20.01.2014
A polysomnogram is a painless test that records your brain waves, heart beat, and breathing as you sleep. The breathing monitors detect reduction or complete cessation of air flow and changes in oxygen levels so that the diagnosis and the severity of sleep apnea can be established.
To establish the diagnosis of obstructive sleep apnea or other forms of sleep breathing disorders such as central sleep apnea or sleep hypoventilation. To set the correct levels of positive airway pressure therapy to correct the abnormal breathing during sleep. To look for behaviors during sleep that can be violent or could be harmful to the patient or others. Your physician may order a sleep study or polysomnogram to rule out or treat sleep apnea or to assess why you may not be getting better after treatment for your sleep disorder.
The staff at the sleep disorders center and sleep laboratory will go out of their way to make you feel relaxed. In the morning the sleep technologists will test the sensors again, and then they will be removed.
It usually takes about 3-4 days for the sleep center staff to get the results of a sleep study sent to your physician.
To establish the diagnosis of obstructive sleep apnea or other forms of sleep breathing disorders such as central sleep apnea or sleep hypoventilation and if significant sleep apnea is detected to set the correct levels of positive airway pressure therapy to correct the abnormal breathing during sleep. In the morning the sleep technologist will test the sensors again, and then they will be removed. If a split night sleep study was ordered but it could not be performed and the sleep doctors think you need to return for a second study (also called a CPAP or positive airway pressure titration study) then the sleep center staff can schedule you for the second night in the laboratory.
Expedited CPAP Care Program: If you are diagnosed with sleep apnea and it was successfully treated with CPAP during the split night sleep study, you may be eligible for Expedited CPAP Care Program. If ordered by your physician, Expedited CPAP Care can save you time while optimizing your care with CPAP therapy. A CPAP or positive airway pressure titration study is performed on someone who has already been diagnosed with sleep apnea or a sleep related breathing disorder by an overnight sleep study or polysomnogram.
At the beginning of the night the sleep technologists will show you a variety of masks so that you can choose the most comfortable one with the best fit.
Similar to an overnight sleep study or polysomnogram, sensors are placed on your head, face, chest and legs. To adequately treat sleep apnea or sleep related breathing disorder in a patient with a established diagnosis of obstructive sleep apnea or other forms of sleep breathing disorders such as central sleep apnea or sleep hypoventilation. Expedited CPAP Care Program: If you are successfully treated with CPAP during the split night sleep study, you may be eligible for Expedited CPAP Care Program.
There are two types of nap studies: Multiple Sleep Latency Test (MSLT) and Maintenance of Wakefulness Test (MWT).
The MSLT reveals a broad range of time in which it takes normal sleepers to fall asleep during the study.
Sleep Review's webinar "Insourcing Versus Outsourcing Home Sleep Testing" is now available for on-demand viewing.
It is well known that adults with obstructive sleep apnea (OSA) can suffer from neurocognitive dysfunction including excessive daytime sleepiness, impaired vigilance, problems with memory and decision making, and mood changes.1 Over the last three decades, there has been increasing attention on how neurocognitive deficits manifest in pediatric patients with obstructive sleep apnea and milder forms of sleep-disordered breathing (SDB) such as snoring. A 5-year, 10-month-old boy with a history of eczema and allergic rhinitis presented to our Pediatric Sleep Clinic for snoring despite adenotonsillectomy.
A week after starting CPAP therapy, his family reported that he was no longer sleeping during the day. Obstructive sleep apnea is characterized by intermittent partial to full upper airway obstruction, resulting in episodic hypoxemia, hypoventilation, and sleep fragmentation.


