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Diagnostic Testing

Obsctructive Sleep Apnea

Polysomnography

Polysomnography is an overnight (or daytime for night shift workers) sleep study performed in a comfortable private room that is very similar to a hotel room. The sleep rooms are equipped with queen sized Select Comfort™ air beds and are sound and light adjusted to ensure a tranquil and quiet environment. Handicapped accessible restrooms and shower facilities are conveniently located near each sleep room.

Polysomnography is used to monitor biological functions during sleep, including brain activity, eye movements, muscle tone, heart rate and rhythm, and breathing. Polysomnography may be conducted as a diagnostic study or to evaluate and adjust certain treatments for sleep apnea including Continuous Positive Airway Pressure (CPAP), Bilevel Positive Airway Pressure (BiPAP), oral appliances and oxygen therapy.

CPAP/BiPAP titration

A CPAP/BiPAP titration study is used to calibrate positive airway pressure (PAP) pressure settings. CPAP (continuous positive airway pressure) is the frontline treatment for obstructive sleep apnea. CPAP keeps your airway open by gently providing a constant stream of air through a mask you wear while you sleep. BiPAP (bilevel positive airway pressure) is a type of CPAP that delivers different inspiratory and expiratory pressures during sleep.

BiPAP has also been shown to be an effective therapy for severe COPD and respiratory failure. In some cases, a CPAP titration study may be performed on the same night as a polysomnogram, but this is usually done only if the sleep apnea is severe and the diagnosis is clear. In more mild cases, the CPAP titration study occurs after the physician reviews the results of the polysomnogram.

Multiple Sleep Latency Test (MSLT)

The Multiple Sleep Latency Test (MSLT) assesses excessive daytime sleepiness by measuring how quickly you fall asleep in a quiet environment during the day. This test is used to diagnose narcolepsy and idiopathic hypersomnia, and is conducted in the sleep laboratory following an over-night polysomnogram.

The MSLT is a full-day test that consists of five scheduled naps throughout the day. During each nap trial, you will lie quietly in bed and try to go to sleep. Each nap will be taken in a dark and quiet sleep environment that is intended for your comfort and to isolate any external factors that may affect your ability to fall asleep. The amount of time it takes to fall asleep on each nap, called the sleep latency, determines whether excessive daytime sleepiness is present and if treatment is necessary. A complimentary light breakfast and lunch are provided.

Maintenance of Wakefulness Test (MWT)

The Maintenance of Wakefulness Test (MWT) is used to measure how well you remain alert during times of quiet inactivity. The MWT is conducted in the sleep laboratory and involves four, 40-minute test periods administered at two hour intervals to assess the ability to remain awake in a dimly lit room while lying semi-recumbent.

The MWT is used to assess how well a patient is able to stay awake after starting treatment. It is also used to help determine whether a patient is too tired to drive or perform other daily tasks, and is often requested for patients involved in the public transportation industry such as commercial truck drivers and airline pilots. A complimentary lunch is provided during the study.

Actigraphy

Actigraphy is used to assess daytime sleepiness in situations when it is important for the patient to stay in their natural sleep environment, such as with insomnia and circadian rhythm sleep disorders. Actigraphy involves the use a small device called an actigraph, which is usually watch-shaped and worn on the wrist.

The actigraph is worn for 1-2 weeks while the device collects data on motion and ambient light, and is useful for determining sleep patterns and circadian rhythms. Because the patient does not need to be located in a laboratory while the information is being recorded, this allows for the collection of more accurate data. At the end of the testing period, the actigraph is downloaded and interpreted by the physician.

PAP Nap (CPAP/BiPAP Desensitization)

A Positive Airway Pressure (PAP) Nap is a daytime study for patients who have anxiety about starting PAP therapy, are claustrophobic, or are having difficulty tolerating PAP therapy for their sleep-related breathing disorder. The procedure itself is a short, in-lab cardiorespiratory sleep study that is attended by an experienced sleep technologist and ranges from 60 to 180 minutes in length.

During the PAP Nap, patients have individual coaching and counseling by a sleep technologist to overcome any fears or hesitations they have about PAP therapy and to help them become more comfortable with the mask and pressure sensations. The goal of the PAP Nap is to help patients get used to using the equipment themselves so they are more likely to use PAP therapy at home on a nightly basis.

Home Sleep Apnea Testing

Home Sleep Apnea Testing is primarily used to diagnose obstructive sleep apnea (OSA) in patients meeting certain criteria. In order to determine eligibility, a comprehensive sleep evaluation is necessary. Candidates for home sleep testing must have a high likelihood of moderate to severe OSA and no other significant medical conditions.

A home sleep test is not recommended if you are at low risk for OSA, the physician suspects you may have another sleep disorder, or if you have other medical conditions including pulmonary disease, neuromuscular disease or congestive heart failure. In these cases, an in-lab sleep study should be done to obtain the most comprehensive evaluation of your sleep.