equipment Frequently Used For A Sleep Study

During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. These signals, which are generated by your brain and muscle activity, are recorded digitally. Belts around your chest and abdomen measure your breathing. A bandage-like oximeter probe on your finger measures the oxygen in your blood.

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What Are The Symptoms Of Sleep Apnea

In either form of sleep apnea, your breathing pauses a number of times during sleep. These are called apneic events. There may be as many as 20 to 30 or more events per hour. Between events, you may snore. But, not everyone who snores has sleep apnea. Sleep apnea may also cause a choking sensation. When breathing starts, you may make a loud snort or gasp. These frequent breaks in deep, restorative sleep often lead to headaches and excessive daytime sleepiness.

Other symptoms include dry mouth or sore throat and problems paying attention.

I Am Being Evaluated For Narcolepsy Do You Have Any Special Instructions For My Sleep Study

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In terms of medications, you should follow the instructions given to you by your physician. Many patients who are being evaluated for narcolepsy are asked by their clinicians to stop taking some of their medications for several weeks prior to the study. If the physician did not give you special instructions, then continue taking your medications as usual. If you do stop, then please let the technician know which medicines you have stopped taking and for how long.

It is extremely important that you allow yourself to sleep for as long as possible in order to have a more reliable assessment. It is fine if you do not sleep very well on the night of the study, but try to let yourself sleep late in the morning. Immediately following the overnight study, you will probably need to stay for the entire day for a nap study. During the nap studyâthe multiple sleep latency test âyou will be given five nap opportunities spread out over the course of the day.

In addition to the instructions above, you should keep a diary of what time you go to sleep and what time you get up for the two weeks prior to your sleep study.

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What Does A Sleep Study Do

A sleep study does exactly what the name suggests, it studies your sleep. This is done via a process called polysomnography which literally translates to many sleep measurements.

  • Breathing rate and effort to provide evidence of breathing interruptions.
  • Eye movement helps to determine what stage of sleep you are in.
  • Sleeping position gives some insight into what triggers sleep apnea.

PSG can also be used to study other conditions such as narcolepsy, restless leg syndrome, periodic limb movement disorder, insomnia, sleepwalking and night terrors.

A Night At The Sleep Center

I arrive at the Advanced Sleep Research Institute in Berlin, Germany, at 8.00 p.m. A medical student is on duty. There are two people here today that she is looking after. She will stay awake all night to monitor our progress.

The medical student takes me to a room with a single, hospital-style bed. There is also a TV. When you lie in the bed, you can see the camera that will record your sleep.

Next, she attaches the electrodes.

She puts two on my legs and several on my upper body, which are linked to the ECG. She then places more electrodes on my upper arms, hands, and a lot on my head.

The student also attaches a mask to screen for sleep apnea to my face. Its hard, and the indents will remain visible on my face for a while after I take it off in the morning.

Finally, she attaches an oxygen monitor to my finger. It has only taken about 5 minutes to get me prepped, but I find it hard to imagine that I will ever go to sleep like this.

As soon as my preparation is complete, I lie down.

A few minutes later, the medical students voice comes on over the speaker. She asks if I can hear her. Then she asks me to do a vision test look left, look right, open eyes, close eyes.

Next, we do a breathing test. I breathe in, breathe out, through my nose, through my mouth, hold my breath. This way, she can check that all the monitors are working correctly.

The lights go off at 10.00 p.m.

Once I fall asleep, the clock starts ticking down the 8 hours allotted sleep time.

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When Is A Home Sleep Apnea Test Appropriate

Home testing is becoming more common to diagnose obstructive sleep apnea, with many insurance providers considering it a cost-effective alternative and some patients preferring its convenience. But it isnt suitable for everyone.

In the past, obstructive sleep apnea could only be diagnosed one way: through a sleep study, or polysomnography.

Thats still the most comprehensive assessment. But it also involves spending a night away from home hooked to a bevy of electrodes and machinery in a clinic bed. Home sleep apnea tests have given many people a convenient, more comfortable means of evaluation.

