1st Class Sleep Diagnostics, Inc.

What is a sleep study?

A sleep study contains 16 or more different measurements used for monitoring your sleep patterns. These measurements are primarily EEG (brain wave activity) and respiratory (breathing). The study will record for 6 or more hours while you sleep. Your sleep technician will greet you when you arrive and will explain the procedure as he/she is applying the necessary measurement sensors. The procedure for applying the sensors will usually take between 30 minutes to 50 minutes.

What are the sensors used for the sleep study?

The measurements are:

EEGs - 6 sensors placed in your scalp area held in place with a water soluble paste or adhesive. Your hair is not cut or shaved and the leads are painlessly placed and removed in the morning. These sensors are the main sensors used in determining if you are asleep or awake. If asleep, there are 5 different stages of sleep that are registered and recorded on the computer.
Eye movements - 2 sensors, one near each eye but not touching your eyes in any way. Each sensor is applied with an adhesive. Eye movements are also used in determining the different stages of sleep.
Muscle activity - 2 or 3 sensors applied on your chin or jaw line. These sensors are also applied with an adhesive and are used in determining the different stages of sleep.
ECG - 2 sensors placed near the left and right shoulder/chest area. These sensors are applied with adhesives and measure your heart's activity during the study.
Leg movements - 4 sensors, two sensors each placed on the left and right leg around your calf/shin area applied with adhesives. These sensors measure leg movement activity during your sleep.
Breathing - 2 sensors placed under the nose and above your upper lip used to determine your breathing patterns during the study. One sensor is a soft plastic wire sensor w/ prongs just under each nostril and over your mouth. This sensor acts as a thermometer recording air you breath in (cold air) and air you breath out (warm air) and is recorded as a waveform. The second sensor is also placed in the same site but is a cannula used to record the carbon dioxide you exhale also recorded as a waveform.
Oximeter - a sensor placed on your finger used to record the oxygen level in your blood. This sensor is placed with adhesive and a low illuminating red light is used to read the level of oxygen.
Breathing effort - Two belts placed one around your chest and on around your stomach used to determine your breathing effort by stretching and contracting as you breath in and out during your sleep study.

Will you give me any medication to help me sleep?

No. This might change your sleep patterns and prevent us from identifying the source of your sleep problem. However, you may take whatever medication you usually take before bedtime. Be sure to inform the technician running your sleep study of what medications you are taking.

What happens if I need to go to the bathroom in the middle of the night?

All sensors are attached to a central box which you will be able to carry with you once detached from the main computer cable. This is a very simple process and can be done in a few seconds to allow you mobility to use the restroom whenever needed.

Will anyone else be in the sleep laboratory while I am there?

A technician will greet you once you arrive at the sleep lab and show you to your room. A member of our technical staff will be present and available to you during your entire night at the sleep lab as well as possibly other patients who will also be at the lab for sleep testing purposes.

When can I leave?

Usually the sleep study will end between 05:00 AM and 07:00 AM. Removal of the sensors usually takes just a few minutes and once done, you may leave at any time thereafter. There will also be a short morning questionnaire. If you need to be up earlier, please notify the technician.

What is sleep apnea?

Apnea is the combination of two Greek words, (a and pnea) meaning ("a") without and ("pnea") air. Sleep apnea refers to the loss of air movement during sleep. This results in a depletion of oxygen and a build up of carbon dioxide in the lungs and blood. Snoring is the most obvious event associated with sleep apnea and results from turbulent air flow in a narrow airway. Airway collapse (apnea) is caused by negative air pressure (vacuum). This vacuum develops when air moves through a restricted space at high speed. The more severe the restriction, the louder the snoring becomes and the more likely apnea is to occur. When the throat collapses like a pinched straw on inspiration, carbon dioxide levels rise and oxygen levels decrease, resulting in arousal. The patient will simply lighten their sleep for a few seconds (arousal), open the airway to breathe and return to sleep, only to resume snoring and repeat the apnea cycle about once per minute. Therefore, in more severe cases, it is possible for a person to experience 500 to 600 episodes of sleep apnea each night. The bed partner becomes aware of this problem because of pauses in air flow that are followed by gasping. They may become concerned that their mate is about to die in their sleep from either not breathing or choking.

What are the effects of obstructive sleep apnea?

Sleep apnea is a progressive disease. Mild snoring converts gradually to sleep apnea as more negative pressures are created because of weight gain, aging, etc. Initially this may be only a few apneas per night. As the number of apneic events increases, both physical and mental symptoms develop. These are usually not noted until there are at least 50 or more events per night.

Several symptoms which indicate the possible presence of apnea:

Weight gain
Fitful sleep
Tired appearance
Loud snoring
Mumbling in sleep
Drooling on the pillow
Frequent urination at night

These cognitive (mental) dysfunctions may be present:

Poor concentration
Inappropriate asleep
Poor memory
Increased irritability
Chronic fatigue
Decreased libido
Some depression
Claustrophobia
Rapid sleep onset
Avoidance of social events
Awakening with a headache
Sweating in sleep

Long-term effects of sleep apnea include:

Increased risk of cardiovascular disease, heart attack, stroke, angina pectoris (chest pains) and hypertension
Impaired performance at work and home

Who is at risk for developing obstructive sleep apnea

" Three risk factors are largely determined at birth:

Age: prevalence and severeity of symptoms increase with age.
Gender: Males are about twice as likely to develop OSA until women reach menopause.

Airway size and shape:

craniofacial structure (cleft palate, mandibular retroposition).
micrognathia (small jaw).
macroglossia (large tongue), adenotonsillar enlargement (large tonsils).
small trachea (narrow airway)

Disease risk factors: Impaired control of breathing in association with:

emphysema and asthma.
neuromuscular disease (polio, myasthenia gravis, etc).nasal obstruction.
hypothyroid condition.

Lifestyle Risk:

Smoking
obesity: 30-60% of OSA patients are morbidly obese.
weight loss improves/lessens symptoms.
weight gain increases symptoms.
weight loss is easier in patients who are treated by nasal CPAP.

How do I know if I have obstructive sleep apnea?

The purpose of the initial interview is to explore those signs and symptoms and to arrange testing as appropriate. The only definitive test for obstructive sleep apnea is an overnight polysomnogram which measures breathing effort, airflow, brain waves, eye movements, muscle tone, heart rate, breath sounds and leg movements across a night's sleep. This data is then analyzed to detect sleep disturbance, breathing impairment, oxygen loss and any cardiac irregularities induced by obstruction of your airway during sleep. With this data, we can quantify the severity of the problem and determine if a significant disorder does exist.

If I have obstructive sleep apnea, is there a treatment available?

Treatments can be generally divided into three types:

Prosthetic devices
Surgical intervention
Changes in lifestyle