Sleep is Critical to Your Health
Restful sleep is an integral part of good health. Most people need 7 to 8 hours of sleep to optimally function. With the advancement of technology, it is becoming more and more difficult to get quality sleep. Our brain is constantly agitated by various forms of alerts and visual stimulants. These irritants do not allow the brain to unwind and focus on rest. There are various forms of sleep disturbances. We will work as a team to figure out the source of your sleep problems and help to try to work through the issues.
What is a Sleep Study?
A sleep study is a painless series of tests performed in an overnight setting that evaluate an individual’s sleep patterns to determine if they have a sleep disorder that can be addressed. The type of test used to evaluate a patient depends on the type of sleep problem the individual is having, but the tests are generally similar. A patient is hooked up to various electrodes that measure brain wave activity, which allows us to determine if the patient is asleep or awake and what stage of sleep they are in. The patient then goes to sleep normally and the test begins. If the patient wakes up or has difficulty sleeping, the study helps determine why. After the study is over, the individual leaves the sleep center the next morning. The study is read and the patient comes back in several weeks to discuss the results.
Understand Sleep Apnea
If you snore, you may know about the nightly jabs in the ribs and grumbling from your bed partner. The noise you make may be disruptive to their sleep. Snoring can become a more serious issue if there are noted pauses in breathing. This medical condition is called sleep apnea.
Common symptoms of sleep apnea include:
- Breathing pauses, gasps, or snoring in your sleep
- Waking up tired, even after a full night of sleep
- A headache upon awakening.
- Feeling sleepy or exhausted during the day
- Need for frequent naps
- Problems with memory or concentration
- Cranky or short-tempered
Children with sleep apnea may also have:
- Issues with bed-wetting
- Behavioral problems
- Restless sleep
- Developmental delay
- Mouth breathing
Problems associated with obstructive sleep apnea:
With obstructive sleep apnea, your airway collapses during sleep and your breathing stops for short periods of time. Your brain must subconsciously wake up in order to start breathing again. This cycle repeats multiple times each hour throughout the night leading to daytime drowsiness and fatigue. If left untreated, it can lead to the possible development of serious medical conditions, such as:
- High blood pressure
- Irregular Heart Beat
- Heart attack
Diagnosing a Sleep Disorder?
To determine the best treatment, your doctor will discuss your medical history and conduct a physical exam (to rule out anatomical issues causing the sleep disturbances). Diagnostic studies, such as an in-labor home sleep study may also be suggested. These studies will help to determine whether or not you have sleep apnea or other sleep disorders.
Treating the Problem
Although CPAP (see below) is the gold standard for treatment of sleep apnea, the following options may also be helpful:
- Sleeping on your side may reduce blockage of your throat, causing less snoring and less sleep apnea.
- Weight loss because excess weight causes the structures in your throat to be more bulky and floppy. This makes breathing harder, which can aggravate snoring and make sleep apnea worse.
- Avoid alcohol or medications, such as sedatives, sleeping pills, and some antihistamines, relax your throat muscles more than usual which may cause or worsen blockage, snoring, and apnea.
- For simple snoring, or mild to moderate apnea, an oral appliance moves the jaw and tongue forward, preventing the tongue from blocking the airway. These devices can work well, but they are not for everyone. You can work with our healthcare team to be fitted with an oral appliance that is customized to you.
Continuous Positive Air Pressure (CPAP) uses gentle air pressure to hold the airway open.
CPAP is often the most effective treatment for sleep apnea or severe snoring. It works very well for many people but an adjustment period may be necessary. Insomnia is the most common sleep disorder in this country. Difficulty falling asleep or staying asleep are common symptoms. More often it affects a woman and people over 65. Common side effects of insomnia include irritability, depressed mood, daytime tiredness, and overall low energy. Medical conditions that could be the source (ie heart failure, chronic pain, thyroid issues, etc) must first be ruled out.
Treatment options include good sleep hygiene with a consistent bedtime and wake hours, quite dark/cool room, regular exercise in the first few hours after waking up. Cognitive behavior therapy and sleeping aids can also be beneficial. Restless Leg Syndrome can sometimes occur with low iron levels, pregnancy, diabetes, arthritis, kidney disease and Parkinson’s. It can also be secondary to certain classes of medications such as antihistamines, antipsychotics, antidepressants, and calcium channel blockers. Sometimes the cause is unknown. It is more often found in a woman and the elderly. Treating the underlying medical condition, sleep hygiene, avoiding alcohol/tobacco can all help. An in-lab sleep study can determine how often this affects your deep sleep.
Sleep Study FAQ
What does a sleep study entail?
A sleep study is a non-invasive, painless evaluation of your sleep. Electrodes attach to paste, and they monitor your brain waves, rapid eye movements, breathing patterns, respiratory efforts, oxygen levels, snoring, muscle tone and leg movements, electrocardiogram, and heart rate. You can move from side to side.
