As a sleep technologist, I get so many people that ask me the same question, “What happens during a sleep study?”
There are more and more people that are being scheduled for a sleep study these days, so I want to help ease your anxiety about the process by sharing some basic information with you. Do note that every lab does not have the same protocol so some of the information may vary.
I took the liberty of making some important words bold throughout this article to help you understand key terms you will hear in the sleep lab or see on your paperwork.
First, I want to encourage you to share any problems you may have sleeping with your doctor. Sleep disorders go undiagnosed and therefore untreated, because the patient is not being transparent about their sleep habits. Although there are plenty of underlying health problems that can be linked to sleep, sleep is not one of the first things your doctor may ask you about, so you should bring it up.
You will need a referral from your doctor to begin the scheduling process with the sleep lab. They want to be able to diagnose or rule out any possibility of a suspected sleep disorder. There are different testing options, so based on the information you give to the doctor, and the information that your doctor gathers from tests run on you, they will be able to select the proper testing.
During the time that your doctor talks to you about the referral, they will tell you what route to take depending on your insurance. Some insurance requires a doctor to request authorization, and you need to know if there is any action that needs to take place on your end as far as billing goes.
Once your referral and insurance is taken care of, you can schedule your appointment with the lab.
The most common study is called a Baseline PSG, a basic overnight study to monitor your sleeping and diagnose sleep disorders like Sleep Apnea. This study can be performed on kids and adults.
Apnea is defined as a complete cessation of airflow for at least ten seconds during sleep. Apneas may be central, obstructive, and mixed.
Based on the findings from your Baseline PSG, you may need a second study and the study could go a couple of different ways. During my time working in the sleep lab, I have noticed that the majority of my patients have no idea why they are coming back for a second time.
#1. If your Baseline PSG report (initial study) shows that the doctor did in fact diagnose you with apnea, you will be fitted for a CPAP mask and the technologist will adjust your CPAP pressure throughout the night to reduce or eliminate your apnea events, which is called a titration study.
During the time the technologist is fitting you for a mask, they will let you get used to your mask by turning on the machine and letting you sit with the mask to your face for several minutes to get used to the air coming through the machine. Many patients are claustrophobic, so getting acclimated to the machine helps you before the actual study.
Patients have asked about the air blowing through the CPAP, but it’s just air. Some patients think we are putting oxygen on them. The CPAP is room temperature air that is adjusted throughout the night. CPAP acts as a splint to hold your upper airway open so that you are able to breathe properly. After the titration study is over, the technologist will tell you how long you will have to wait to get your mask to begin using it at home.
#2. If your baseline PSG indicates that you have a severe number of obstructive apneas, your doctor will order what is called a split night study. A split night study is a blend of both baseline PSG and a titration in one night. This test is ordered if the doctor has seen your apneas are severe in your previous study.
The first couple of hours of the split night study will be the baseline PSG part where the technologist will document and observe the data to determine if you meet requirements in a specific time frame to be titrated the rest of the study.
After the test is reviewed by the doctor, they will provide you with therapy recommendations that will work for you.
Equipment Used During Study
My patients have a lot of questions about the eqipment. They like to pause after I finish hooking them up to take pictures to send to their family. They get a real kick out of everything that has to be put on them. If you look at the picture of the patient I have, I am going to walk you through this process starting at the legs and I’ll work myself up explaining what is going on with all the eqiqment.
It usually takes the technologist a total of 30-40 minutes to do a complete hook up for your sleep study.
You have electrodes that will go on your legs to monitor your leg movements throughout the night. Leg movements are associated with apnea events.
You have respiratory belts on (The white belts you see around the patient in the picture) that show the technologist the effort you are putting in to breathe.
You have EKG leads that will monitor your heart rate throughout the night.
You will have chin electrodes that help the technologist determine what stage of sleep you are in throughout the night.
You have two sensors in your nose( Patient does not have these in the picture probably because he will be wearing a CPAP): one called a “T-flow”, and one called a “P-flow”. The T-flow detects the absence of airflow; the P-flow detects the decrease in airflow.
You will have eye leads that will help the technologist determine if you reach a deep stage of sleep throughout the night.
You will have 7 electrodes placed in your head and 1 electrode behind each ear. You will have a total of 9 electrodes on your head for the technologist to see your brain waves in order to determine what stages of sleep you go into during the night and which ones you don’t, and how long you stay in those stages.
You will have an Oximeter Finger Sensor to detect oxygen levels in your blood.
Some labs use a snore sensor to document snoring throughout the night.This is what is placed on the patient's neck in the picture.
Your sleep study will usually take 6 hours and 30 minutes from the time the technologist tells you the study has started.
After your study ends, the technologist will come in and unhook you, have you fill out a few papers and you will be ready for discharge.
Your technologist is not a doctor, and can not diagnose you. You will have to wait for the study to be interpreted by a doctor. The doctor will contact you and go over your results from the study. From there they will make therapy recommendations. That’s it.
Tech Recommendations
When you are scheduled for a sleep study, you want to make sure to fill out all paperwork the lab sends you or gives to you personally. The paperwork is needed to start the study, so even though there are a lot of papers, just make time to fill them out before you get to the lab. They are just going to hand you the packet and have you fill it out before the technologist begins.
Make sure to bring your insurance and identification with you.
Bring any medications that you usually take at home.
Bring sleepware. You are on camera all night, and there is no sleeping naked in the sleep lab.
Bring snacks, water, anything you will need. Some labs provide snacks, some don’t.
I know it’s a new environment, but you have to remember that you are there for a study, and you want the technologist to get the best sleep study possible for the night.
Try not to nap during the day so that you will come to the lab sleepy the night of your study.
The technologist will not leave a TV on to put you to sleep during the study, and your phone must be turned off. Light signals the brain that it’s time to wake up.
Last but not least, if you are prescribed one, use your CPAP machine. Remember it will take some time to adjust, but it will help you breathe better and you will feel a significant difference during your days. The patients that I know with CPAP all say they love their machine, and they sleep 100% better!
If you are diagnosed with Sleep Apnea or suspect you may have it, please look into getting an appointment at a sleep lab. Sleep Apnea can cause so many health problems or just make the ones that you have worse.
Some problems you can experience due to having Sleep Apnea are:
Stroke
Headaches
Daytime Sleepiness
High Blood Pressure
Insomnia
Obesity
Cardiac Arrhythmias
Sudden Death
I hope this article helps you. If you know someone that is preparing for a sleep study and doesn’t know what to expect, please share this article with them. And if you’re reading this and you have had a sleep study, please comment and let others know about your sleep lab experience!
If I did not cover a question that you may have about what you can expect in the sleep lab, please do not hesitate to reach out to me: erica@thrivingleaf.org
I pray that your experience in the sleep lab goes well!
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