Tests Performed

• Diagnostic sleep study performed in the clinic (Attended polysomnogram)
• Diagnostic/therapeutic sleep study performed in the clinic (Split-night study)
• Therapeutic sleep study performed in the clinic (CPAP Titration)
• Mean Sleep Latency Test (MSLT) or Maintenance of Wakefulness Tests (MWT)
• Testing At Home

Diagnostic sleep study performed in the clinic (Attended polysomnogram)

For a diagnostic sleep study done in the clinic, you will spend the night in a private room in the clinic. You will be asked to arrive at either 8 PM or 9 PM on the night of your test. The technician will tape dime-sized sensors to your scalp, face, neck, chest, and legs to check your brain, heart, lungs, and muscle movements. Small plastic prongs are placed at the opening of your nose and mouth measure the rate at which air enters and leaves your lungs. Elastic bands are placed around your chest and abdomen to measure the effort with which you breathe. A device is clipped to one of your fingers to record the oxygen level in your blood.

Occasionally, esophageal pressure recording (Pes), a very sensitive means of determining increased resistance in your upper airway, will be ordered by your physician. Pes recording involves the technician's inserting a small (infant-sized) feeding tube containing an esophageal pressure sensor in one of your nostrils and you will be asked to swallow the tube while sipping water through a straw until the proper length of the tubing is inserted.

A technician watches you on monitors the whole night and makes sure the equipment is working. If you awaken at night and want to go to the bathroom, you will use a call button and the technician will disconnect you from the jack box, so you can go to the bathroom. Afterwards, the technician will reconnect you to the jack box and continue the recording. The recording usually ends at 6 AM, at which time the technician will awaken you and take off your sensors.

Although it is scheduled as a diagnostic study, if you have severe sleep apnea during the night, the technician may provide a device called CPAP (see description below) to try to keep your air passage open and help you breathe.
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Diagnostic/therapeutic sleep study performed in the clinic (Split-night study)

You will be asked to arrive at either 8 PM or 9 PM on the night of your test. The technician will tape dime-sized sensors to your scalp, face, neck, chest, and legs to check your brain, heart, lungs, and muscle movements. Small plastic prongs placed at the opening of your nose and mouth measure the rate at which air enters and leaves your lungs. Elastic bands are placed around your chest and abdomen to measure the effort with which you breathe. A device is clipped to one of your fingers to record the oxygen level in your blood. A technician watches you on monitors the whole night and makes sure the equipment is working. After 3 hours of recording sleep, the technician will put you on CPAP, a device to try to keep your air passage open and help you breathe. The recording will continue through the rest of the night while on CPAP to try to find the appropriate pressure to open your air passage. The recording usually ends at 6 AM and the technician will awaken you and take off your sensors. After your study has been interpreted, if your therapeutic portion (time on CPAP) is not sufficient time to adjust your pressures, our sleep physician, Dr. Abad, may recommend that you undergo a separate full night therapeutic sleep study (CPAP titration).
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Therapeutic sleep study performed in the clinic (CPAP Titration)

You will be asked to arrive at either 8 PM or 9 PM on the night of your test. The technician will tape sensors to your scalp, face, neck, chest, abdomen, finger, and legs to check your brain, heart, lungs, muscle movements, airflow from your nose and mouth, and your blood's oxygen level. In addition, you will be placed on CPAP, a device that will try to keep your air passage open and help you breathe. During the entire night, the technician will monitor your recording and adjust the pressure settings of the CPAP machine to determine your optimal pressure. The recording usually ends at 6 AM and the technician will awaken you and take off your sensors.
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Mean Sleep Latency Test (MSLT) or Maintenance of Wakefulness Tests (MWT)

These are diagnostic day studies done in the clinic to provide an objective measure of sleepiness.

The MSLT is done the next day after an overnight sleep study (either diagnostic or on CPAP). The MWT may be done without an overnight sleep study.

For both tests you will have sensors on your scalp, your face, your legs, your chest and finger to monitor your brain, muscles, heart, and oxygen level.

Both tests involve 4-5 naps conducted every 2 hours during the testing day. The technician will give you specific instructions before and during each nap session.

It is important that you maximize your nocturnal sleep the week before the test (MSLT or MWT) and avoid sleep deprivation. Certain medications may affect the results of the test (for example antidepressants, stimulants, and sleeping medications). In general, these medications need to be discontinued 2 weeks before the test. However, please consult your referring physician before discontinuing any of these drugs.

A urine drug screen is conducted as part of the MSLT to validate test results
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Testing At Home

1. Unattended diagnostic polysomnogram

This is a diagnostic study that is performed at your home. An appointment will be made for you with the sleep technician at the Sleep Clinic, who will demonstrate how to attach and detach sensors that record your body position, leg movements, airflow through your nose and mouth, and heart rhythm and how to complete the questionnaires. You will bring back the equipment and the completed questionnaire on the next business day.

2. Unattended CPAP titration

This is a therapeutic study which involves one week of getting used to the CPAP machine. An appointment will be made for you with the Sleep technician at the Sleep Clinic, who will fit you with a mask and demonstrate how to use the CPAP equipment and how to complete the questionnaire. You will use the CPAP equipment by itself for 6 nights. On the 7th night, in addition to using the CPAP machine, you will attach sensors to yourself just like with your diagnostic study. This will help us determine whether the CPAP pressures being delivered are adequate to treat your breathing disorder. You will return the equipment on the next business day after completing your CPAP treatment and overnight recording.
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