December 12th, 2014 by sleepcureblog

  What is a Sleep Study?

Sleep study is an overnight observation of an individual’s sleep.  This involves monitoring number of physiological parameters simultaneously like  EEG (brain activity), the eye moments (EOG), the chin tone (EMG), breathing (nasal flow), breathing efforts, Oxygen level, heart rhythm (ECG).

Sleep is not a unitary phenomenon .It is divided into different stages like REM sleep (dreaming sleep) and Non REM sleep which is further subdivided into three stages.  The nature has made sleep like an orchestra with different notes at different points and diseases like Sleep Apnea disrupt this rhythm. This can be easily deciphered by a well conducted comprehensive sleep study.

What are different levels (types) of Sleep studies?

There are 4 types –

Level 1 study being the gold standard where are all the above mentioned parameters are observed and attended to by a well-trained sleep technologist  and the recordings are scored by scoring technologists and reviewed by Sleep physician who interprets the same and provides with the final diagnosis and recommendation. The Sleep Specialist then discusses the report and advises the next line of treatment.

Level II study is similar to level 1 but not attended by the sleep technologist  and therefore there is a possibility of potential loss of data.

Level III study involves monitoring  of just two parameters mainly the breathing  and the Oxygen level without monitoring the brain activity and the sleep.

Level IV study is only monitoring the Oxygen level overnight.

In most situations Level 1 study is required however sometime the Sleep physician may conduct a simpler test.

What are the different forms of Sleep Studies?

Diagnostic studies – In these only the diagnostic gear is used; this can be level 1 to level IV study.

Titration studies – which involve titration with CPAP or the BiPAP :this can be performed only in level 1 study setting .

Sleep studies are generally conducted in a split night format in which the first part of the night is the Diagnostic arm and in the later half Therapeutic part where titration with CPAP is done. Split night studies are only possible with the level 1 format where a trained sleep technologist will conduct this study under the guidance of a Sleep Specialist.


Sleep study is a very powerful monitoring tool which gives us opportunity to peep into one’s mind and health. It’s utility goes much beyond diagnosing simple Sleep Apnea and extends to diagnosing conditions like periodic limb movement, Sleep architecture problems, Parasomnias, Complex Sleep Apneas, Bruxism, loss of REM Atonia etc.

Eyes cannot see what our mind does not know” is old saying very apt for the field of Sleep Medicine in the region. Device companies in order to fuel the growth of devices are trivializing the sleep diagnostics pushing vendors to conduct sleep studies in a completely unregulated environment; the quality of these can put any regulator to shame. Nevertheless each patient need to be an empowered consumer and decide for themselves what is best for their health.

Who needs a sleep study:

People complaining of the following symptoms need to be screened for Sleep Apnea and may require a Sleep Study

  • Snoring
  • Episodes of choking in the night
  • Morning headaches
  • Unrefreshing /Disturbed Sleep
  • Abnormal movements during night
  • Excessive Daytime Sleepiness.
  • Patients with comorbid conditions like Diabetes, heart failure, depression, fibromyalgia, atrial fibrillation, obesity

Author: Dr Himanshu Garg

Posted in Patient Information Tagged with: , , , , , , , , , , ,

October 11th, 2014 by sleepcureblog

“Think of this as a prearranged  marriage arranged by people who best understand your interest and once you decide to sleep together the relationship is for lifetime. Going ahead you may not like few things about your new partner but mostly it will be fine’ is the mantra given to me by guru about using CPAP, something I try to tell all my patients. If you have been prescribed to “sleep with the CPAP”, before you embark on this journey few things you should be sure about;

  • Who has prescribed you the CPAP; is the person a qualified sleep physician who has personally looked at your sleep study raw data to make that judgment. Unfortunately this is often not the case in the subcontinent where HME providers in order to push the sales are doing sleep tests and giving out invalidated reports. As an empowered patient you should understand what’s in your best interest.
  •  Do you understand the need of CPAP– like any chronic disease management you need to have insight about the disease, the implications of non-treatment and mechanism of action of the therapy?  This is a critical part of your physician’s job which impacts the success of the therapy.
  • Have you had a successful CPAP titration study; this helps the physician understand your pressure requirements and which machine shall best suit you. Different physicians/sleep services will use different pathways in lab/at home for doing this. This is followed by few days of trail of CPAP so that you can become accustomed to using this every night.
  •  Are you satisfied by your mask– Most Titration studies and /or CPAP trials shall give you the opportunity to try a few of these to see with which you are most comfortable. The step is the key to success of this therapy.
  • Do you understand how to operate the CPAP-it’s important for you to understand some of the basic operations; most HME suppliers will be happy to demonstrate the same for you.
  • Have you considered the need of accessories– most important being that of a humidifier; many machines come with inbuilt humidifiers with others it can be easily added. The other accessory to think about is the battery backup especially in the subcontinent where electricity is often erratic.
  • Have you been explained about other potential problems– these could be eye problems because of leak, nasal bridge ulceration due to pressure, aerophagia etc.
  • Do you have a follow up plan– No prescription is complete one; you must work one out with your physician.
Sleeping With CPAP - A Prearranged marriage

Sleeping With CPAP – A Prearranged marriage

One you have ensured all of the above  you are ready to SLEEP WITH THE CPAP TO A WHOLE NEW TRANSFORMED LIFE!!

Posted in CPAP Tagged with: , , , , , , ,

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