Sleep Disorders and Tests for Sleep

Types of sleep disorders

There are many types of sleep disorders, but they usually fall into one of the following major categories:

Insomnia - A persistent inability to fall and/or to stay asleep with daytime symptoms of fatigue, poor concentration, aches and pain etc.

Hypersomnia - Sleeping too much or sleeping inappropriate times. Increased sleepiness when sleepiness interferes with daily routine activities or reduces ability to function it is called "Problem Sleepiness" and may be a sign of a serious sleep disorder. Sleep apnoea and narcolepsy are the chief causes of hypersomnia.

Parasomnia - Problems that occur only during sleep or are brought about by sleep, such as recurrent nightmares, sleep talking, abnormal movements and bedwetting.

Disorders of sleep-wake schedule - These disorders occur when the opportunity to sleep does not coincide with the body's desire to sleep and often appear in patients who do shift work.

What's involved in a sleep study?

The patient comes to the hospital at 8:30 - 9:00 pm at night of the study and leaves the following morning when the study is complete, at about 5:30 - 6:00 am.

On the day of your sleep study, avoid caffeine (coffee, tea, cola, chocolate) after 2.00 pm and try not to take an afternoon nap. Before coming to the sleep centre, wash and dry your hair, and do not apply hair sprays or oil.

The sleep study/PSG is a non-invasive test. This records a variety of body functions during sleep such as electrical activity of the brain, sleep pattern, breathing, oxygen levels, heart rate and rhythm, and muscle tone. The sleep technologist will connect the patient to the monitoring equipment via a series of stick-on electrode patches. The wires are long enough so that you can sleep in any position you wish. Once the study is complete, the test data is reviewed and "scored" by a specialist and relevant recommendations are made.

What do I need to bring? 

• Your night clothes, including bathrobe and slippers.

• Toiletries

• Any medication that you regularly take.

• If you need special bed clothings (thin mattress or pillow) to sleep well, please feel free to bring these along.

• Shampoo wash your hair but do not use hair oil or cream on the day of the study.

• If you are already using CPAP, bilvel machine please bring these along with previous medical records.

• You may have dinner at home before coming or can bring it along with you.

When will I know the result? 

Usually after 3-4 days.

Important

If your symptoms change significantly (either better or worse) or if you are unwell just prior to your allocated night in sleep laboratory, please notify us immediately.

Where do I go for a sleep study? 

• Present to the Admission office (02) on the Ground Floor by 8:30 pm.

• If you are unable to get to the center by 8:30 pm, please inform.

If you have any queries that are not answered here, please call.
Tel.: 42251728, 42251731, 42251726

C.P.A.P. (Continuous Positive Airway Pressure) Trial

Treatment for sleep apnoea (stopping breathing during sleep) involves the use of a nasal CPAP (Continuous Positive Airway Pressure) machine. A mask is fastened over the person's nose with head straps and fastened to prevent air escaping. Depending on the severity of the sleep apnoea, different air pressures may be needed by different people. The first trial of the CPAP machine in the Sleep Disorders Centre is to introduce the sleep apnoea sufferer to the machine and determine the pressure they need to prevent the throat from becoming blocked. The set-up for the CPAP trial involves all the same leads as the diagnostic study. The technicians will increase the pressure of the machine until the person stops snoring and they are breathing without obstruction.

Airway splinted open air flows freely to lungs

A CPAP machine involves the motor unit, to which a tube is attached. This tube is flexible and runs from the machine to the patient. There is a soft mask, which fits snugly over the person's nose and is held in place by a rigid mask and straps. The tube attaches to the rigid mask and it is through this tube that air is blown into the throat. The soft masks come in different styles and sizes so that you can find one to suit your own needs. The straps and masks also have different styles. There are other accessories available to make the machine easier to use, such as a humidifier.

M.S.L.T. (Multiple Sleep Latency Test)

This test is conducted during the day and usually follows immediately after a routine study. You get up at your usual time, but no later than 7:30 am, get dressed and have breakfast.

At around 9:00 - 9:30 am you lie down in a quiet dark room for twenty minutes to see whether or not you fall asleep. After twenty minutes you get up and read or do some work until the next nap which is at around 11:00 - 11:30 am. There are at least four naps finishing at around 3:30 pm.

During the test you are not allowed to have any caffeine as this will affect your sleep. This means no tea, coffee, or chocolate!

Actigraphy - the new technique applied in sleep medicine. Actigraphy is the use of instruments, sensitive to movement to record activity overtime. ACTIGRAPH is device use in actigraphy.  It is based on miniaturized acceleration sensor, that translates physical motion to a numeric representation.

Indications: Insomnia Restless Leg Syndrome (RLS) Periodic Limb Movement Disorder (PLM) Sleep in Psychiatric and Medical Condition Chronic Fatigue Syndrome Sleep Apnoea and Respiratory Disturbances Excessive Daytime Somnolence To monitor/evaluate effect of treatment

The actigraph is initialized using the specific software, required data about the patient is stored. The device is worn (around ankle/wrist).  He is asked to press the button on the actigraph when he lies in bed and on waking up.  The duration of recording can be from 24 hours – 5 days.

The actigraph is connected to a computer, data is downloaded, the software automatically analyses the movements, which are represented graphically. These movements are analysed into PLM/Isolated movements in leg up/down position.  The summary is reported based on PLM/hours in down position.

Caution: Actigraphy is useful as a complementary assessment method for Insomnia, RLS, shift work and for assessing sleep quality.