Although more severe OSA has been associated with worse memory and learning measurements,3 the adverse neurocognitive consequences of obstructive sleep apnea are not limited to those with severe OSA. Although the patient highlighted in the case above did not have formal neurocognitive testing, he exhibited obvious signs of neurocognitive dysfunction including excessive daytime sleepiness, inattention, hyperactivity, restlessness, impulsiveness, grouchiness and poor academic performance.
Sleep studies are also performed to evaluate unusual sleep movements or behaviors, narcolepsy or excessive daytime sleepiness. The sleep technologist gently applies the sensors on your skin and connects them to a computer. At some point during the night you will be informed by the sleep technologist that the lights and TV will be turned out and it is time for you to try to fall asleep.
Alternatively, the original referring physician who ordered the split night sleep study can order a CPAP or positive airway pressure titration study after reviewing the results of the initial overnight sleep study. However, Expedited CPAP Care Program needs to be ordered by your physician when the sleep study is scheduled.
In line with our mission to deliver the best service, should you be diagnosed with sleep apnea, we will help set up the CPAP therapy before you leave the sleep center. Therefore, a prior overnight sleep study or polysomnogram is necessary for the sleep center to perform a CPAP titration study. However, Expedited CPAP Care Program needs to be ordered by your physician when the CPAP titration study is scheduled.
Patients are asked to report to the sleep disorders center within one to one and a half hour after their usual wake time. Normal sleepers tend to fall asleep in an average of about ten minutes or more during the five naps of the MSLT. For the MSLT to be accurate, you should have had a total sleep time of at least six hours during the overnight sleep study. The case of a young boy who presented with snoring despite adenotonsillectomy highlights some of the behavior and learning challenges seen in children with obstructive sleep apnea and the improvements that can be seen with treatment.
Although definitions of OSA by PSG testing differed in studies of children ranging in age from 2 to 18 years, most prevalence reports range from 1% to 4%.2 Obstructive sleep apnea has a bimodal peak. The association between sleep disordered breathing, academic grades, and cognitive and behavioral functioning among overweight subjects during middle to late childhood. Cognitive and academic functions are impaired in children with all severities of sleep-disordered breathing. Impaired behavioral and neurocognitive function in preschool children with obstructive sleep apnea. Effect of adenotonsillectomy on nocturnal hypoxaemia, sleep disturbance, and symptoms in snoring children. Sleep disordered breathing: effects of adenotonsillectomy on behaviour and psychological functioning. Neurobehavioral function is impaired in children with all severities of sleep disordered breathing. C-reactive protein, obstructive sleep apnea, and cognitive dysfunction in school-aged children. Pediatric obstructive sleep apnea in obese and normal-weight children: impact of adenotonsillectomy on quality-of-life and behavior. Behavioral changes in children with mild sleep-disordered breathing or obstructive sleep apnea after adenotonsillectomy. CPAP and bi-level PAP are devices that generate flow and the pressure generated maintains upper airway patency to relieve apneas, shallow breathing, and snoring. The results will be given to a board-certified sleep specialist who will review the study to find out what kind of sleep problem you may have.


If you were seen by a sleep specialist at our sleep center and the sleep specialist ordered the sleep study, then he or she will tell you the results. With Expedited CPAP Care, you will be seen by a sleep specialist approximately 31– 45 days after being treated with CPAP to address any problems you may have with the device. The recording of brain waves and eye movements allow the sleep technologists and sleep physicians to stage the depth of your sleep and detect REM (rapid eye movement) sleep.
The first MWT sleep trial is performed between 1.5 and three hours after your normal wake-up time.
Due to the wide range of normal times, the results from these nap trials alone are not enough to diagnose a sleep disorder. For purposes of calibration at the beginning of the study you will be asked to move your eyes, clench your teeth and move your legs.
His mother would prop him up on two pillows to sleep at night, hoping to decrease episodes of witnessed apneas and gasping for air. CPAP at 7 cm of H2O pressure eliminated snoring, hypopneas, and maintained SpO2 values in the mid-90s and above. These neurocognitive improvements after treatment of his OSA demonstrate for us the important impact that managing a child’s obstructive sleep apnea can have on day-to-day family and school function. In most cases, you do not need to sleep for a full eight hours to find the source of your problem.
The results will be given to a board-certified sleep specialist who will review the study to determine the appropriate pressure levels required to treat your sleep apnea.
A shorter four-nap study may also be used but the five-nap version is more reliable at detecting narcolepsy. She noted that after apneic events, he would briefly awaken, look around, reposition himself, and fall back to sleep. In this sleep lab, ETco2 values on the majority of patients (both with and without sleep-disordered breathing) run high despite appropriate methods of trouble-shooting.
All the wires are connected to one main cable so that if you need to use the washroom, the sleep technologist can simply disconnect the main cable and allow you to use the washroom.
If the sleep study shows that the sleep apnea is fairly mild or if there is not enough time to start treatment, then the CPAP treatment may not be performed on the same night. During the study CPAP (or other forms of positive airway pressure therapy) is titrated so that your breathing and oxygen levels become normal. Even so, the ETco2 values on the CPAP titration showed improvement compared to the PSG study (ETco2 values measured >50 mm Hg for 10% of the study time).
Upon arrival to the sleep disorders center the sleep technologist will apply the sensors on your head and face. These sensors send tiny electrical signals to a computer in order to record brain waves and eye movements to allow us to stage the depth of your sleep and detect REM (rapid eye movement) sleep.
After the last MSLT nap trial, the sleep technologist will test the sensors again, and then they will be removed.
Your sleep specialist should help you properly schedule the use of any other medications and make the final decision as to which medications can be continued.



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