Eeg Sleep Test

[Denisha Padley]

Polysomnographyknown as a sleep study, is a test used to diagnose sleep disorders. Polysomnography records your brain waves, the oxygen level in your blood, and your heart rate and breathing during sleep. It also measures eye and leg movements.

A sleep study may be done at a sleep disorders unit within a hospital or at a sleep center. The test is usually performed at night. But it may be done during the day for shift workers who usually sleep in the daytime.

If you're doing a sleep study from home, there are different types of devices that may be used. Each device uses a different combination of sensors. Home sleep apnea tests generally record your breathing rate and airflow, as well as oxygen levels and heart rate. One style also includes information on blood vessels.

The typical process of falling asleep begins with a sleep stage called non-rapid eye movement (NREM) sleep. During this stage, brain waves slow down. This is recorded during a sleep study with a test called an electroencephalogram (EEG).

After an hour or two of NREM sleep, brain activity picks up again. This sleep stage is called rapid eye movement (REM) sleep. Your eyes quickly move back and forth during REM sleep. Most dreaming occurs during this stage of sleep.

Don't consume drinks or food containing alcohol or caffeine during the afternoon and evening before a sleep study. Alcohol and caffeine can change your sleep patterns. They may make symptoms of some sleep disorders worse. Also don't nap in the afternoon before a sleep study.

For a home sleep apnea test, the equipment is delivered to you. Or you might pick up the equipment at your provider's office. You'll be given instructions on how to use the equipment. Ask questions if you're unsure about how the test or equipment works.

If you're having a home sleep apnea test, follow your regular bedtime schedule. You'll need to place the sensors on your body and turn on the machine according to the instructions you've been given. Your health care provider may ask you to keep a sleep log.

If you're at a sleep center, the room where polysomnography is done is similar to a hotel room. It's dark and quiet during the test. You won't share the room with anyone else. Each room has its own bathroom.

The sleeping area will typically have a low-light video camera. This allows the polysomnography technologists to see what's happening in the room when the lights are out. It also has an audio system. This allows them to talk to you and hear you from their monitoring area outside the room.

After you get ready for bed, one of the technologists will place the sensors. They're applied to your scalp, temples, chest and legs using a mild adhesive such as glue or tape. The sensors are connected by wires to a computer. The wires are long enough to let you move around in bed. A small clip also is placed on your finger or ear. This monitors the level of oxygen in your blood.

During the study, the technologist may have you try a positive airway pressure (PAP) machine for sleep apnea. This is a device that consists of a tight-sealing nosepiece or face mask through which a gentle stream of air is delivered to help you breathe.

You may have the opportunity to try on a PAP device before the sleep study begins. This makes you familiar with the device if the technologist suggests you try it later in the night. If necessary, oxygen also may be used during the study to bolster your breathing.

Although you probably won't fall asleep as easily or sleep as well at the sleep center as you do at home, this usually doesn't affect the test results. A full night's sleep isn't required to obtain accurate polysomnography results.

After polysomnography in a sleep center, the sensors are removed and you may leave the sleep center. You're given an appointment for a follow-up visit with the heath care provider who recommended the test. You can return to your usual activities after polysomnography.

In the morning following a home sleep apnea test, you can remove the sensors when you wake. You'll return the testing equipment to your provider's office or by mail. Some home sleep apnea tests are now disposable, so they can be discarded when the test is over.

The information gathered during a sleep study is evaluated first by a polysomnography technologist. The technologist uses the data to chart your sleep stages and cycles. Then the information is reviewed by your sleep center provider.

An evaluation often involves overnight monitoring of your breathing and other body functions during sleep testing at a sleep center. Home sleep testing also might be an option. Tests to detect sleep apnea include:

Home sleep tests. Your health care provider might provide you with simplified tests to be used at home to diagnose sleep apnea. These tests usually measure your heart rate, blood oxygen level, airflow and breathing patterns. Your provider is more likely to recommend polysomnography in a sleep testing facility, rather than a home sleep test, if central sleep apnea is suspected.

If the results aren't typical, your provider might be able to prescribe a therapy without further testing. Portable monitoring devices sometimes miss sleep apnea. So your health care provider might still recommend polysomnography even if your first results are within the standard range.

If you have obstructive sleep apnea, your health care provider might refer you to an ear, nose and throat specialist to rule out a blockage in your nose or throat. An evaluation by a heart specialist, known as a cardiologist, or a doctor who specializes in the nervous system, called a neurologist, might be necessary to look for causes of central sleep apnea.

To eliminate snoring and prevent sleep apnea, a health care professional may recommend a device called a continuous positive airway pressure (CPAP) machine. A CPAP machine delivers just enough air pressure to a mask to keep the upper airway passages open, preventing snoring and sleep apnea.

For milder cases of sleep apnea, your health care provider may recommend only lifestyle changes, such as losing weight or quitting smoking. You may need to change the position in which you sleep. If you have nasal allergies, your provider may recommend treatment for your allergies.

Continuous positive airway pressure (CPAP). If you have moderate to severe obstructive sleep apnea, you might benefit from using a machine that delivers air pressure through a mask while you sleep. With CPAP (SEE-pap), the air pressure is somewhat greater than that of the surrounding air and is just enough to keep your upper airway passages open, preventing apnea and snoring.

Although CPAP is the most common and reliable method of treating sleep apnea, some people find it cumbersome or uncomfortable. Some people give up on the CPAP machine. But with practice, most people learn to adjust the tension of the straps on the mask to obtain a comfortable and secure fit.

You might need to try more than one type of mask to find one that's comfortable. Don't stop using the CPAP machine if you have problems. Check with your health care provider to see what changes can be made to increase your comfort.

Oral appliances. Another option is wearing an oral appliance designed to keep your throat open. CPAP is more reliably effective than oral appliances, but oral appliances might be easier to use. Some are designed to open your throat by bringing your jaw forward, which can sometimes relieve snoring and mild obstructive sleep apnea.

Once you find the right fit, you'll need to follow up with your dentist repeatedly during the first year and then regularly after that to ensure that the fit is still good and to reassess your symptoms.

Surgery may be an option for people with OSA, but usually only after other treatments have failed. Generally, at least a three-month trial of other treatment options is suggested before considering surgery. However, for a small number of people with certain jaw structure problems, surgery is a good first option.

Tissue removal. During this procedure (uvulopalatopharyngoplasty), a surgeon removes tissue from the rear of your mouth and top of the throat. Your tonsils and adenoids usually are removed as well.

This type of surgery might be successful in stopping throat structures from vibrating and causing snoring. It's less effective than CPAP and isn't considered a reliable treatment for obstructive sleep apnea.

Creating a new air passageway, known as tracheostomy. You may need this form of surgery if other treatments have failed and you have severe, life-threatening sleep apnea. In this procedure, your surgeon makes an opening in your neck and inserts a metal or plastic tube through which you breathe.

Adaptive servo-ventilation (ASV). This more recently approved airflow device learns your typical breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to regulate your breathing pattern and prevent pauses in your breathing.

ASV may be an option for some people with treatment-emergent central sleep apnea. However, it might not be a good choice for people with predominant central sleep apnea and advanced heart failure. And ASV is not recommended for those with severe heart failure.

Continuous positive airway pressure (CPAP) masks and headgear come in many styles and sizes to comfortably treat your sleep apnea. Everyone has different needs, preferences and face shapes, and sometimes you will need to try different mask styles before you find the one that works the best for you.

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