What can you Expect From a Typical Sleep Study?

I previously wrote an article explaining a typical sleep study. In that

account, I basically described the sleep study itself. However, you can’t really know about something unless you’ve experienced it. That’s why I’d like to attempt to define what you can expect from a typical sleep study. So, if you’ve never had one, and wonder what a typical sleep study is like, this will help you understand it a  little better.

Welcome to my world
Typical Sleep Study
Me in my office

When I share experiences as a sleep tech. I don’t like to gloss over anything. I prefer to be open and share the good the bad and the ugly. In doing so, I hope to give you a better understanding of the world I live in. So that if you ever need a sleep study, you’ll have some fairly realistic expectations.

Personally, I really enjoy my life as a sleep Technologist. And I’ve talked with many other Technologists who enjoy what they do as well. Being a sleep Technologist definitely has its rewards, as well as its challenges. It’s nice to know that I’m helping people, but it’s even more awesome to actually hear people tell me how much better they feel.

Although I usually don’t get to hear from a patient unless their spouse or someone they know comes in for a sleep study. But when they tell me about that friend or relative of theirs, it makes my day.

With that in mind, let’s look at what can you expect during a typical sleep study.

First Night Syndrome

It’s quite natural to be a bit nervous when you come in for a typical sleep study. even if you’ve talked with others who have had one, or you researched it online. This is now you about to experience this. And the reasons you’re here can bring questions and concerns to mind.

You might be concerned about the effects of sleep apnea on your health. Then there’s the concern about using CPAP. Are you claustrophobic? What if you can’t stand wearing the mask? And will you be able to sleep with all those wires attached to you? Let alone some strange person watching you sleep. And even though we don’t ‘watch you sleep’ it can feel that way. Or maybe you think that the study is just a waste of your time and money.

However, once you’ve decided to come, don’t worry about bringing some personal item in with you. For instance, several years ago, an older gentleman brought a teddy bear with him. He said his granddaughter gave it to him ‘so you won’t have to sleep alone’. More recently I had a big tough looking dude bring his blanket in with him, ‘because it smells like my dog’.

So don’t feel weird or embarrassed about bringing something with you that has meaning to you.

There’s also what we call ‘first-night syndrome’.  This happens when a person who usually has no problem falling asleep,  now just can’t get to sleep no matter what. It’s called first-night syndrome because this can occur the first night in a sleep lab.

But there are also problems we can face with the equipment.

Houston, we Have a Problem

Unfortunately, the equipment doesn’t always work flawlessly. However, those of us techs who’ve been working long enough can pretty much take care of many technical difficulties ‘on the fly’. Rarely do we have to cancel a study because of some issue we can’t resolve.

And usually, if there’s a problem, you, the patient, probably won’t  even know about it. We’ll do our troubleshooting without letting you know there’s  problem. That’s usually because we’re pretty confident we can fix whatever the issue is. And if we can’t fix it, then we’ll let you in on it. But only after we’ve come to the place of needing to cancel your study. Although this rarely happens.

For example, I had this wonderful experience years ago:

I got my patient hooked up without incident. However, when I fired up the study, BAM! Something wasn’t right. The signals were totally unreadable. I went in and re-prepped some of the leads I thought might be suspect. And actually made several trips into the patient’s room, checking different things; eventually making all kinds of adjustments. At first, I really had no idea what in the world could be wrong.

But all I told the patient was that the signals weren’t perfect, and I was just making some adjustments to ensure a good quality study. I can’t remember what all as wrong, and actually, I thought I might need to cancel this study. That’s how bad it really was

Ultimately, however, I miraculously got the study up and running nicely (as I wiped the sweat from my brow). Oh, and that’s another thing, we’ll never let you see us sweat. Anyway, through all this, the patient had no idea how bad things really were. But in the end, the study turned out really well.

And the next morning the patient told me how impressed they were that I made extra sure the study was good!! If they only knew!!

But there are times when we do need to cancel a sleep study.

This is not a Typical Sleep Study!

Yes,  there are times when a study needs to be canceled,. And again, it’s rare. But sometimes a problem just can’t be resolved. Like the time I wasn’t feeling 100%. And by the time I got to the lab, I had developed a fever, complete with aches and chills. I obviously couldn’t be around patients that way. And all I wanted to do was lay down and go to sleep.

