You have tried everything, from tart cherry juice for insomnia, to teas and essential oils, your GP still thinks that you need to change something about your lifestyle, but somehow nothing is working, and you still cannot establish a healthy sleep routine. Well, maybe it is time to check-in into a sleep clinic. Sleep disorders can be tricky, and not so easy to get rid of once they take control over our daily life.
If you are having troubles with excessive daytime sleepiness, snoring, falling and staying asleep, and none of the behavioral changes that you made did not provide any results, consult your doctor to refer you to a sleep clinic. However, it is essential to keep in mind that sleep clinics only set diagnose, identify the sleep disorder and recommend proper treatment, they do not cure the problem. Sleep clinics are probably the best way to learn everything in-depth about your sleep and get an official diagnosis of a specific sleep disorder such as insomnia, sleep apnea, narcolepsy, restless leg syndrome, etc. Since Americans are having a lot of sleep-related issues, there are hundreds of these clinics in the US at the moment, and their number keeps growing.
Sleep clinics are basically medical labs and diagnostic centers in which patients can spend a night if it is necessary, so they are adjusted for the accommodation and comfort of the patients. Each room is equipped with medical monitoring devices, and the patient can be monitored during the day or at night so that the medical staff can gather enough information about their sleep. The data collected from the sleep study will be used for setting a diagnose and determine whether or not someone has a sleep disorder.
Some sleep clinics are attached to hospitals and function as a part of them, but the majority of them are standalone. Each clinic has to have a supervising physician, but usually, technicians are doing all the work, they are taking tests and monitoring patients, while the doctor analyses the final results and sets a diagnose.
If you are planning to visit a sleep clinic, keep reading to find some useful information and tips that will help you prepare for your sleep study.
How to Prepare for a Sleep Study?
Once you make an appointment, the clinic will probably send you some information and tips to help you prepare yourself better for your sleep study. During the few days before your sleep test, you should not do anything special, but on the day of your sleep study, there are some things that you should not do. Avoid alcohol and caffeine intake, do not take any nap during that day because that way you will fall asleep faster at the clinic, remove nail polish from your index fingers and wash your hair since it will be easier for electrodes to get attached to your scalp if there are no oils or gels. You should eat before going to the clinic and pack everything you need for a one night stay, toiletries, clothes, a book, or medications if you are taking them but you must inform technicians about your therapy. Even though you did not take a nap, it might be hard at first to relax and fall asleep, and that is normal since we are not in sleeping in our bedroom and we are nervous about the test and its outcome.
Many sleep studies need to be taken overnight, and they demand at least 7 hours of sleep testing in a clinic room. Sleep clinics will schedule your arrival during the evening hours so that in the early morning hours patients are free to go and continue with their daily chores, some clinics even have shower rooms. Technicians will welcome the patient and do all the necessary paperwork, then set all the equipment and start monitoring while the patient is sleeping. Sometimes they will leave the patient to wake up naturally, but they can also wake you up at the preselected time.
Do not expect to get your results and diagnose right after; the technicians will forward your results to a doctor, who then analyzes them and goes through your medical history. Within 7 to 10 days from your visit to a sleep clinic, your results will be ready, and the doctor will tell you what the treatment options are and is it really a sleep disorder and which one.
How Does Sleep Study Procedure Look Like?
Once you enter the clinic and fill out all papers, technicians will measure your blood pressure and start applying monitors that will measure the activity in your body while you are sleeping. Wires with small electrodes will be attached to your scalp to measure your brain activity, and from this, technicians will know whether you are sleeping and in which stage of sleep you are. More wire electrodes will be attached to your face, near the eyes and chin to follow the activity of muscles. Electrodes around eyes also provide information about sleep stages, while the ones on the chin can indicate some disorders like nocturnal teeth grinding.
Two elastic belts, one around the chest and the other one around the stomach will measure breathing effort. A monitor will be attached to your nail polish-free index finger to follow the level of oxygen during the study. A nasal cannula and heat monitor will measure all breathing activities, while a small microphone will be placed near the throat to capture snoring. There will also be wire electrodes on each leg to monitor body and muscle movements and two or three EKG monitors to follow and show heart rhythm and rate. All wires are long enough so that they do not hinder your normal movements during sleep.
