What happens during a sleep study?
A sleep study or Polysomnogram (PSG) is an overnight study, during which we monitor your breathing, heart rate (EKG), oxygen, movements, and brain waves (EEG). Typically you arrive at our sleep lab about 7:30 p.m. (child) or 8 p.m. (adult) and check in with the sleep technician. Sensors are placed on your head, face, chest, abdomen, one finger and legs. You can then read or watch TV/DVD's in your private room with private bathroom. When you are ready to go to sleep, preferably very close to your usual bedtime, the technician will start monitoring all of your sensors from a room just down the hall. If any sensors come loose in the night, the technician will come in quietly to reattach them, hopefully without waking you. If you need to go to the bathroom, just say so and the technician will hear you on the microphone and come in to unhook you, then hook the equipment up again when you return. In the morning, the technician will remove the sensors and you will be ready to go home. You will meet again soon with your provider to go over the results of your PSG. Once in awhile, we ask a patient to stay in the sleep center for a Multiple Sleep Latency Test (MSLT) the next day, usually if the person has excessive sleepiness without explanation and your provider thinks the person might have narcolepsy. This test is similar to a PSG but consists of several 20 minute naps provided every two hours during the day.
What problems can sleep disorders cause?
Since we now know that sleep is not just a passive resting state but rather a crucial process of recharging all your bodily systems, it makes sense that any sleep disorder that leads to sleep disruption will have wide-ranging health consequences. In fact sleep disorders have been shown to be associated with higher rates of obesity, hypertension, high cholesterol, type 2 diabetes, heart disease and harder control of your asthma or other medical conditions. Conversely, treatment of your sleep disorder can improve all of these health problems and lower your health risks. In fact many people note that after treatment is started, they find it easier to lose weight, they have more energy to exercise, and they feel more upbeat, agreeable and hopeful.
What is sleep apnea and how is it treated?
Sleep apnea is a sleep disorder in which a person's airway tissues relax so much during sleep that they flop together and block airflow. This is more common among men than women and kids (4% versus 2%) and it causes repeated brief awakenings all night long, robbing the person of good deep sleep. Adults with sleep apnea are usually treated with CPAP (continuous positive airway pressure) or if the sleep apnea is mild, an oral positioning appliance similar to a bite-guard. CPAP consists of wearing a soft facial mask that delivers humidified pressurized air to literally prop open those floppy airway tissues to keep air flowing. Some children with sleep apnea also need CPAP but more commonly, they need tonsillectomy, adenoidectomy or nasal surgery. Using an air purifier in the bedroom, using saline or steroid spray at bedtime and regularly changing the air filters in the house can also be helpful.
What is Sleep-Disordered Breathing?
Sleep-Disordered Breathing (SDB) refers to any breathing problem that occurs during sleep, ranging from severe sleep apnea to mild upper airway resistance and snoring. Hypopneas and RERA's are milder airway blockages than apneas but can also cause repeated arousal and sleep disruption. SDB affects 24% of men, 9% of women and 5-10% of children/teens. Treatment is similar to that for sleep apnea described above but an oral appliance, nasal sprays, allergy treatment or lower CPAP pressure settings may be sufficient.
What is Restless Legs Syndrome and how is it treated?
Restless Legs Syndrome (RLS) is a very common Sleep Disorder, affecting about 10% of the adult population, especially women and often dating back to childhood or teen years. It consists of a restless uncomfortable sensation in the legs, most prominently in evening or at rest and relieved by movement. This delays sleep onset at bedtime and is often accompanied by excessive movements during sleep called Periodic Limb Movement Disorder (PLMD). RLS can be diagnosed by history but PLMD diagnosis usually requires a sleep study. Both are treated with medicines that increase dopamine in the brain and sometimes with iron supplementation. Exercise in the evening, followed by a hot bath or shower can also be helpful.
What is insomnia and how is it treated?
Insomnia is a persisting difficulty with falling asleep, staying asleep or both. This is very common, affecting about a third of the population, especially women and people with anxiety, depression, stress and sensitive temperaments. It seems that the brain develops a physiologic habit of remaining partially aroused or "hyper-vigilant". Because of this, insomnia is best treated with psychological techniques such as cognitive behavioral training to "re-train" the brain to let go and sleep. Medications can be helpful too but should not be the only treatment.
What could cause excessive sleepiness during the day?
Excessive sleepiness or hyper-somnolence is most commonly due to not getting enough sleep or not getting good quality sleep. Most Americans (of all ages) do not really get enough sleep, probably due to overly busy schedules, early school start times, and our 24/7 culture of connectivity. Excessive sleepiness can also stem from a sleep disorder such as sleep apnea or Periodic Limb Movement Disorder that repeatedly rouses a person from deep sleep into lighter sleep or even awakens them. Such poor quality sleep will leave the person feeling tired in the morning and unrestored to face the day. Infrequently, excessive sleepiness is a sign of narcolepsy, a condition in which sleep and awake states are not as distinct as they should be. Some people with narcolepsy also have cataplexy (loss of muscle control briefly while awake), sleep paralysis or dream-like hallucinations upon waking or when falling asleep. Sometimes excessive sleepiness can also be due to medication or other medical conditions.
Will my insurance cover sleep evaluation and treatment?
Every insurance is different. When a sleep study is ordered, we will contact your insurance company to obtain a prior authorization, but we ask that you also check with your insurance company to be sure that you can manage any deductible or copay amount required by your insurance policy.
Where could I learn more about sleep disorders?
Please refer to the Resource Links section in the Patient Tools tab for more information and resources to help you understand sleep disorders. These links provide information that will help you keep up with the latest research to help you sleep well to be well.