11.02.2015
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.
The mask that is placed on your nose (or nose and mouth) can detect air flow and whether there is any evidence of upper airway narrowing and collapse. 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.
Norbert von der Groeben Robert Upchurch, an aircraft-mechanic trainer who suffers from obstructive sleep apnea, was having trouble adjusting to his continuous positive airway pressure machine until he attended a new class at the Stanford Sleep Medicine Center. For some people suffering from obstructive sleep apnea, the remedy feels every bit as troublesome as the disorder.
Upchurch, 48, who trains aircraft mechanics for United Airlines, was diagnosed with obstructive sleep apnea last August after an overnight evaluation at the sleep medicine center. More than 12 million Americans suffer from this potentially fatal condition, which occurs when the muscles in the back of the throat relax during sleep, narrowing or completely collapsing the airway. Upchurch was set up with a continuous positive airway pressure, or CPAP, machine, which blows air into the upper respiratory tract through the nose to keep the airway open. Several months later, he received a notice in the mail about a new, monthly CPAP class to help sleep medicine center patients adjust to their machines. Norbert von der Groeben Sleep medicine center employee Jennifer Harpe models a portable sleep study device.
Upchurch said he also has benefitted from the guidance he received at the center on adjusting his diet and his sleep schedule to help ensure better rest.


Established in 1972, the center, widely recognized as the birthplace of sleep medicine, treats both adults and children. When Upchurch went for his sleep study, he spent the night in one of the center’s 18 beds, each of which is in a private room with state-of-the-art monitoring equipment and sound-proofing. Now, the center is increasing the number of portable, or ambulatory, monitoring devices it makes available to patients, allowing sleep studies to be conducted at home. But studies have shown that cognitive behavioral therapy is as effective as sleep medication in the short run and much more effective in the long run. The therapy helps patients establish their bed as a cue for sleep and weaken it as a cue for wakefulness. A sleep study is the best way to test for certain sleep disorders like sleep apnea or narcolepsy.
For your sleep study, you will stay overnight at our state-of-the-art Sleep Center located in West Knoxville (map).
Your in-lab sleep study provides your doctor with the most complete evaluation of your sleep. Cameras in your room allow the technologist to monitor you while you sleep in case any help is needed. It might seem like it would be hard to sleep while connected to sensors, but most people sleep enough to allow for a diagnosis. If you show signs of having moderate to severe OSA, then your sleep technologist may start a CPAP titration study during the night. If you need CPAP during the night, the technologist will enter your room and put a CPAP mask on you.
Even if the technologist does not use a CPAP on the night of the study, you may still have OSA. The information gathered during the sleep study will be reviewed and evaluated by a sleep specialist. 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.
She lowered the airflow pressure on his machine a few notches and also refitted his face mask, which looks a little like the oxygen mask a professional football player uses on the sidelines. The center is increasing the number of such devices it makes available to patients, allowing sleep studies to be conducted at home. Its faculty comprises some of the foremost medical experts on obstructive sleep apnea — a term coined by the center’s Christian Guilleminault, MD — as well as other sleep apneas, insomnia, restless legs syndrome, narcolepsy, idiopathic hypersomnia (disabling daytime sleepiness) and parasomnias, such as teeth-grinding and sleepwalking.
The technology in these devices has improved tremendously over the past several years, Kushida said, making them almost as accurate as the larger versions at the sleep medicine center. The Stanford Sleep Medicine Center has been at the forefront of the nonpharmacological treatment of insomnia, and it has the only Bay Area program — and one of the few such programs nationwide — devoted to cognitive behavioral therapy for sleeplessness.


It also teaches them strategies for reducing thoughts and worries that interfere with sleep. For many children, that rumbling is a sign of obstructive sleep apnea, which occurs when extra tissue in the nose or throat blocks breathing and interrupts sleep. Our office staff will obtain pre-certification for the sleep study should insurance require one. 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.
Both are common symptoms of obstructive sleep apnea, which stresses the heart and can slow down the body’s metabolism, leading to weight gain. This pattern, which may repeat hundreds of times each night, leads to shallow sleep, daytime sleepiness or fatigue, and cognitive dysfunction. They are best-suited for patients thought to have a high probability of having obstructive sleep apnea, as well as for patients who need to spend the night in their own beds for reasons of comfort or health.
However, we advise all of our patients to contact their specific provider before arriving for a sleep study to check benefit coverage.
When you fall asleep, the technologist will monitor and document your response to the CPAP pressures.
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.
The mask allows the air to gently blow into the back of your throat to maintain you upper airway open so that you can breathe normally.
Many people turn to prescription sleep medication, which often helps but also can lead to drug dependence or tolerance. 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. 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. 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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