Also, there are times when our equipment just won’t co-operate. I, as well as other Technologists, have had computers die on us at the last minute.  That’s not fun. That and other technical difficulties beyond our control have caused more than one cancellation.

And again, while it’s rare to have to cancel a sleep study, things happen; or don’t happen, as the case may be. Although we do our best to make sure your study will be done when scheduled. And we do have other Technologists who might be available to come in at the last minute. But we’re all generally pretty busy, so that can be a bit of a juggling act.

Conclusion

So you’ve seen what a typical sleep study might actually feel like to you.  As well as addressed some of the technical difficulties that can occur. I’ve also  shared openly and honestly some things that can occur during a not-so-typical sleep study. But if you still have any questions or concerns, please feel contact me.

Till next time…Blessings.

Is a Home Sleep Test as Good as an in lab Sleep Test?

What is a Home Sleep Test, and is it as good as in lab sleep test?

Home Sleep Test

It’s exciting to see the advancements in sleep medicine.  Along with all the changes taking place in the insurance industry, Technology, and the economy in general. Many of these developments are changing how sleep studies are performed. For instance, a Home Sleep Test is becoming more common.

So, let’s take a rather brief look at a Home Sleep Test, and see how it compares with an in lab sleep study.

About Insurance

First of all, insurance is a major player in sleep medicine. And in order to keep premiums down, insurance companies push for the least expensive tests. The reason behind this is that the less the insurance company pays out, the lower your premiums will be; which makes sense. There’s also the economic pressure to keep costs down.

Now consider that one Technologist can do two, maybe three in lab sleep studies at a time. However, that same Technologist can handle more Home sleep tests at once. And a Home Sleeps test, or HST doesn’t cost as much. So you can see where this trend is going.

But, are HST’s as good as in lab sleep tests? Let’s first take a look at the type of sleep tests available. Then we’ll look at a typical Home Sleep Study. We’ll also compare costs and see who can have an HST. I’ll also explain why some people shouldn’t have an HST; in fact, can’t even qualify for one.

Types of Sleep Tests

The Centers for Medicare and Medicaid Services or CMS defines 4 types of sleep studies, based on what’s being monitored. A type 1 study is an in lab sleep study,  attended by a Technologist. This has been the gold standard of sleep tests, as it’s the most thorough.

Types 2-4 are home studies. These studies are defined by the number of channels recorded. Type 2 studies record more channels than type 3 studies. While type 4 studies record the fewest channels. And while an in lab study can test for a whole range of sleep disorders, an HST only monitors breathing.

Another downside to an HST is that something can come unhooked during the night while you’re sleeping. And that could make the study incomplete.

With that in mind, let’s take a look at a typical Home Sleep Test.

A Typical Home Sleep Test

You go into the sleep center the evening of your study and pick up the equipment needed for the night. The Technologist will go over everything with you; showing you how to put things on, and should answer your questions.

Then, in the comfort of your own home, you hook yourself up and (hopefully) go to sleep. In the morning, you bring the equipment back to the sleep center, where they’ll download your data. If it’s determined that you need CPAP, you’ll be set up with what’s called an auto-PAP machine. This type of device is set to automatically change pressures through the night based on how you’re breathing.

You can keep the auto-pap. But you might also have the option to get a CPAP machine. In that case, you’ll bring the auto-pap in and they’ll download the data. Then they’ll  use that to determine your optimal pressure. And they’ll give you a CPAP machine set to your best therapy level.

Other Home Sleep Test Information

Cost of a Home Sleep Test vs an in lab study

An in lab study can run anywhere from $600, to $5,000; with an average being around $1,000. However, a Home Sleep Test runs anywhere from $150 to $500. And insurance covers both.

Who should not have an HSAT?

A Home Sleep Test just monitors breathing. Therefore, it only detects sleep apnea, but none of the other sleep disorders. That’s why a careful assessment of your medical history is important. For example, if you have any heart or lung conditions, you might need an in lab study.