OSA is characterized by repeated obstructed or restricted breathing for periods of 10 seconds or longer, and it affects more than 25 million Americans. It leads to oxygen shortages that, in turn, result in health outcomes far worse than simply noisy breathing and unrefreshing sleep. OSA is associated with increased risk of stroke and heart disease, among other medical conditions.

Doctors, then, might recommend home testing or a formal sleep study to make sure people get the accurate diagnosis and treatment they need.

Below, Kaplish explains a few pros and cons of home sleep apnea tests.

Pro: They are comfortable

Pro: They cost less

Con: They arent as detailed

Con: They work best with serious cases

  • Snoring loudly
  • Tiredness, fatigue or sleepiness during the day
  • Observation by someone else of stopped breathing
  • Having high blood Pressure

How Do I Get A Sleep Study

What to expect during a sleep study

Medical referral

If you think you might have sleep apnea, first assess your risk with some questionnaires. Scoring high on screening questionnaires such as the STOP-Bang questionnaire and the Epworth Sleepiness Scale can be useful in persuading clinicians that a sleep study is necessary.

You can then see your doctor to request further investigation into your sleep breathing problems.

As well as your screening questionnaire results, SnoreLab can often be very helpful in giving your doctor some evidence of your loud snoring or maybe even some apnea episodes.

If seeing a general practitioner for your initial consultation, you may first be referred to a sleep specialist or an ear, nose and throat clinician before being offered a sleep study.

Requesting a home study online

In some countries, there are online companies that conduct home sleep studies without you ever having to attend a medical consultation. After filling out an online assessment form and paying a fee, these companies will post your study equipment to you with instructions.

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Screening For Sleep Apnea

To screen for sleep apnea or other sleep disorders, your doctor may ask you about common signs and symptoms of this condition, such as how sleepy you feel during the day or when driving, and whether you or your partner has noticed that you snore, stop breathing, or gasp during your sleep. Your doctor may ask questions to assess your risk for developing this condition and take your physical measurements. Your doctor will also want to see whether you have any complications of undiagnosed sleep apnea, such as high blood pressure that is difficult to control. If the screening suggests a sleep breathing disorder, you may get a referral to a sleep specialist to help confirm a diagnosis.

How Does A Sleep Study Work

    Sleep disorders cause many troubling symptoms that can affect ones mood, energy level, and overall health . Unfortunately, sleep disorders are notoriously underdiagnosed because they often develop gradually over time and have symptoms that are difficult to recognize.

    Accurate diagnosis is necessary to enable effective treatment for sleep disorders. A sleep study provides valuable insight into the causes of a persons symptoms including which, if any, sleep disorder is present. Sleep studies are also used in people diagnosed with sleep disorders to monitor their response to treatment.

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    What Are The Patient Rooms Like

    Beside the bed, the patient rooms in a sleep clinic contain medical equipment to monitor you while you sleep. Youll be hooked up to this equipment via wires and sensors. Different pieces of the equipment monitor various vital signs while you sleep, such as your brain waves, breathing patterns, and eye and body movement.

    There is also a observation window on one side, with an intercom. The sleep clinic technician will stay in this other area for the duration of your study, able to watch you while you sleep and communicate with you over the intercom.

    In hospital sleep clinics, the patient rooms often look similar to other hospital rooms, but with more comfortable beds and sleep diagnostic machinery. The rooms in a standalone sleep clinic, on the other hand, tend to look more like hotel rooms. Many sleep clinics aim to make the rooms a hospitable environment, since theyre aware of how difficult it can be for someone to fall asleep in a strange environment.

    Will I Need To Do Anything To Prepare For The Test

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    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.

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    I Have Heard That I Might Be Able To Get A Split

    During a split-night study, patients who have apnea will be able to try treatment on the same night of their first study. In order to qualify for this type of study, you must demonstrate severe obstructive sleep apnea within two hours of sleep in order to be sure that no other therapy will be available to you. In addition, the technologists will need you to have at least four more hours of sleep after starting the therapy in order to try to adjust the pressure on the mask and fully evaluate treatment.

