So your doctor has ordered a sleep study for you and you're not sure if you should do it and have anxiety about it. That’s understandable—it can be a strange and vulnerable experience, to imagine going sleep and being monitored by strangers in an unfamiliar environment.
But these tests are very much worth doing. Sleep studies deliver critical information that helps doctors properly diagnose and treat sleep disorders. The professionals who conduct sleep studies are not only trained in sleep science—they’re also there to help you be as comfortable as you can be during your stay. For nearly all of my patients, the idea of the sleep study is much more uncomfortable than the actual experience.
What Kind of Sleep Test Will I Take?
There are several different sleep disorders that typically involve a sleep study as part of the diagnosis, including: sleep apnea, narcolepsy, restless leg syndrome, and REM behavior disorder. Depending on your symptoms, your doctor will schedule one of several different types of sleep studies.
How Does a Sleep Study Work?
Unless your doctor specifies, a typical sleep study is split between two appointments usually. The first study is a diagnostic study called a Polysomnography (PSG) and the second study is a CPAP titration study done only if the first test confirms the patient has Obstructive Sleep Apnea (OSA). The PSG monitors many body functions including brain (EEG), eye movements (EOG), muscle activity or skeletal muscle activation (EMG) and heart rhythm (ECG), oxygen saturation during sleep; essentially, it tells us whether or not you have Obstructive Sleep Apnea (OSA). Your second study (CPAP) will be similar to your first with the only difference being you will be sleeping with a CPAP device. The goal of the second night study would be to identify the optimal pressure (CPAP) to treat the sleep apnea.
Diagnostic Sleep Study
A diagnostic sleep study, or polysomnogram (PSG), is a test that electronically transmits and records specific physical activities while you sleep. This test is usually performed in a sleep lab by a licensed sleep technician. There are many things that are monitored during this test such as your breathing pattern, your heart rate/rhythm, limb movements, oxygen levels in the blood, snoring, and the electrical activity of your brain.
What’s a polysomnogram like?
When you go for a polysomnogram, you’ll sleep in a quiet, private room. During the night, you’ll sleep with electrodes attached to different parts of your body, which will collect data as you rest. The wires that connect the electrodes to monitoring equipment are long, allowing you to move around in bed in your natural way. There are typically video and audio systems in the room, allowing sleep techs to observe your activity as you sleep. If you need to get up at night, sleep techs will help you detach from the equipment temporarily so you can use the bathroom. Your doctor will review the results of your test and follow up with you, in person or on the phone, to go over your test results and discuss next treatment steps.\
Some tips to prepare for your sleep study:
Stick to your regular routine in the days before your study. Keep your regular bedtime and wake time, exercise and eat your meals as you normally would.
Don’t nap during the day, if possible.
Limit your caffeine (and avoid altogether if your doctor recommends).
Your doctor may ask you to make adjustments to your medications ahead of a sleep study.
Bring comfortable sleep clothes, as well as toiletries you need for the night and next morning.
Don’t forget a change of clothes for the next day and some reading material to keep you occupied.
After completing a diagnostic sleep study your doctor will decide if you indeed have sleep apnea and need to have a titration sleep study with CPAP (continous positive airway pressure). This test is similar to the diagnostic study but a CPAP machine will be used to help with the treatment plan for your sleep apnea. CPAP is a treatment that involves the delivery of air into your airways through a special type of mask. There are many different types of masks you can choose from such as nasal masks, nasal pillows and full faced masks. The sleep technician will place the mask on your face and while you are asleep change the air pressure to determine the best level that corrects your sleep apnea problem.
What’s a CPAP titration like?
Similar to a polysomnogram at a sleep center, when you have CPAP titration you will sleep in a quiet, private room. While you sleep, you will wear sensors and also a nasal mask, which directs the air from the CPAP device into your airway. During the night, a sleep technician will adjust the levels of air pressure, to determine what level is right for you. Your doctor will follow up with you with test results and details about using CPAP at home.
The MSLT (multiple sleep latency test) is a test for patients with excessive daytime sleepiness and measures how quickly you fall asleep in a quiet environment during the day. This test is often used to help diagnose narcolepsy and idiopathic hypersomnia. This test takes a full day and consists of 5 scheduled naps separated by 2 hour breaks. You will be sleeping in a dark and quiet environment and the sleep technician will wake you after 15 minutes of sleeping. They will also be measuring how long it takes for you to fall asleep. If you do not fall asleep within 20 minutes, the nap trial will end.
The MWT (Maintenance of wakefulness test) is a test used to measure how alert you are during the day. It will show if you are able to stay awake and remain alert during a period of time during the day of inactivity or quiet times. It is often used to help determine if a patient is too tired to drive or perform their job duties (such as truck drivers or pilots).
In recent years, at-home sleep tests have become more common. It’s important to know: at-home tests are accurate for sleep apnea testing and sleep apnea testing only. These tests are done at home but are ordered by your physician, just as in-laboratory tests are. When your doctor raises the possibility of a study for sleep apnea, you can ask about an at-home option.
What is an at-home sleep study like?
Your doctor will arrange for you to receive the equipment you need for your at-home study. You may receive it through the mail or you may pick it up from your local hospital, doctor’s office, or medical center. You will receive instructions for using the equipment for 1-3 nights of at-home sleep assessment. Afterward, you will return the equipment, and the data will be analyzed at delivered to your doctor, who will follow up with you about treatment plans.
The advantages of at-home sleep studies are pretty clear: comfort and convenience. You get to sleep in your own bed and maintain your natural nighttime routine while your sleep is measured. These tests are less expensive than sleep-laboratory testing. At-home sleep testing isn’t for everyone, so it’s important to follow through with a sleep-lab test if that’s what your doctor recommends.