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What is a polysomnogram? It is a continuous
recording of brain waves, eye movements, and muscle tone to determine
sleep stages. The polysomnogram (PSG ) almost always records heart
rate and rhythm, leg and body movements, sounds you make while sleeping,
breathing effort, airflow through the nose and mouth, and oxygen levels.
If other disorders are suspected, additional data is recorded.
What should I do on the day of the test?
Do
- Review the Sleep Study checklist for what you should bring
- Eat supper before reporting to the lab
- Take your regular medication
- Bring a book, magazine, or newspaper.
- Bring pajamas
- Bring your toiletries
- Bring all of the medications that you take in the evening, overnight,
and in the morning
Do not
- Drink large amounts of caffeine within 12 hours of your test. This
includes caffeinated soda, coffee, tea, and chocolate
- Nap the day of the test
- Use creams, oils, or sprays on your hair or skin the day of your
test
- Consume alcohol
Will the recording be painful? No. However,
patients with sensitive skin may notice mild irritation from electrode
paste or adhesive.
Who will be in the laboratory while I am sleeping?
You will have a private room and will be monitored
from an adjacent control room by a trained sleep laboratory technologist.
The technologist is responsible for making your stay comfortable and
safe while obtaining a high-quality sleep recording.
Will the recording procedure disrupt my sleep? Most
patients who undergo polysomnographic recordings are excessively sleepy.
In many cases their sleep in the laboratory is similar to, or even
better than, their sleep at home. Other patients may have difficulty
sleeping well in the laboratory. If you think you might be anxious
about sleeping in the laboratory or wearing an airtight nasal mask,
talk to your referring physician, who may prescribe a small dose of
a short-acting, tranquilizer to take in the laboratory before bedtime.
We take into account any disruptive effects of the laboratory when
your recordings are scored and interpreted.
Are there any precautions I need to take getting
to or from the laboratory? If you have difficulty
staying awake while driving, or anticipate that you might if you sleep
less than usual in the laboratory, you should make arrangements for
someone to drive you to and from your sleep test. If this is not possible,
you should use a taxi or other public transportation.
Will I be given a sleeping pill?
No. However, if you have been taking a sleeping pill every night then
you should consult with your referring physician to determine whether
you should bring that medication to the laboratory to take on the
night of your sleep test. If your referring physician is unsure, please
have him/her contact Dr. Biber, the Medical Director of Neurocare,
to discuss this issue.
Should I continue to take my medications before
the test? You should continue to take all
your regular medications unless your physician instructs you otherwise.
During the 10 days before your sleep test, do not change your medications
without approval from your referring physician. You should direct
any questions about your medications to your primary care provider.
If your physician has questions about your medication or your sleep
test, our Medical Director is available for prompt consultation. Sleep
technologists cannot administer any medication.
What kinds of sensors are applied during the
recording? Most of the sensors are tiny gold-plated disks that
the technologist applies to your scalp, face, and chest. Your blood
oxygen is monitored using a small, lightweight, cushioned plastic
clip on your finger. A very thin plastic sensor is placed between
your nose and upper lip to monitor your breathing. To record your
breathing effort, lightweight belts will be placed around your chest
and abdomen. Tiny movement sensors will be applied to your lower legs
and the small electrodes applied to your chest will record your heart
rate and rhythm. The monitoring equipment is attached to a small box.
If you need to use the bathroom, the technologist will unhook two
connections so you can take the box with you.
Will I just be tested, or will treatment be
started in the laboratory? In most cases,
your test will focus on diagnosing your sleep problem. However, when
breathing problems during sleep are anticipated, your doctor may request
that treatment be started during your test. In this case, , the sleep
technologist will begin continuous positive airway pressure (CPAP)
treatment, if the data recorded during the night meets the criteria
specified by your medical insurance. Even if your physician has not
ordered that CPAP treatment be started during your sleep test, we
may initiate CPAP treatment if the apnea problem is so severe that
we believe there might be a risk in delaying treatment,. Most often,
we determine whether you need CPAP treatment in the early stages of
your sleep study. In some cases, there may be too few upper airway
obstructions during the first three hours or so of the recording to
start CPAP treatment during the same night. If this is the case, you
most likely will need to schedule a second sleep study to start or
complete the adjustment.
What is the CPAP apparatus like and how is it
applied and adjusted? To start CPAP treatment,
the sleep technologist will first apply a small silicone rubber and/or
plastic nose mask that is held airtight by light straps. Some patients
use a silicone rubber nasal tube that contains branches that fit into
your nostrils in place of the mask. It resembles nasal prongs often
used to administer oxygen, but the tubes are larger. A CPAP machine
delivers air or, when warranted, air with supplemental oxygen through
the mask or tube. The technologist will adjust the CPAP during the
night to the pressure that works best for you. A full report will
be sent to your physician to outline your CPAP information.
What happens to my sleep recording after completion
of the test? The morning your test is completed,
a detailed summary report will be faxed to your referring physician.
This will be followed by a comprehensive analysis of your sleep study.
First, a qualified sleep technologist will score your test data, which
will then be reviewed by a physician who specializes in sleep medicine.
This specialist will write a final detailed report that will be sent
to your doctor.
What treatment am I likely to receive after
I complete my overnight sleep test? If your sleep test confirms
that you have moderate to severe obstructive sleep apnea syndrome,
a home trial of nasal CPAP treatment will most commonly be prescribed.
Most patients who meet diagnostic criteria for moderate or worse obstructive
apnea will have already started a trial of CPAP treatment during their
night in the laboratory. If the test results indicate that you do
not have obstructive sleep apnea or you have marginal or mild apnea,
your referring physician will likely want to meet with you to discuss
the results and consider treatment options. Treatment should be customized
to the circumstances of the individual patient. Options may include
CPAP, weight loss if you are overweight, dental appliances to hold
your jaw and tongue forward during sleep, or surgery to decrease resistance
to airflow in your upper airway. Your sleep test may document evidence
of other sleep disorders that degrade your sleep. Specific and appropriate
treatment for these should then be considered. Consultation from expert
Neurocare sleep specialists is available to your referring physician
on request.
When will I be able to begin home treatment
with nasal CPAP? If you meet the criteria of your medical insurance
company for treatment with CPAP and your referring physician has provided
Neurocare with specific written permission, you may receive a CPAP
mask and a flow generator the morning following your overnight sleep
test before you leave the laboratory. If you meet your insurance company's
criteria, but your physician has not provided permission, he/she may
order your home CPAP hardware and treatment initiation by contacting
a home care company.
Will my insurance pay for my sleep testing?
Yes. We accept insurance for most patients, and most major health
insurance carriers cover sleep studies. You will only be responsible
for your deductible and insurance co-payment. If you have questions
about billing or insurance coverage, call us at 800-432-8808 at least
72 hours before your study.
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