Other reasons you might need an in lab study

If your Doctor suspects you might have some other sleep disorder, he/she could order an in lab study. And anyone 18 years and younger would need an in lab study as well.

So, While A Home Sleep Test is becoming more common, it’s not for everyone. And even with all the advancements in sleep medicine, there might always be a place for in-lab sleep studies.

Conclusion

We’ve taken a rather brief look at a Home sleep test. We’ve seen the advantages of an HST. And also discovered why a Home Sleep Test isn’t for everyone. We’ve also seen why this type of test might become more common in the future.

How about you? Have you had a Home Sleep Study?  Would you like to share your experience? Or do you have questions about HST’s vs in lab studies? Please leave a comment and let me know what you think.

Till next time…Blessings.

My Wife Always Complains About my Snoring

My wife’s made me aware of my snoring for several months now.

Snoring
Me, chillin’ by our Lilac Bushes

So I’ve finally decided to talk with my Doctor about having a sleep study. Please join me in my journey as I share some personal experiences and other insights.

This then is my story…kind of.

Is it More Than Snoring?

A sharp jab to my side jars me from a sound slumber.

“Kent, you’re snoring!” (It’s never “Honey, you’re snoring”. No, when it’s bad, I’m always on a first name basis). I usually end up mumbling something, turn over, and go back to sleep. There are, however, times when I wake myself up choking or something else that’s quite disturbing.

For example, I travel to different hospitals and occasionally stay at hotels. One time in particular, I was rudely awakened; finding myself totally unable to breathe. I also had a bad burning sensation in my throat and the most horrible taste. I was literally halfway onto my feet before I fully woke up, and ran to the bathroom.

Not being able to breathe was bad enough. But with only a locked door between me and any chance of rescue only made it worse. I did end up catching my breath but also threw up some crud. That only happened once (so far). But more and more I wake with some real thick phlegm stuck in my throat. I can still breathe o.k., but it’s a bit uncomfortable.

My wife’s complaints of my snoring surprised me at first. But now that surprise has turned to concern. And because I’m aware of the dangers of untreated sleep apnea, I began to wonder if I might have fallen victim to this thing. So while I don’t fit the profile of a typical person with obstructive sleep apnea (OSA), that doesn’t automatically rule me out.

But just what does a typical person with sleep apnea look like?

A Typical Sleep Apnea Person

Although the average person with OSA is an overweight middle-aged male, almost anyone can have sleep apnea. In fact, I’d be willing to bet that 100% of the population of planet Earth has moments throughout the night where they stop breathing for a time. So it’s not just a matter of if you stop breathing, but how often do you stop breathing. And how long do you stop breathing for?

As for me, I’m 6 ft. tall (72 inches), and I weigh 180 pounds. That puts my  Body Mass Index (BMI) at 24.4, which is average for a fellow my age (I’m 60). Yet I’m displaying some of the symptoms of OSA.

And my wife has made me aware of my snoring for some time now. Plus, every now and then I do wake myself up choking; though it doesn’t happen often. But, I rarely wake up with a headache, and only score a 3 on a sleepiness questionnaire.

Also, my dad died of a heart attack at 71; although I don’t recall snoring being an issue with him. I’m also not on any prescription medications, and really don’t feel too bad. And even though I spend many hours a night (and day), at a computer, I do try and stay pretty active. For instance, I have a couple road bicycles, and my wife and I like to go for walks as well. But, I figure I should at least get a checkup.

Would you Have a Sleep Study?

I’m trying to imagine what it would be like to not know what happens during a sleep study. What if I wasn’t aware of the dangers of sleep apnea? Would I even have any reasons to talk with my Doctor? I’m not sure, but the following are some things that come to mind:

My wife says my snoring is really bad, and sometimes I breathe really shallow.  I’m tired sometimes, but isn’t everybody? Why should I waste my money on some expensive test, and for what? What if I don’t have this sleep acne, or whatever they call it? And if I do and get this breathing machine, what will that do? Help me sleep better?  I really don’t sleep all that bad now. Oh, I won’t snore, and that’ll make my wife happy. But I could just get some of those breathe right strips and be done with it, no?