How long does the test take?
The hookup procedure starts shortly after the scheduled appointment time (between 7:30 p.m. and 9:30 p.m.) and will take roughly 30 to 45 minutes. Your study is performed in a private room equipped with a television. The testing procedure typically starts between 9:00 p.m. and 11:30 p.m. and will continue until about 5 a.m. The technologist will be located in the monitoring room in the hallway next to the bedroom throughout the night. Although you are not expected to go to sleep at a specific time, you will be encouraged to fall asleep as soon as possible to maximize the amount of sleep time during which you can be observed. Patients needing to use the bathroom during the study need only to notify the technologist. He or she will unhook one or two central connections, which will enable you to get up and walk to the bathroom.
What if I can’t fall asleep?
“There’s no way I can fall asleep with all that stuff on me!” The good news is that almost everyone does, it just may take you a little longer than usual. If this is a concern, please voice this to our physician during your appointment as you may need a sleep aid.
Does the test hurt?
The test is non-invasive and not painful. The sleep lab environment is dark and quiet and conducive to sleeping. However, the presence of the wires and electrodes occasionally affect the sleep of some patients. If you are concerned about your ability to fall asleep during the testing procedure, we suggest that you deprive yourself of some sleep the night before the test by waking up earlier than usual.
Can I use a sleep aid?
Yes, either over the counter or prescription sleep aids are fine to use. Please advise of the need for one at the time of scheduling your sleep study.
Can I bring my pillow?
Bringing items such as your pillow may make you more comfortable and may facilitate getting more restful sleep. Please do not carry pagers or cell phones, as these things may interfere with lab equipment, disrupt the sleep study and affect your test results. If you must have these devices with you, please make sure they are turned off during testing. A refrigerator is available, and you are welcome to bring a bedtime snack.
What if a spouse or caregiver wants to accompany an adult patient?
If a patient needs 24-hour care, we ask that the caregiver stays with the patient in one of our rooms specially fitted with two beds. If a spouse wishes to accompany the patient so as not to stay home alone, arrangements can be made. If the patient is a child, someone will have to keep up the night with him or her. We have recliners for you to sleep in or in many cases with younger children the parent will sleep in bed with them. The second parent may stay but will have to sleep in the recliner.
Can I have my sleep study done at home?
Yes, The Sleep Center offers both in-lab and in-home testing; however, home sleep testing isn’t an option for everyone. We start with a consultation with one of our sleep specialists to see if home testing is right for you. Sometimes, more information is needed than an in-home study can provide, so our sleep specialists will work with you to make the right decision for your health.
What nights are you open?
We’re open around the clock and can conduct your sleep study any night that works best for you. We also perform daytime sleep studies for second and third-shift workers.
What should I wear?
We ask that you bring something comfortable to sleep in, such as pajamas or sweatpants (shorts) and a T-shirt. If you need to stay for additional testing the next day, please bring something you can wear in our public lounge. We do not permit sleeping in the nude.
How prevalent are sleep disorders?
More than 100 million Americans have a hard time sleeping. It’s estimated that 18 million of have sleep apnea, however, only 3 million have been diagnosed. The danger in not seeking diagnosis and treatment can be seen in the number of annual deaths: approximately 38,000 people die annually from complications caused by sleep apnea.
How is my privacy protected?
Sleep studies routinely include a digitally recorded video that enables the Sleep Center physician to visually observe sleep position, movements, respiration and other sleep-related information. We are required to have your written consent to perform the sleep study and to record the video. This data is protected by the Health Insurance Portability and Accountability Act (HIPAA), which established national standards for the security and privacy of health data.
How do I get the results of my study?
A Sleep Center physician will review the sleep recording in conjunction with your clinical history in order to arrive at a diagnosis. The technologist cannot discuss any results with the patient. Once the Sleep Center physician reviews and interprets the study, a final report will be forwarded to your doctor within a week. Please follow up with your physician after the study.
Are sleep physicians covered by insurance?
Yes. Medicare and most private health insurance companies cover office visits, sleep studies and CPAP services. We offer affordable cash prices for those with high deductibles or no insurance.
When should I visit a sleep specialist?
It’s time to see a doctor specially trained in sleep disorders when you have had trouble sleeping for more than a month or if you are tired during the day for unknown reasons. If you have trouble falling asleep or staying asleep, it is important to have the cause evaluated in a sleep lab. You and your primary care physician should not assume that you have “insomnia”. Recent studies show that a high percentage (30-50%) of people diagnosed with insomnia actually have another sleep disorder such as obstructive sleep apnea. Also, it is very important to have your nocturnal breathing pattern evaluated before starting sleeping agents, because they may depress your respiratory drive.
What are some of the consequences of sleep disorders if left untreated?
- Daytime sleepiness and fatigue
- Cognitive impairment and poor job performance
- Anxiety, depression, memory loss and dementia, hypertension, cardiac disease, stroke, and traffic accidents.