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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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