Nocturnal Polysomnography

WHAT IS POLYSOMNOGRAPHY?

Polysomnography is a type of sleep study, and it is a multi-paramedic test that is used in the study of sleep and as a diagnostic tool in sleep medicine. The test result is called a polysomnogram (PSG).

Polysomnography records your brain waves, the level of oxygen in your blood, the heart rate and breathing, the eye and leg movements during the study. PSG is usually done overnight (nocturnal polysomnography), though it may be performed during the day (rarely). It can also be done at home, primarily to diagnose Obstructive Sleep Apnea (OSA).

WHY IS POLYSOMNOGRAPHY DONE?

PSG is a test carried out for the following reasons:

• To study sleeping habit
• To diagnose a sleep disorder
• To help or adjust treatment plan for a sleep disorder

WHO IS ELIGIBLE?

A polysomnography sleep study can be best recommended for those who have sleeping difficulties, and abnormal sleep experiences. It may also include patients whose health disorders are associated with sleep patterns.

SPECIALTY

The study test is performed by technicians and technologists who are specially licensed and accredited in sleep medicine?

PREPARING FOR POLYSOMNOGRAPHY

Alcohol and caffeine can alter your sleep patterns and may worsen the symptoms of some sleep disorders. For these reasons, you may be advised not to drink or eat foods containing alcohol or caffeine during the afternoon and evening before a sleep study.

Also discouraged is napping in the afternoon before a sleep study. You may be asked to bathe or shower before a sleep study. Avoid putting on lotions, gels, colognes, or makeup before your sleep study, they can interfere with the test. If you are embarking on an at-home sleep apnea test, the equipment will be delivered to you or you can pick up the equipment at your doctor’s office. 

Specific instruction will be given to you, describing how to use the equipment. Seek clarification on any misunderstanding bothering on how the test or equipment works.

THE POLYSOMNOGRAPHY PROCEDURE

Polysomnography is usually performed in the sleep center. 

Before Polysomnography,

• You will come in the evening and stay overnight.

• You may bring all items you need for your bedtime routine, including your nightclothes

• For those having a home sleep apnea test, you should follow your regular bedtime schedule. 

• You need to place the sensors on your body and turn on the machine. Follow the instruction that was given to you.
• You may ask yourself to keep a sleep log.

During PSG, 

When you are ready for bed, sensors will be placed on your scalp temples, chest, and legs using a mild adhesive (glue or tape). The sensors are connected to a computer, using long enough wires to enable you to have free movement in your bed. The technologist will also place a small clip on your finger or ear to monitor the oxygen level in your blood.

While you sleep, a technologist monitors your:

• Brain waves.
• Heart rate.
• Breathing pattern.
• Eye movement.
• Blood oxygen level.
• Limb movement.
• Chest and abdominal movement.
• Body position.
• Snoring and other noise you may make during sleep.

The technologists will monitor you throughout the night. You can also talk with them, through the monitoring equipment, if you need any assistance. They will come into the room to attend to you.

The technologists may test your positive airway pressure [PAP] using the PAP machine for sleep apnea. You may be asked to use continuous positive airway pressure (CPAP). CPAP devices deliver a constant stream of air that keeps the airway passages open while you sleep.

The technologists will also test your continuous positive airway pressure [CPAP]. The CPAP devices deliver a constant stream of air that keeps the airway passages open while you sleep.

The technologists may choose to use bi-level positive airway pressure [PAP] machines instead. For some people, BiPAP machines may be a more comfortable choice to choose. These devices deliver more pressure when you’re breathing in, and lower pressure when you’re breathing out. (You may not have a full sleep as when you sleep at home. Don’t worry; it will not affect your data. Sleep study does not require a full night’s sleep).

After Polysomnography,

The technologist will remove the sensors. You will be given an appointment for a follow-up visit. Thereafter, you can return and participate in your normal activities on the same day.

POLYSOMNOGRAPHY RESULTS & INTERPRETATION

It may take up to about 3 weeks to receive the results of the polysomnography test. A technologist will compile the data from the nights of your sleep study to graph your sleep cycles. (The result is your Polysomnogram). The asleep center doctor will review the data, your medical history, and your sleep history to arrive at a diagnosis. If your polysomnography results are abnormal, based on the PSG information about your sleep patterns, for example:

• Brain waves and eye movement
• Heart and breathing rate changes and changes in the blood oxygen 
• Frequent leg movements
• Unusual movements’ behavior during sleep. Maybe signs of rain sleep disorder or other sleep disorder
• The correct setting for PAP or oxygen

With these parameters, your doctor may be able to identify the following sleep-related illnesses indicative of the abnormalities

• Sleep apnea or other breathing disorders
• Seizure disorders
• Narcolepsy or other sources of unusual daytime fatigue
• Periodic limb movement disorder or other movement disorders

At a follow-up appointment, your doctor may review the results with you. Based on the data he/she gathered, your doctor will discuss any treatment option with you, or further evaluation that you may need.

RISKS

Polysomnography is a noninvasive and painless test. Over time, it has been proven that sleep study carries the risk, and almost without side effect. The most common side effect is a skin irritation caused by the adhesive used to attach test sensors to your skin. This may be temporary and may go overtime. Over-the-counter medicine can relieve skin irritation.

COST

PSGs cost averages $1000 to $2000 per night in the U.S. This cost value is often different in other countries.

FAQS

• What are the 5 major sleep disorders?

Thankfully, there are treatments available that you can talk to your patients about for the first most common sleep disorders. They include Insomnia, Sleep apnea, Narcolepsy, Restless legs syndrome, REM sleep Behavior Disorder

• How long does it take to do a Polysomnography? 

Polysomnography can take 1 to 3 months for an actual diagnosis.

• What if I can’t sleep during a sleep study?

If you absolutely can’t sleep during your study, you may be able to take a sleeping pill. This is one of the questions to ask ahead of time. Unless you have a prescription and sleep regularly, you’ll be able to use a light over-the-counter medication like restoring or Benadryl.

• How much does Polysomnography cost?

Overnight Polysomnography may cost from $600 to $5,000 (or more) for each night, the average is typically around $1,000 to $2,000 per night. Insurance, including Medicare, may cover the majority of the expense.

• Can I go to the bathroom during a sleep study?

Patients needing to use the bathroom during the study need only to notify the technologist. He or she will on-hook two central connections, which will enable you to get up and walk to the bathroom. Does the test? The test is non-invasive and not painful.