Sleep Medicine | Sleep Disorders

More than 100 million Americans regularly fail to get a good night's sleep. There are over 84 sleeping and waking disorders that lead to a lowered quality of life, reduced personal health, and endanger public safety. Without a proper night's sleep, you may experience the following:

• Fatigue
• Irritability
• Depression
• Reduced attention and concentration
• Increased blood pressure
• Impotence
• Lost productivity
• Workplace/Motor Vehicle accidents
• Frequent illness

Direct Referral Form

Direct Referral Instructions

Stop-Bang Questionnaire

The EPWORTH

Berlin Questionnaire

Sleep study instructions for Children

Sleep Study instructions for Adults

Sleep Study instructions for MSLT

Breathing disorders

Body clock disorders

Circadian rhythm sleep-wake disorders

Hypersomnia

Insomnia

Movement disorders

Obstructive sleep apnea

Parasomnia

Sleep Apnea

Polysomnography (home and in-house)

CPAP titration

Multiple sleep latency testing

Why do I need a sleep study?
Your doctor has ordered a sleep study due to a concern that you may have a sleep disorder that is affecting your health. The goal of the study is to obtain data that will help the physician determine the next steps in your care. The most common type of sleep problem, sleep apnea, is a disorder in which your breathing is irregular at night. This causes stress on your heart, which can lead to low oxygen levels, hypertension, and heart rhythm problems. It may also lead to increased plaque build-up in your arteries of the heart and brain, and is associated a higher risk of stroke and heart attack. Not all people with apnea have sleepiness during the day or insomnia at night. Some people may have other symptoms such as morning headache, fatigue, weight gain or worsening memory. Even if you are unaware of any breathing problems, you may still have sleep apnea if you do not sleep well.

What is measured during a sleep study and why?
While you are sleeping, your body physiology is different from when you are awake. As a result, we need to take several different measurements during the sleep study including heart rate, breathing, sleep level (as measured by the EEG on your scalp), oxygen levels, and movement. These measurements help us determine the causes of your sleeping problem. For example, some people may have abnormal brain waves during sleep that prevent them from reaching the expected types of sleep stages. Their brain waves may be affected by movement, which in turn may be affected by respiration. It is important to evaluate how each of these different factors interact.

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 to measure movement. About ten electrode patches are attached to your head with paste to detect your brain waves and sleep level. You may have some paste residue in your hair after the study that washed out with soap and water during your next shower.

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.

What kind of room will I be in for the sleep study? What if I need to use the bathroom?
You will be given a private sleeping room with a shared bathroom for the night of the sleep study. You will have a television in your room which, you can use prior to the start of the sleep study. If you need anything during the night, you can call out and the technologist will hear you on the intercom. They will also assist you if you need to use the bathroom.

Will the bed and pillows be comfortable?
The lab has standard beds that are designed to meet the qualifications for hospitals. Pillows, blankets and sheets are also standard. If you are particularly sensitive to pillows and bedding, you are welcome to bring your own pillow and comforter.

Can I control the temperature of my room?
Each room is equipped with its own thermostat, which can be adjusted according to your request. Please let the technician know if you prefer to have the room hotter or cooler.
Will I sleep as well during the sleep study as I do at home? Does it matter if I do not sleep well during the study?
We try to make your experience as comfortable as possible, but the sensors and the new environment are likely to make you feel less comfortable than when you are at home and you may not sleep as well. However, even if you sleep for only a few hours we should be able to gather a great deal of information. It only takes a few hours of sleep for a breathing disturbance such as apnea to be detected, even with less restful sleep.

Will the technologist wake me up during the study?
We will try to avoid waking you, but it is possible that the technologist will need to do so in order to fix some cables or replace some of the sensors that might fall off. As mentioned previously, we do not expect this night to be entirely typical for you, but we can collect a lot of information within a few hours and sometimes the issues may be obvious early in the study.

Should I take my usual medications on the night of the sleep study?
Yes, you should take your usual medications on the night of the sleep study unless otherwise indicated by your doctor. You will need to bring any medications you take at night since we do not have any access to any medications. If your doctor orders any special medication for you to take on the night of the sleep study, you will need to bring it with you.

Does it matter what position I sleep in during the night of the study?
Our goal is to collect the best data we can about you while you sleep. To do this, we will want to see you sleep in your usual positions, but we may also ask you to sleep in other positions as well. Some people have severe problems with apnea when they sleep on their back, but none when sleeping on their side. If you have only been sleeping on your side during the study, the technologist may come into the room at some point and ask you to try to sleep on your back. If you never sleep on your back or can’t sleep in that position, we will not require it for this study.

What type of foods and beverages contain caffeine?
We ask that you refrain from consuming any caffeine during the daytime prior to the study. Please remember that caffeine is contained not only in coffee, but also in tea (hot, iced and sweet), soda (regular and diet), chocolate and coffee ice cream. There is also caffeine in decaffeinated coffee and in some medicines, including Excedrin.

Will I need to tell someone about all of the medications I am taking when I come in for the sleep study?
Yes, please bring a list of all of your medications and supplements as well as your prescription bottles to review with the technician. This review is very important since these substances may affect your sleep and need to be included in the study report. Please include any over-the-counter medications that you take as well as prescription medications.

What happens after the sleep study?
On the morning following your sleep study the sleep technologist will not be able to discuss detailed information regarding your sleep study results. The study must be scored by a Registered Sleep Technologist and interpreted by a Board Certified sleep Medicine physician before the final results are available. You will receive your results from the practice that referred you for your sleep study. Please allow 2-3 weeks for this process.

I am being evaluated for narcolepsy. Do you have any special instructions for my sleep study?
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.

Immediately following the overnight study, you will probably need to stay for the entire day for a nap study. During the nap study—the multiple sleep latency test (MSLT)—you 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. You will need to bring your sleep diary with you to your sleep study.

Source: https://www.med.unc.edu/neurology/divisions/sleep-1/frequently-asked-questions/what-to-expect-at-your-sleep-study