The problem with that thinking is that breathe right strips open your nasal passages, and can stop the snoring caused by that. However, they do nothing in the way of holding your airway open. And that’s where the problem is. Besides, CPAP does more than give you a better nights sleep. That’s really just a beneficial side effect. It can literally save your life.

What if it’s More Than Just Snoring?

On the one hand, I hope that I don’t have obstructive sleep apnea. Or should I say sleep apnea that needs to be treated.

You see, there are various degrees of OSA. The severity of sleep apnea is based on a formula we call the AHI scale. This AHI scale stands for Apnea Hypopnea Index. It’s calculated based on the number of times you stop breathing each hour. But we don’t even count every time you stop breathing, only those times you stop for 10 seconds or more.

Also, if your airway is going to collapse, it will after you’ve breathed out. So try this once, breathe out and then stop breathing for at least 10 seconds. This describes apneas. That’s when your airway closes completely. If your airway only partially collapses, we call that a hypopnea.

Now consider that you usually will stop breathing for way more than 10 seconds before waking. And your heart is taking quite a beating during this time. But you’re not going to die from suffocation. Your brain will wake you long before then. However, your heart can only take so much.

So, if I do need CPAP, I’ll be very compliant with treatment. ‘Cause, even though I’m not afraid to die, I don’t want to just yet.

Now What?

So I met with my Doctor yesterday(Friday), and I have some doubts about having sleep apnea. And although he did order a sleep study, we both agreed that it’s not really that much of an issue with me. I think I’d still feel better if I had the test, and at least rule it out. However, I’m going to spend some time looking more into this and see if I really need to go through with it.

I’ll keep you updated.

Conclusion

I’ve shared some of my personal concerns about snoring and sleep apnea. And this has also made me more aware of what a person might be thinking who doesn’t know the dangers of OSA.

Now, what about you? Whether you’ve had a sleep study or not; or even if you suspect you might have sleep apnea, I want to hear your insights. Please leave an appropriate comment or question.

Till next time…Blessings.

Do you Have What it Takes to be a Sleep Technologist?

The life of a sleep technologist is far from boring. Are you one of the many that think we just sit there all night watching you sleep? Think againIn this article, I define what a Sleep Technologist is and does.

What is a Sleep Technologist?Sleep Technologist

I can’t speak for all Sleep Technologists, but when I first heard of this field of study, I was immediately interested. What’s so fascinating about staying up all night watching people sleep, you ask? I have no idea, I don’t do that. Although, it’s amazing how many people think I do.

Let’s clear this misconception up a bit shall we? But before I go into what a Sleep Technologist does, let’s define what one is.

First of all, not just anyone can be a Sleep Technologist. And I don’t think everyone would want to be one! For one thing, we’re up at night and sleep during the day. Also, many of us work alone and spend hours at a computer. Actually, we’re usually working 2 computers at the same time because we routinely test 2 patients each night.

But really, I enjoy working by myself; especially at night when it’s nice and quiet. And by quiet I don’t mean sitting there twiddling my thumbs…that would drive me crazy!

No, a quiet night just means a nice pace where I’m able to keep up with everything. And because not everyone’s the same, what works for one person might not work for someone else. So it’s good to keep ahead of things in case something unexpected happens. Thus, good time management, with an eye for detail, is a must.

And while you’d think it would get boring doing the same thing every night, it’s not at all. That’s because, even though I have the same routine every night, I deal with different people. And it’s the people that make my career most interesting.

Not that everything else isn’t interesting. As one of my patients put it “You have a really cool job!” And while that may be true, they were wrong about one thing. It’s not just a job. I’m helping people live a longer, more enriching life. It’s what I’ve become.

But just what does a Sleep Technologist do?

What Does a Sleep Technologist do?

One of the more frequent comments I get is ‘It must be boring watching people sleep.’ Another question people ask is ‘Did you have to go to school for this?’ It’s tempting to answer that question with, ‘No, I’m smart enough to have figured this out all by myself’. But I don’t. ’cause I’m not.

Of course, people who say such things just don’t understand the complexities of this position. And for the record, we don’t watch you sleep. That would be a silly, boring and quite useless job, no?  However, after I explain what I do, the question usually becomes “How much schooling did it take you to learn all this?”

With that, let’s take a look at some of the things that take place during your sleep study.

