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Diagnostic Services

Sleep Programs

Polysomnogram Test

If you are concerned that you have fallen victim to a sleeping disorder, discuss with your doctor if you should have a polysomnogram test done. This comprehensive test monitors eye movement, muscle activity/activation, heart rhythm, respiratory airflow and brain activity during sleep or attempted sleep in order to diagnose or rule out specific sleep disorders in the patient. Although this is ineffective for determining circadian sleep-cycle disorders, it can identify parasomnias, narcolepsy, muscle-related sleep disorders (RLS), sleep apnea and disorders encompassing REM abnormalities.

There are two separate states of sleep. One is rapid eye movement, or REM sleep, which is the dreaming phase. None of the bodily muscles move except for the eyes and breathing muscles. The other is non-rapid eye movement, or NREM sleep, which has four separate stages of changing electrical activity in the brain. When functioning normally, we are supposed to alternate between the two states in approximately 90 minute cycles.

Polysomnograms are typically performed at a sleep center. The test is conducted at night in a bed in an individual room so it feels somewhat like going to sleep in a hotel room. Electrodes are positioned on the chin, scalp and the outer sides of the eyelids and they remain there for the duration of the night. The electrodes send signals to machinery that can measure the length of time it takes for the patient to fall asleep as well as when the REM stage is entered. Heart and breathing rates will also be monitored, and sometimes video will be used to record sleeping movements.

Sleep apnea, a disorder in which you stop breathing for periods during sleep, can be diagnosed using a polysomnogram either at a sleep facility or at times at home. Your doctor can provide a portable device and instruct you in its use. Common symptoms of sleep apnea are loud snoring, sleepiness during the day, gasps or snorts during sleep and restless sleep.

The sleep study will yield results about how frequently the patient stops breathing for at least 10 seconds at a time, whether breathing is partially blocked, patterns of brain waves during sleep and what muscle movements are taking place. Along with a medical history and a full physical examination, a polysomnogram can help determine just what condition is present.

There are many sleeping disorders that can have debilitating effects on a patient's overall health and quality of life. These can range from simple trouble with procuring/maintaining sleep to severe detriment to social, physical and emotional functioning.

CPAP/BiPAP Titration Study

Sleep testing with CPAP/BiPAP titration enables patients to undergo a polysomnogram sleep study either at a sleep center or from the comfort of their own bedroom. Your doctor may recommend a sleep study if he suspects you are suffering from obstructive sleep apnea, since this can help provide a more accurate diagnosis.

Obstructive sleep apnea is a common condition that involves breathing problems during sleep, as the throat muscles relax and block the airway. Patients with obstructive sleep apnea often experience loud snoring, daytime sleepiness, morning headaches, insomnia and waking up with a sore throat. This condition can affect anyone, but is most common in older adults.

If the study is taking place in a sleep center, a technician will handle all of the preparation and equipment. To perform in-home sleep testing, the patient will receive a portable monitor that measures activity while he or she is sleeping, and a CPAP (continuous positive airway pressure) or BiPAP (bilevel positive airway pressure) device. The CPAP delivers pressured air at a constant rate, while the BiPAP delivers pressured air at a higher pressure while inhaling and a lower pressure while exhaling. It is the air pressure that aids in keeping the breathing passages open.

Whichever device you are given is connected to a mask that is placed over the mouth, the nose or both. It will automatically titrate, or adjust the amount of air pressure needed to breathe during sleep without causing apnea. For accurate test results, you must sleep for at least two hours on the night of your sleep testing. The machinery will record your brain waves, heart rate, oxygen level and muscle movements.

The next morning, the polysomnogram is over. If it was performed at a sleep facility, you will go home and discuss the results at your next appointment with your doctor. If it took place at home, you will return the monitor and the CPAP or BiPAP device to your doctor. Once the results have been interpreted, your doctor can create a customized treatment plan for your individual condition.

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Sleep Programs

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