Sleep Studies
Other Laboratory Sleep Evaluations
For a brief description of the Maintenance of Wakefulness Test and Nap Study, see http://www.sleepeducation.com/Studies.aspx
Alternatives to a Laboratory Sleep Study
In-home test though a physician. Some physicians and insurance companies suggest an in-home test. The patient wears various sensors and belts through the night. The results are monitored and reported. Sleep stages and brain waves cannot be measured as they are in a laboratory sleep study. One in-home process used by Kaiser, http://www.sleepdata.com/homecare.htm, measures apneas and hypopneas per hour, heart rate, respiratory effort, nasal-oral airflow, oxygen saturation using a pulse oximeter, body position, and snoring intensity and frequency. Simpler devices are the SLP Sleep Strip, http://www.slp-med.com/SleepStripTech.htm and the Accutest SleepStrip, http://www.accutest.net/products/sleepstrip.php. If you explore these alternatives, discuss with your physician the need and ways to detect OSA (obstructive sleep apnea) vs. central apnea (brain not giving a signal to breathe) and mixed sleep apnea (combination of OSA and central), since treatment is different for the three types, as well as detecting other sleep disorders such as Restless Leg Syndrome. Also determine whether your insurance or Medicare will pay for subsequent treatment based on testing that is not the standard sleep study.
Inexpensive screening for obstructive sleep apnea for the uninsured, for those who can’t afford insurance co-pays for a sleep study, or for those who want screening before a sleep study: https://www.cpap.com/productpage/slp-sleep-strip-at-home-sleep-study.html
Diagnosis based on symptoms and perceived need may be an option for non-insured patients or patients with highly suspected obstructive sleep apnea (OSA) based on symptoms. Not Every Patient Needs to Go to the Sleep Lab, http://www.alaccoast.org/pdf/Phillips_0830.pdf is a thought-provoking Powerpoint presentation by a well respected board certified sleep doctor/pulmonologist, Dr. Barbara Phillips, at a meeting of the American Lung Association of the Central Coast in November 2004. Dr. Phillips is a professor of medicine at the University of Kentucky and is on the board of directors of the National Sleep Foundation. This approach would not detect central sleep apnea or mixed sleep apnea. Treatment differs depending on the diagnosis. If eligible, find out whether Medicare or Medicaid would pay for subsequent treatment without an overnight laboratory sleep study.
What to Expect during a Sleep Study
Three definitions are useful for the sleep study.
Apnea. The Greek word “apnea” means “without breath.” You stop breathing during sleep for ten seconds or longer.
Hypopnea. There is airflow through your throat but at a much reduced level, which leads to not getting enough oxygen. It’s abnormally shallow breathing lasting at least ten seconds.
AHI, Apnea-Hypopnea Index for Obstructive Sleep Apnea: Less than 5 events (apnea or hypopnea) per hour is considered normal. 5 or more events per hour is considered Mild 15+ considered Moderate 30+ considered Severe (from T. S. Johnson MD, Sleep Apnea - The Phantom of the Night, page 211)
A sleep study uses a pulse oximeter, a device with a red light that clips on your finger. It measure oxygen levels in your blood by noting the color; oxygenated blood is bright red, blood with hemoglobin desaturation is darker red.
Comprehensive Sleep Lab Orientation in Print
There are two chapters on sleep testing and understanding your report in the book Sleep Apnea – The Phantom of the Night by TS Johnson MD et al.
Short Sleep Lab Orientation DVD or Online Video
“Introduction to the Sleep Lab” Order from https://www.cpap.com/productpage/cpaptalk.com-introduction-to-the-sleep-lab.html Allow time for delivery or view online at http://www.cpaptalk.com/cpaptalk-cpap-video-movie.php?videos=video&VGID=58
Tips for Wearing a Mask and Using CPAP for the First Time
• Expect elaborate headgear, face straps, and stiff, bulky plastic nose pieces that make you look like an astronaut.
• While the sleep technician puts the mask on you, breathe through your mouth.
• Before you are hooked up to the CPAP machine, ask the technician to let you feel the airflow from the hose on your hand. It’s surprisingly breezy. It will feel much less breezy when felt through a mask.
• You won’t need it, but to make you more comfortable psychologically, ask the technician to show you how to quickly remove the mask and how to disconnect the mask from the hose or CPAP machine. The technician will show you how to call him or her during the night.
• While sitting up, spend a few moments “practice breathing” through the mask with CPAP turned on. It works! You can do it. You can even fall asleep while wearing it.===Sleep Lab Posts=== Discussion threads:
http://www.cpaptalk.com/viewtopic/t14035/Cheap-Sleep-Apnea-Screening-Diagnosis-and-Auto-CPAP-Rx.html
http://www.cpaptalk.com/viewtopic/t14578/At-Home-Obstructive-Sleep-Apnea-Screener-Now-Available.html
Comments from a SleepStrip engineer: http://www.cpaptalk.com/viewtopic.php?t=14035&postdays=0&postorder=asc&start=15=Sleep Symptoms=