Let’s begin with the hookup. There’re a lot of wires attached to you. These sensors measure leg movement, breathing, oxygen levels, heart rate, and brainwaves; as well as muscle tension, eye movement, and snoring. And while I’m hooking you up to all these sensors, I like to explain what I’m doing as I go. I also explain what Obstructive Sleep Apnea, or OSA, is. And this naturally leads to a brief discussion of CPAP.

After you’re hooked up, I have you try on different CPAP masks, just in case I decide to start you on treatment. This not only gets you accustomed to the mask but also helps you relax, as you now know what to expect. Then, during your sleep study, I need to determine if you need CPAP or not. And if I start you on treatment, when to adjust pressure to get you breathing well.

Once I have your study up and running, you’re reduced to a bunch of crisp clear squiggly lines on my computer monitor. All these lines show me what your version of sleep looks like. At that point, I settle into my chair and began the process of helping you live a longer more enriching life…Literally.

But in order to do this, I need to be knowledgeable about a few things.

A Sleep Technologist Does Know Some Stuff

A Sleep Technologist wears many hats. And once we pass a board exam, our ‘official’ title is Registered Polysomnographic Technologist or RPSGT.

Among the many skills we possess are:

♦ Basic EKG interpretation One of the things I record is your heart rate and rhythm. It’s not a full EKG but still gives me a heads up if something isn’t right, that is as long as I know what I’m looking at. Additionally, when I’m at a lab in a hospital, I can always call the charge nurse and get a second opinion on anything questionable.

♦Charting. Accurate assessment of your condition. Knowing what’s significant and what’s not. And with proper spelling and medical terminology (so I don’t look dumb to the Doctor)

♦ Computer skills.

♦ Medical knowledge. Diseases, medicines, medical terminology. I need to know how different diseases affect sleep. Also, medications that are prescribed for these diseases have their own effects on the sleep-wake cycle. All these variables not only affect your sleep but also influence how you respond to CPAP.

♦ Pattern Recognition-When I look at the computer monitor, all I see are a bunch of squiggly lines. But each squiggle means something. And I need to be able to determine whether a squiggle is significant or not. By morning, I’ll have around 900 pages of data recorded on you, so I really need to know what I’m looking at. Therefore, I’m the eyes and ears of the Doctor.

♦ People skills-The hook up process is 1 on 1 time. Not only is that the time to gather information on your medical history. It’s also the time to help you relax and prepare for the night. Interpersonal skills are very important. Especially at this time.

♦ Troubleshooting both equipment and computer. Although I do have access to an on-call person, I need to be able to handle problems as best I can. Of course, experience alone helps there.

We also attend monthly classes that keep us up to speed on the ever-evolving fields of sleep.

Conclusion

I hope this rather brief description of what a Sleep Technologist is and does helps you better understand this complex and highly technical field.

I’m a Sleep Technologist and I love what I do. Helping people live a longer more enriching life is awesome!!

Till next time…Blessings.

There are different ways to qualify for a Sleep Technologist. Our exact titles are Registered Polysomnographic Technologist or RPSGT. And depending on your medical background, there are the various ways you can become one of us.

The Challenge of Life With Obstructive Sleep Apnea

Have you heard of Obstructive Sleep Apnea, but aren’t really sure what it’s all about? This article will help you understand it better. And although the following story is fictional, the events are taken from real life experiences. It’s about a fellow I’ll call Ron, who has Obstructive Sleep Apnea, or OSA.

This is his story.

Ron’s Story

“Honey, you’re gonna be late for work!! Hurry up!”  Once again, Ron drags himself out of bed, his head throbbing. ‘Why do I always wake up with these @#$% headaches?’ he wonders as he staggers to the bathroom in a daze.

Ron, a fairly overweight 54 year old, works down at the local factory. He’s on several medications for both high blood pressure and diabetes. And just like this morning, he usually wakes with a headache.

Sue, his wife, has been concerned about Ron for some time. His loud snoring eventually led them to sleep in separate bedrooms so that she can get some sleep. But it’s those anxious moments when he stops breathing that are especially alarming to Sue. She’s told Ron about these things, but he doesn’t believe her and says he’s just fine.

