Basic Facts:

  • The American Heart Association in a 2011 study linked poor sleep quality with an increased risk of high blood pressure.
  • Approximately 42 Million American adults have some type of Sleep Apnea,
  • Approximately 76% of congestive heart failure patients have some type of sleep apnea. 
  • Obstructive Sleep Apnea noted in 49% of atrial fibrillation patients and 30% of cardiovascular patients.

Polysomnogram  (PSG): PSG is a diagnostic study where numerous aspects of sleep are monitored. The study will evaluate sleep stages, leg movements, and a comprehensive evaluation of apnea.  It will also assist in the diagnosis of other disorders, which may present with excessive sleepiness, such as narcolepsy, or periodic leg movement disorder.  The patient will be prepped by a Registered Technologist for the study by gently placing electrodes and sensors in specific areas needed to gather certain information.  The patient will be asked to sleep as much as possible in order for us to gather enough information to diagnose the patient. 

Split Night Study:  This study follows a similar protocol as the PSG study for the first two hours. If in those two hours one meets the criteria for sleep apnea treatment, then a PAP device is applied and worn through the remainder of the night in order to find a therapeutic setting.

 

Continuous Positive Air way Pressure (CPAP) Titration:  CPAP Titration is a nighttime study using a PAP device.  The PAP device blows pressurized air through a mask and prevents the upper airway from closing while you sleep.  The diagnostic equipment used in this study is the same as the PSG with the addition of a PAP mask. This test determines the correct pressure measurements to effectively maintain an open airway. There are different types of PAP therapy devices such as Bi-Level PAP (BIPAP) or Adaptive Servo-Ventilation (ASV).  These types of therapies use an advanced algorithm to treat more complex breathing disorders.

 

Multiple Sleep Latency Test (MSLT): MSLT is a daytime study that assesses daytime sleepiness.  An MSLT study is used to diagnose neurological disorders such as Narcolepsy with or without cataplexy and idiopathic hypersomnia.  This test involves a series of naps set at specific times that will run most of the day.  Each nap is separated by a two-hour break in which you will be required to stay awake.  During these naps we will monitor the patient’s ability to fall asleep and enter the deepest stage of sleep also known as Rapid Eye Movement (REM).  Having an abnormal amount of REM sleep has been associated with Narcolepsy.

 

Maintenance of Wakefulness Test (MWT): Opposite to an MSLT, during an MWT study the patient will be asked to remain awake during allowed quiet times of inactivity.  These scheduled sessions will be similar to an MSLT as they will last most of the day.

 

Inspire Titration Study: Inspire ® is an FDA approved implanted device for the treatment of obstructive sleep apnea.  It consists of a neurostimulator and two sensors that work with the body’s natural breathing cycle.  The unit can be turned on and off by the patient as needed.  As the unit is turned on, it will deliver a mild signal to the hypoglossal nerve to help keep the structure of the airway open, thus treating the sleep apnea.  During an Inspire titration study, similar to a PSG, the patient will be asked to sleep while the technologists adjusts the unit to find a therapeutic setting.

 

1. How does my sleep impact my cardiovascular health?

Getting the proper amount of sleep decreases the amount of work that your heart has to do while you sleep.  People that get less than 6 hours of sleep have proven to have an increased risk of Hypertension, Atrial Fibrillation, Coronary Artery Disease (CAD), diabetes, depression, anxiety, heart attack and stroke.  While lack of sleep does not cause heart disease, it can greatly increase your risk factors for heart disease as well as other serious conditions.

2. What is sleep apnea? 

Sleep Apnea is a condition in which you stop breathing while you sleep.  It is sometimes related to a physical obstruction in your airway that creates a blockage which causes you to not breathing properly.  Other times, it could be miscommunication between your brain and your diaphragm which eventually leads your brain to not send the signal to your body for it to breathe.

3. What is CPAP? 

Continuous Positive Pressure Airway Pressure (CPAP) is still the golden standard for the treatment of Sleep Apnea.  It is a mask that you would wear while you sleep.  This mask is connected to a machine that pushes air at a certain pressure.  As the pressure increases it acts as a stent and opens the airway helping the patient breathe properly.

4. What if I couldn’t tolerate CPAP in the past?

If the patient is unable to breathe against the pressure, Bi-Level therapy would be a great option.  Bi-Level therapy provides 2 different pressures; the difference in between the two can be significant.  These two pressures are generally much easier to tolerate as it can make your breathing feel more “natural”.  Most patients are treated perfectly fine with CPAP therapy.  However, for many patients CPAP therapy is usually the first step along the process.

5. What if CPAP is not right for me?

Other options of treatment such as oral appliance or surgery are available for patients that meet certain criteria. Oral Appliance Therapy (OAT) uses an oral appliance that is comfortable and easy to wear. Studies show that patients have longer-term benefit using the oral appliance more consistently and for a longer period of time than patients using PAP therapy.  In addition, lifestyle changes are often recommended including avoiding alcohol or sedatives at bedtime, avoiding sleeping on your back and losing weight.    New therapy devices such as Provent and Inspire are also becoming more popular.  Please ask your sleep specialist for details.

6. I can’t fall asleep at 9pm, or not until much later. Will this impact the sleep study?

You do not have to fall asleep by 9:00pm since this is your appointment time.  It will usually take about 20 to 30 minutes for our sleep technologist to prepare all the necessary connections.  After this you can lie in bed and try to relax in your private room until you are able to fall asleep.  Each room has cable TV and guest Wi-Fi access available for your entertainment.

7. I have to go to the bathroom many times during the night. Will this impact the sleep study?

This is okay and should not interfere with your study.  There is one centralized plug to unplug and plug back in if you need to exit your room and use the restroom during the night.  We do advise to reduce fluid intake overall after 5:00pm on the study date.  Avoid caffeine and alcohol after 12:00pm on the study date as well.

8. What if I do not sleep much, or I wake up many times during the night during the sleep study?

It is not required for you to have a full, uninterrupted night of sleep in order to have enough data to analyze your sleep. We want you to have as much sleep as possible, but if you sleep less than normal or wake up, we are still generally able to gather enough data in order to diagnose any sleeping issues you may have.