You’ve got your overnight bag packed, and check-in is at 7 pm. No, this isn’t a vacation – it’s a sleep study and the only similarity between the two is you’ll be sleeping in a strange bed for the night.
If you’re a regular reader of our blog, you know how complex sleep is. Each time you close your eyes on your buckwheat pillow and drift off to sleep, a force of biological processes is just ramping up. Despite its importance, sometimes sleep doesn’t come as easy or isn’t so flawless. For example, disorders like sleep apnea, restless leg syndrome, chronic insomnia, narcolepsy, periodic limb movement disorder, and REM sleep behavior disorder can cause various health issues and leave you feeling exhausted the next day.
If you have gone to your doctor complaining of morning migraines or lingering fatigue, they may recommend you visit a sleep lab. Sleep studies often use a polysomnogram which measures your brain activity, movements, breathing, heart rate, and blood oxygen to tell you more about your sleep.
These studies are typically carried out in special labs or occasionally within a hospital. However, in some cases, you may be set up to complete the test at home. Regardless of where it is completed, polysomnography, also known as a sleep study, is painless and non-invasive.
You will have to do little to prepare for the study, but generally, doctors or specialists will provide you with some guidelines to follow. For example, the technician or your doctor may advise you to avoid caffeine or alcohol during the afternoon or evening as it could disrupt your sleep. Further, you may be advised to avoid napping the day before and come with clean skin as lotions and makeup could interfere with the electrodes.
If you are completing an at-home sleep apnea test, you will receive all the equipment you need and instructions on how to use it. However, if you go to a sleep lab, you will likely visit the center in the evening and spend the night in a lab room.
Although the environment is foreign, and you likely don’t sleep with electrodes stuck to you at home, the goal is to replicate your sleep routine. Therefore, you will bring your own nightclothes and anything you usually use for your bedtime routine. In some cases, you may even be able to bring your own buckwheat pillow, a favorite blanket, or even a hot water bottle if that’s what you are used to.
The sleep study rooms are designed to look more like a hotel room than a medical lab. You’ll be able to adjust the light, and it will have a connecting bathroom for you to use whenever you wish. According to Dr. Neil Kline, D.O., internist and sleep physician and representative of the American Sleep Association, sleeping at a sleep center is like sleeping at a hotel but without the added luxuries of turn down or room service.
Although it isn’t exactly private per se, you won’t be sharing the room with anyone else. There is, however, a low-light video camera where the technician will monitor you. The room is also equipped with an audio system, so any sounds are recorded, and they can communicate with you if needed.
On the day of your sleep study you will be scheduled to arrive sometime after dinner in the early evening. After you arrive, you will complete some brief administration tasks and then get ready for bed. Once ready for bed, a sleep lab technician will place sensors on your scalp, temples, legs, and chest with a mild adhesive. These sensors are connected to wires and a computer. In total, there are about 20 wires attached. Although the wires are long enough for you to move, they aren’t the most comfortable and take some getting used to.
If you are wondering how you go to the bathroom with all those wires, you aren’t alone. This is the most common question regarding sleep studies. You can get up whenever you want, you just speak to the technician through the audio equipment, and they will come in and free you from the wires so you can use the restroom. Again, not ideal, but it’s just one night (hopefully).
The second most common question is if you can watch tv before bed at a sleep lab. Many of us have different bedtime routines that help us wind down after a busy day. TV watching, meditation, or drinking a cup of chamomile tea could help you relax and in many clinics, you can still enjoy these activities.
In addition to the sensors, your blood oxygen levels will be measured with a small clip that is placed on either your ear or finger. The technician will also monitor snoring or any sounds you make (e.g., sleep talking), brain waves, breathing patterns, body position, eye movements, and chest movements.
After monitoring you for some time, the technician may suggest trying a positive airway pressure (PAP) machine. This is a device that provides a gentle stream of air to enhance your breathing. Continuous positive airway pressure (CPAP) is one of the most common types, often prescribed to sleep apnea patients. This type of sleep study is called CPAP Titration. This is when a technician determines the amount of air pressure you need from a CPAP so your device can be programmed accordingly. If you are suspected of having sleep apnea, a split-night sleep study may be done. The first half of the night is used to diagnose sleep apnea (with polysomnography), and the second half of the night CPAP Titration is completed.
During your sleep study don’t worry about not sleeping well. This is to be expected and usually doesn’t impact the results. However, worrying about your sleep quality can just make it that much more challenging to fall asleep. So do your best, and try not to overthink it.
The following day, you will have the sensors removed and then head home. Results aren’t provided right away – instead, you will be scheduled for a follow-up visit with your doctor, who will review the results of your polysomnogram. It takes a significant amount of time to analyze the results, so don’t expect to hear back right away. One night in a sleep lab will produce about 1000 pages of data which, as you can imagine, takes a while to go through! The technicians will go through the data and then provide a condensed report to your doctor, who will review the results with you.
The data will reveal different things. For example, if you were observed making frequent leg movements that disrupted your sleep, it could indicate that you have periodic limb movement disorder. Or, if your heart and breathing rate changed through the night, it could show that you have sleep apnea. There is no pass or fail grade. The study will give your doctor the necessary information to prescribe intervention or tools to help improve your sleep and health.
In most cases, you will only need to spend one night in the sleep lab, but if they acquired insufficient data you may be advised to complete a repeat study.
Although polysomnography is the most common type of sleep study, there is also the multiple sleep latency test, also called a “nap study.” This measures how quickly you fall asleep and enter REM sleep during a mid-day nap. This is often used to diagnose narcolepsy or idiopathetic hypersomnia. This study is often paired with overnight polysomnography, beginning
about three hours after you wake up with five nap opportunities. The sleep cycles you go through during this study will tell the technician why you may feel tired during the day.
Your health care insurance may cover a sleep study, but each case is different. That said, if you were to pay for a sleep study at a sleep lab, it would cost between $500 to $3000, where at-home tests cost between $300 and $600. If you are simply curious about your sleep and are not being referred by your doctor, you can look for a private facility that offers the service. Alternatively, you could join a sleep study facilitated by researchers at a local University. Sleep research is a fascinating area, and you could help further this research while simultaneously learning more about your own sleep patterns.
Knowing what to expect can reduce any anxiety associated with an upcoming sleep study. The process is easy and can be quite an exciting experience. Just remember, if you are worried about not being able to sleep, bring items from home that are integral parts of your bedtime routine, like a buckwheat pillow, hot water bottle, or a travel mug of your favorite tea. You don’t need to sleep soundly for 8 hours to get the necessary data – if you did, sleep studies wouldn’t be of much use! So rest easy; you are taking the next step in improving your sleep quality and overall health!