Once you are all hooked up, the RSPGT machine in the other room will start to follow and collect all the data. If there is a need for communication between the patient and technicians in a different room, it can easily be achieved via intercom which is usually used at the beginning to test the equipment. As if not sleeping in your room is not enough, you know that you are monitored and attached to various devices, and it may seem that it will be impossible to relax and fall asleep. However, a sleep study rarely fails or gets rescheduled because the patient was unable to fall asleep.
Types of Sleep Studies
Sleep clinics today offer various sleep studies, and we are going to briefly represent you a few of the most commonly used ones.
- Polysomnogram (PSG) is the most often performed overnight sleep study which monitors brain activity, blood pressure, oxygen levels, heart rate, eye and body movements. This test is used for diagnosing obstructive sleep apnea, sleep disorders caused by excessive daytime sleepiness, movement disorders or seizure disorders that are sleep related.
- MSLT or Multiple Sleep Latency Test is a daytime sleep study which measures how sleepy you get. It is usually performed after PSG, and it records if you fell asleep during the test, and which stages of sleep you reached. Patients have to try and take a 20-minute nap, five times with two-hour breaks in between each nap. Technicians will monitor eye movements and brain activity to measure the level of sleepiness and how quickly can a patient reach the REM stage. MSLT is used as a test for narcolepsy or to check if the treatment for sleep apnea is working properly.
- Maintenance of Wakefulness Test (MWT) is another daytime sleep study, often performed right after PSG, and it measures our ability to stay awake or if our sleepiness can be a potential safety concern. MWT is also great for checking if the sleep apnea treatment is helping, but it is also useful for people who are working in transportation, for example, truck drivers because their employers sometimes require them to deliver MWT results.
- Continuous Positive Airway Pressure (CPAP) Titration study is an overnight study which manages breathing disorders that are sleep related, some of them are obstructive and central sleep apnea, and hypoventilation. This study monitors the patient’s breathing while adjusting the CPAP pressure in order to determine the amount of air pressure which is necessary to prevent the restriction of upper airway which causes breathing pauses during sleep. Patients need to carry a nasal mask connected to a tube on a pressure device, it starts with low-pressure levels, and then it gradually rises.
- Split Night Study is used for diagnosing obstructive sleep apnea, and it actually combines two different studies in one night, saving the patient’s precious time. During the first part, patients will undergo a PSG, and then after a CPAP titration.
Tips for Choosing the Best Sleep Clinic
Since they are quite popular at the moment, sleep clinics can be found on almost every corner, so how to pick the one that you will trust? Here are some things on which you have to pay attention.
- Medical certification – you need to be sure that the doctors and technicians who will be examining you have a proper medical certificate for what they are doing. The doctor that will set a diagnose needs to be a board-certified in sleep medicine because only that can guarantee you that this doctor attended two-year training for specializing in sleep medicine. Technicians or sleep technologists need to have one of these certifications: CPSGT, RST, RPSGT or SDS. A patient who is diagnosed with sleep apnea will encounter a sleep respiratory therapist who will train them on how to use the CPAP machine. This person needs to have SDS certificate and CRT or RRT. You can check the certifications on the webpage of the American Board of Medical Specialties.
- Price and insurance coverage – sleep studies are not cheap, their price goes from 1000$ and higher, but if your doctor refers you to a sleep clinic, many insurance companies will cover the cost of it, just do the research. High prices of medical studies and treatments are the main reason why many people are not treating their sleep disorders correctly. If you are trying to undergo a study to diagnose sleep apnea, some insurance companies will require you to take a home sleep study first. Compared to sleep studies those home sleep tests are somewhat affordable with a price around 200$, and they are designed to diagnose how severe obstructive sleep apnea is. But anyway, you should think about sleep tests and studies as an investment in your self-care, since our sleep quality impacts more than our dark undereye circles, it can jeopardize our health and all other aspects of our life.
- Additional accreditation – most sleep clinics are accredited through the American Academy of Sleep Medicine, and if a clinic wants to have this recognition, it has to meet certain standards, including a doctor with proper qualifications, educated and certified technicians who all must meet requirements of continued education.
- Reviews – as we tend to google everything, google your nearest sleep clinic and seek for genuine experiences of former patients who have similar symptoms or sleep disorders.
- Location – in big cities there are many sleep clinics, so check on the map which one is on your way when you are going back home from work, or when you are driving kids to kindergarten. Make a short stop to visit some clinics and see how it looks and feels in reality, away from smiley and polished pictures on their webpages. They will also probably provide you with all the information and brochures about their clinic and sleep studies they perform. This way you can compare two or more clinics and choose the one that is the best for you.