If you suffer from a sleep issue, it is essential that you’re knowledgeable about the types of sleep tests that are available and what each test accomplishes.

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1. Polysomnogram (PSG)

A polysomnogram is a test done if there’s suspicion of a sleep disorder and if there is hint of a diagnosis which should be defined.

What is a Polysomnogram test?

A Polysomnogram Test (PSG) is a diagnostic tool which determines if someone is dealing with a sleep disorder. This test is conducted overnight at a sleep lab, a sleep center or hospital.

This particular test monitors someone’s sleep cycles and stages. Identification of any disturbances caused by their sleep disorder is key to the success of the test.

Connections upon the person lead to monitoring:

• Brain activity
• Breathing activity
• Muscle activity

This collection of data can successfully lead to a definitive diagnosis.

Best Candidates for a Polysomnogram?

The best candidates for a PSG are those who might be dealing with a sleep disorder, like obstructive sleep apnea (OSA). This is a disorder when there are numerous reductions or blockages of airflow during sleep. There are indicators that someone might be suffering from OSA, such as:

• Snoring
• Lack of energy
• Morning headaches
• Frequent nocturnal urination
• Depression
• Excessive daytime sleepiness
• Nighttime gasping, choking or coughing
• Gastroesophageal reflux (acid reflux)
• Witnessed apneas

Diagnoses Result from a Polysomnogram

A polysomnogram diagnoses sleep disorders such as:

• Central sleep apnea, OSA, sleep-related hypoventilation disorders, and other sleep-related breathing disorders.
• REM behavior disorder, or other parasomnias (abnormal actions or behaviors while sleeping).
• Idiopathic hypersomnia, narcolepsy, and other hypersomnolence disorders.
• Non-24-hour sleep-wake syndrome, delayed sleep phase syndrome (DSPS), or advanced sleep phase syndrome and other circadian rhythm sleep-wake disorders.
• Bruxism, periodic limb movement disorder (PLMD), restless legs syndrome (RLS), and other sleep-related movement disorders.

2. Multiple Sleep Latency Test (MSLT)

MSLTs test the probability or lack of excessive daytime sleepiness. The primary measure is testing how fast someone falls asleep in a low or no sound environment in the daytime. This test also proved the existence of narcolepsy, and idiopathic hypersomnia.

Who is a Candidate for a Multiple Sleep Latency Test?

Good candidates for a MSLT are individuals who have excessive daytime sleepiness without reason, escpecially during waking hours or while driving or at work.

What is a Multiple Sleep Latency Test?

MSLTs are full-day tests with five scheduled naps, each two hours apart. Sensors are placed upon the candidate’s face, head, and chin to monitor their asleep and indicate REM sleep. The candidate lays in a bed quietly, attempting to go to sleep. The candidate’s first nap is two hours after the overnight sleep study. This test measures how long the candidate takes to fall asleep when the lights are doused.

The candidate should be made conscious after 15 minutes of sleep. During the test, if the candidate doesn’t fall asleep within 20 minutes, the nap attempt should end.

Diagnoses That Come from Multiple Sleep Latency Tests

A sleep physician uses MSLTs to diagnose narcolepsy (sudden sleeping) or idiopathic hypersomnia (sudden deep sleep making the sleeper someone who can’t be awakened, all without obvious causes(s)) in patients. The multiple sleep latency test is essential in patients with suspected narcolepsy.

3. CPAP Titration Test

Physicians in a sleep lab or hospital can prescribe a device called a CPAP (Continuous Positive Airway Pressure) to manage sleep-related breathing disorders. These disorders include:

• Obstructive sleep apnea
• Central sleep apnea
• Hypoventilation

Once the candidate is diagnosed, they are involved in a CPAP study before they can be provided with treatment.

What is CPAP Titration?

CPAP titration studies are arranged and completed overnight. In the lab, the candidate’s breathing is monitored and has the CPAP pressure adjusted to to prevent upper airway blockage during sleep.

The candidate is fit with a nasal mask that connects to tubing stemming from a small pressure generating device (i.e. PAP device).  During the CPAP titration, the following is monitored:

• Heart rate
• Oxygen levels
• Brain waves
• Arm and leg movements

The CPAP pressure will be changed remotely throughout the night. The CPAP starts at low levels of pressure, which change when events are seen.

A CPAP re-titration study may be needed previous symptoms like snoring, apnea, or daytime sleepiness reamerge during CPAP treatment. This procedure is intended to determine the correct pressure setting.

A board-certified sleep physician reviews the data afterwards and decides what CPAP treatment level works optimally for the patient.

4. Split Night Study

It combines both the polysomnography test and a CPAP Titration test, both done during the same night.

What is the goal of a Split Night Study?

Split-night studies performed to diagnose and immediately treat suspected OSA.

5. Maintenance of Wakefulness Test (MWT)

This test challenges candidates to remain awake through mutliple and variously planned periodic trials.

What is a Maintenance of Wakefulness Test?

This test takes the space of a full day inside a sleep clinic. This test measures wakefullness  for a specific amount of time while in a calm, quiet, and distraction-free environment.

Candidates undergo two to four (forty-minute length) trials througout the day while inside a low-light, comfortable and noise-free bedroom.

The first trial starts about two to three hours after the candidate’s wake-up time.

Trials are conducted two hours apart. And candidates are monitored between trials to assess readiness for the next trial, until the whole test is completed.

A Maintenance of Wakefulness Test (MWT) is Important Why?

• The MWT determines the effectiveness of CPAP therapy, medication, or other treatment therapies.
• The MWT measures a candidate’s ability to stay awake and qualify whether the inability to remain awake is challenged (i.e safety concerns, such as pilots or truck drivers).
• After a MWT, the data is sent to a sleep physician for review. The results determine changes to therapies, medications, etc.

Questions?

Call 1.877.430.2727 for help.

Edited by Bill Bistak B Sc.,SEO/SEM Spc, CRT

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