But Sue also notices that he’s just not himself lately. He easily becomes irritable, and she suspects he might be depressed.

Looking at himself in the mirror he groans ‘you can do this’. Although that little pep talk really doesn’t do much, it’s still better than nothing. Splashing some water on his face, he mentally prepares for the day. As he lumbers down the steps, he smells his favorite coffee waiting for him.

Coffee. “That’s what I need”. Just the thought lifts his mood a bit.

Slamming down his breakfast, he fills his mug with more Java and heads off to work. His headache is gone by the time he pulls into the parking lot, and the coffee is kicking in. But, he knows this level of wakefulness won’t last long. For some reason, this reminds him of a conversation he had with a co-worker. They had mentioned something about obstructive sleep apnea. But Ron just shrugged it off.

He drinks some more coffee at his morning break and has an energy drink with his noon meal. But by the afternoon, he’s struggling to stay awake. He got some more coffee, but it’s not doing much good at this point. Finally, after fighting sleep all afternoon, it’s time to clock out for the day.  He feels like he weighs a ton as he walks out to his truck. ‘I just wanna lay down’, he thinks to himself, blinking the sleep from his eyes.

But he has to drive home yet. Good thing he doesn’t have far to go. He climbs into his pickup and pulls out of the parking lot…The loud screech of car tires startles him, as he realizes he had just pulled out in front of someone. Ron’s not very alert at this point.

In fact, most of his drives home are performed with numerous battles to stay awake. There are even times he doesn’t remember parts of the drive home. ‘Funny I haven’t killed someone yet’, Ron thinks as he fights the strong urge to just close his eyes and drift off to sleep.

Does Ron Have Obstructive Sleep Apnea?

He hasn’t told his wife about those near accidents, and how he struggles to stay awake. He just doesn’t want her to worry. ‘Besides’, Ron says to himself, ‘I’ve done o.k. all this time.’ And actually, when he thinks about it, there are some days where he doesn’t feel bad at all. But Sue is all too aware. And she’s quite concerned. In fact, she finally convinces Ron to at least talk with his Dr. “You snore and sometimes you actually stop breathing. That scares me.” She says.

“O.K.”, Ron replied, “I’ll talk to him at my next check up”.

Ron visits his Doctor

Sue accompanies Ron to his next annual physical. And there she tells his Doctor all about Ron’s sleep habits. The Doctor asks Ron some pointed questions, which includes a sleep questionnaire. This assesses’s his level of sleepiness throughout the day. Ron’s answers are alarming. They show he’s bordering on dangerously sleepy.

Additionally, when his Doctor points out that obstructive sleep apnea can cause high blood pressure and lead to sudden death, Ron takes notice. He remembers how loud his dad would snore. And he passed away from a massive heart attack when he was only 50. Ron figures he’s already beating the odds.

His Doctor also explained how obstructive sleep apnea can cause numerous trips to the bathroom.

“What happens is this” Ron’s Dr. began. “Obstructive sleep apnea causes stress . And this stress makes your body think there’s extra fluid around your heart. So it flushes out what fluid is there. Hence the extra trips to the bathroom”.

Between his Dr. and his wife, Ron is beginning to see the seriousness of what he’s facing. So when his Dr. orders a sleep study, he actually feels some relief.

Ron has a Sleep Study

Ron’s sleep study shows that he stops breathing around 30 times an hour. He’s placed on a CPAP machine at a pressure of 9 CmH20.  It takes Ron a couple weeks to really start getting used to the machine, but he’s glad he didn’t give up. Now, he can’t believe how much better he actually feels. And no more waking up with a headache.Obstructive Sleep Apnea

Also, his blood pressure is coming down, so Ron’s Dr. decreased his blood pressure meds. His blood sugar number look better too! Not only that, but his wife notices that he’s in a much better mood lately. And they’re back sleeping in the same bed.

Conclusion

Is Obstructive Sleep Apnea something that you struggle with? Is there anything about Ron’s story that sounds familiar? If so, I’d recommend you talk with your Doctor. Or maybe you know someone that’s suffering from this disorder. If so, you could possibly save a life. Seriously.

Till next time…Blessings.