Sleep Disorders Center of Santa Maria
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DIAGNOSTIC SLEEP STUDIES (POLYSOMNOGRAM – PSG)
Adult PSG – Adult polysomnography (In Lab Sleep Study) is a general monitoring of sleep. It includes monitoring of brain activity, eye movements, muscle activity, nasal airflow, respiratory effort and heart rhythm. This study is performed without the initiation of CPAP therapy during the night.
PEDIATRIC PSG – Pediatric polysomnography is a general monitoring of a child’s sleep. It includes monitoring of brain activity, eye movements, muscle activity, nasal airflow, respiratory effort and heart rhythm. This study is performed without the initiation of CPAP therapy during the night. Pediatric sleep studies in most cases also include monitoring of the carbon dioxide levels or ETCO2 monitoring.
SPLIT NIGHT PSG – A split polysomnography is a test that is usually ordered for adults as a first-time study or if a patient has not been evaluated for several years and does not use their therapy at night. This study monitors many body functions including brain activity, eye movement, muscle activity and heart rhythm during sleep. If the patient qualifies and clearly has moderate or severe sleep apnea during the first part of the night, the patient will be placed on continuous Positive Airway Pressure (PAP) therapy in an attempt to determine the optimal pressure that will resolve the sleep related breathing disturbances.
TITRATION PSG – A titration polysomnogramis performed to determine the necessary CPAP pressure required to alleviate apnea or other sleep disorders such as snoring. This study monitors the same body functions as the PSG while the patient is using CPAP.
HSAT – HOME SLEEP APNEA TESTING
A Home Sleep Study is for diagnosing obstructive sleep apnea (OSA). The Out of Center Sleep Test (OCST) or HSAT is often required as the initial screening tool by certain insurance companies today. Although home sleep testing works fairly well for the diagnosis of moderate to severe obstructive sleep apnea, the OCST has a high false negative rate. Cases of mild obstructive sleep apnea are often missed with this method of testing and an in lab polysomnogram will be necessary is there is significant suspicion of sleep apnea. For the home sleep test you will be given a device to take home and monitor your sleep. One of the staff will instruct you in proper use of the device in our office before you take it home. You will sleep with the device for one or two nights and you will return the monitor the next day for our review and analysis. In home sleep testing, your breathing and nasal airflow is monitored as well as your heart rate and oxygen levels.
PAPNAP: A PAPNAPis a daytime study which is done to desensitize and acclimate you to CPAP therapy. This allows you to try several styles and sizes of masks and to find the best fit and size. At the Sleep Disorders Center of Santa Maria we will spend time with you at an office visit during the day to get you comfortable with CPAP, fit you with a comfortable mask, adjust the pressure and the ways with pressure is delivered, and adjust the temperature and humidity. After these important parameters have been adjusted you will be allowed to lay down with the comfortable mask on and perhaps take a nap. During your PAPNAP your will be educated about PAP treatment and your questions will be answered. You will be allowed to lay down with the CPAP on and different pressure settings will be applied to establish what pressure settings will work best for you. If necessary we will provide coaching to help you overcome anxiety, claustrophobia, stress, frustration, discomfort and insomnia which may be associated with use of your CPAP.
MSLT – MULTIPLE SLEEP LATENCY TESTING (MSLT)is a daytime nap study that tests for narcolepsy or other forms of hypersomnia. This study is performed in conjunction with a PSG the night before. This test is to assess how quickly a person is able to fall asleep during the day after a typical night of sleep.
MASK FITTING AND CPAP TROUBLESHOOTING: To sleep well with CPAP, your mask must fit very comfortably on your face. There are hundreds of variations of CPAP masks in styles and sizes. There are masks which just cover the nostrils, just the nose, nose and mouth, entire face and masks that fit in the mouth. There are small masks sized to fit infants and toddlers as well as sizes for people who weigh 600 pounds or more. Nasal masks may be for a very wide or narrow nose. With a CPAP mask, just like with a shoe, it must fit perfectly. The first step in successful use of CPAP is getting you a comfortable, well-fitting mask. CPAP mask fitting can be done during a brief visit (usually less than 30 minutes) where we will optimize the mask interface. This is important to maximize you comfort and to avoid excessive air leak around your CPAP mask. This is also an important visit if you are having difficulty tolerating your mask at home before you repeat an overnight titration study.