The Sleep Evaluation
An evaluation will include a review of your history by a sleep physician or provider (nurse practitioner or physician’s assistant). The appointment for review of your sleep problem will typically be scheduled during the day. You should allow adequate time for this appointment and the facility should give you an estimate of how long it will take. Be prepared to fill out questionnaires regarding personal, financial, medications, past medical history and details of the sleep problem. When you sleep, how long you sleep, awakenings are among the questions that will be asked. During this visit often you will watch a video describing the sleep study process. You should take this opportunity to discuss your sleep problem with the physician and learn what to expect regarding testing, results review and possible treatments.
Once this review is completed, the appropriate sleep testing will be scheduled if needed.
What to expect when scheduled for a Home Sleep Apnea Study
Home sleep apnea studies are performed by the individual in their home and not in the sleep center. At the time of your daytime appointment, you will meet a sleep technologist who will describe the process to you. You will be instructed in how to put on the testing equipment at bedtime, how to turn it on, what to do when you awake during the night, how to turn it off and when to return the unit.
What to expect the night of the sleep study (Polysomnogram)
Arriving at The Sleep Center
You will be asked to arrive at the sleep center at an appointed time the night of your scheduled sleep study. Usually there will be several individuals undergoing testing on the same night. The appointment times are designed to have all the persons being tested ready to start the testing at bedtime. When you arrive at night, each facility will have procedures to follow at the front door for entry. Accredited testing facilities are usually secure and safe.
The facility may be difficult to find in the dark. It is best to locate it during daylight so that it will be easier to find on your night of study.
What to Bring
Be prepared for the sleep technologist to ask for a list of the medications you took that day. Bring your usual bedtime medications, unless a physician has told you not to take them for the sleep study. If you are not sure if you should take your usual medications, contact your physician or the facility. Bring all toiletries you may need the night of the sleep study and the next morning. If you would like to bring a snack, ask your facility. They might have a refrigerator where the sleep technician can store your food. If you were given paperwork to fill out before your sleep study, bring it with you.
Your Sleeping Room
Sleep technologists will greet you and show you to your bedroom. They will explain the steps you will be going through during the night and allow you to get settled. Each sleep technologist is responsible for two patients each night. While there are multiple patient rooms, it is unlikely you will see or be seen by any other patients outside of the lobby area. Each testing room will have similar beds, furnishings and decor.
The sleep technologist will monitor your test from the control room and will only enter your bedroom when it is necessary. The staff will view your test measurements on computer monitors, your activities with an infrared camera system, and your snoring and spoken words with a voice monitor.
Clothing for Sleep
For your sleep study, you should wear comfortable sleep clothing. Fabrics that are slick, such as satin or silk should not be worn because they will make it difficult for the belts to remain on your chest and abdomen. Temperatures at sleep centers are usually cool. Cotton shirt, pants, shorts, etc. are all appropriate.
Testing Your Sleep
The sleep test is designed to measure sleep stages, breathing, body movements, heart function and oxygen levels. Measuring all of these functions is done with sensors that are placed on you. You may be the first patient to be hooked up to the equipment or follow someone else. This order is usually based on the time you normally go to sleep. You can expect the sleep technologist to spend between 30 and 45 minutes placing the sensors. Once you are connected to the monitors, you can go to sleep or read, watch TV, etc. until the test begins. The test will begin as close to your normal sleeping time as possible, but the center need to consider the time needed to complete the test. A minimum of six (6) hours of recording time is required.
The sleep technologist will explain the procedure of connecting you to the recording equipment. There will be wires pasted on your head, chin and legs. A small sensor will be placed under your nose and heart monitoring leads on your chest. You will be wearing belts on your chest and abdomen. You will have a conducting paste in your hair and on your face. This paste conducts signals from your body to the monitors and gives us the information to make the needed measurements.
Will you sleep?
Most people worry that they will not be able to sleep during the test. Will I sleep long enough? Will it be good enough sleep to get results? These worries are usually unnecessary. The vast majority of patients sleep long enough and well enough for the equipment to get adequate information about their sleep.
If you are concerned and have trouble going to sleep, before the day of the test speak with your physician or the facility’s staff. It may be possible to be prescribed a mild sleeping aid (pill) for you on the night of your test.
Problems During the night
If you have problems with the sensors, the temperature of the bedroom, or if you just want to ask the sleep technologist a question during the night, it is easy to notify the technologist. You simply speak aloud and ask your questions. The technicians will hear your request(s) and respond appropriately and in a timely manner.
Getting to the bathroom
If you need to use the restroom during the night of your sleep study, it is not a problem. Upon waking up and realizing that you must use the restroom, you simply need to speak aloud and say, “I need to use the restroom.” The sleep technologist can hear you and will come into the room. All the wires that will be attached to you plug into one small box that the technologist will unplug for you. You are then free to use the restroom alone. When you are finished, the sleep technologist will plug the box back in and you can return to sleep.
The sleep technologist will wake you and end the test the next morning. It takes approximately 10 minutes for the technologist to remove the electrodes. After this is complete, you will be asked to answer some questions about your night’s sleep. Then you are free to go. You will have paste from monitors in your hair that will come out with warm water and shampoo. Most facilities have a shower available for you to use if you must get ready for work at the facility. You should bring your own shampoo and conditioner if you wish to shower there.
Problems with confusion, incontinence, and arthritis or other disabilities can usually be accommodated. It is very important to discuss these issues with the facility before the day of the test so that arrangements can be made for any change in staff or testing required.
A tremendous amount of information is gathered during a polysomnogram. It is a significant task to review the measurements and calculate the results. The data from the test is usually ready for the sleep physician’s review one or two business days following the test. The physician who reviews the test will dictate a report of their interpretation of your results. This dictation will be typed for the sleep physician and the referring physician(s). This process takes one to three days for most physicians to complete. However, it is dependent upon the physician’s time and availability.
It is best to not expect completed results from your physician for at least five working days after your test. Your facility will be able to give you an estimate of when the results will be available and who will review the results with you.