    When warranted, we will try to do a split-night study in order to save you another visit to the laboratory for a treatment trial, but be aware that about one in four patients will need to return for another night due to insufficient information from the split-night study. Typically, an apnea patientâs breathing is worse during the last third of the night, which in turn gives us the best clues as how to approach your sleep disorder.

    How Do I Prepare For A Sleep Study

    To get ready for your sleep study at home, experts recommend that you turn off or dim any lights in your bedroom about an hour before bedtime. If youre watching television, choose something light and soothing to watch not a thriller! Read for a while instead of watching TV or staring at the computer screen. Keep your phone turned off so it wont disturb you during the night.

    During the day of your test, try to keep to your normal schedule. That means going to work and doing errands during the day but give yourself a break in the evening. The best thing you can do is get plenty of exercises, then relax before bedtime with a soothing activity such as reading. No napping or caffeine afternoon!

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    What Happens After A Sleep Study

    After you complete a sleep study, the collected data is reviewed and scored by the sleep technicians and sleep physician. Once your referring doctor receives these results, they will explain what they have learned from the study. From this point, your medical team can make recommendations and write prescriptions to help remedy any problematic findings.

    If you have been prescribed a Continuous Positive Airway Pressure machine a common occurrence after the diagnosis of sleep apnea a second sleep study may be required to determine the correct airway pressure setting.

    While an overnight sleep study may feel strange at the time, it is worth doing. Once a sleep disorder is diagnosed, your doctor can take steps to correct it, leading to better sleep in the future.

    What Happens During An Apnea

    What happens during a sleep study? | Summa Health

    To understand what is going on in an apnea, it’s helpful to think of this analogy. Imagine trying to drink a milkshake through a paper soda straw. As you suck in, the weak paper straw collapses, and you don’t get any of the milkshake. This collapsing is similar to what happens to people with OSA, but instead of missing out on a milkshake, they don’t get enough air into their lungs. This does not occur with normal breathing during wakefulness because signals from the brain activate the tongue and the muscles surrounding the airway and stiffen the airway. Therefore, air can flow into the lungs uninterrupted. In other words, normal breathing during wakefulness is like drinking the milkshake through a plastic soda straw.

    When we sleep, there is an increased risk for the airway behind the tongue to collapse with each breath . For most people this collapse does not occur because activation of the muscles surrounding the airway during sleep is still strong enough to prevent any blockage. However, for someone with OSA, the muscles do not respond adequately. Like the paper straw that collapses, the airway collapses and air does not reach the lungs.

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    Healthy Lifestyle Changes To Prevent Sleep Apnea

    If you are concerned about having risk factors for developing sleep apnea, ask your doctor to recommend healthy lifestyle changes, including eating a heart-healthy diet, aiming for a healthy weight, quitting smoking, and limiting alcohol intake. Your doctor may recommend that you sleep on your side and adopt healthy sleep habits such as getting the recommended amount of sleep.

    What Kind Of Sensors Will Be Used To Measure My Sleep During The Study

    There are no invasive measurements required during the sleep study unless your physician specifically orders something. Most of the sensors used in a sleep study are attached to the skin or on the surface of your body. An exception is the sensor prongs that are placed in your nose to measure the air flow coming in and out. EKG patches are placed on your chest to measure your heart rate. Similar patches are placed on your legs and arms to measure movement. About ten electrode patches are attached to your head with glue to detect your brain waves and sleep level. You may have some glue residue in your hair after the study that will be removed with a cleansing solution in the morning.

    We will have you wear some elastic bands around your chest to measure how your chest moves while you breathe. A sensor that is taped on your finger measures oxygen levels. Naturally, you may find sleeping with all these sensors is not as comfortable as sleeping in your normal bed. We expect that your sleep will be somewhat disturbed while being tested, but even if you sleep for only a few hours, we will be able to gather a great deal of information that will be useful.

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