Colin Snow
Sleep apnea is a disorder that causes you to stop breathing while you sleep. This happens either due to a blockage in your airway (obstructive sleep apnea) or because your brain doesn't correctly control your breathing (central apnea). To diagnose sleep apnea, your doctor may ask you to take a sleep apnea test, also known as a polysomnogram (PSG), which can be done in a sleep disorder centre or at home. This test electronically records specific physical activities while you sleep, including your heart rate, breathing, blood oxygen levels, brain waves and more. The data is then analysed by a qualified sleep specialist to determine if you have sleep apnea or another type of sleep disorder.
| Characteristics | Values |
|---|---|
| Name of test | Polysomnogram (PSG) or sleep study |
| Where it can be done | Sleep disorder center or at home |
| What it does | Electronically sends and records specific physical activities while you sleep |
| Who analyses the data | Qualified sleep specialist |
| Preparation | No caffeine or alcohol the day of the test |
| What to bring | Comfortable pyjamas, a book or magazine, and a special pillow if you use one |
| Equipment used | Surface electrodes on face and scalp, belts around chest and abdomen, oximeter probe on finger |
| Other tests | EEG, EMG, EOG, EKG, nasal airflow sensor, snore microphone |
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What You'll Learn
Polysomnogram (PSG) or sleep study
A Polysomnogram (PSG) or sleep study is a multiple-component test that electronically sends and records specific physical activities while you sleep. The test is conducted to diagnose sleep disorders and can be done in a sleep disorder centre or at home.
During a PSG, surface electrodes are placed on your face and scalp to record electrical signals generated by your brain and muscle activity. These signals are then sent to the measuring equipment and recorded digitally. The test also involves placing belts around your chest and abdomen to measure your breathing, and a bandage-like oximeter probe on your finger to measure the oxygen in your blood.
A PSG can be used to identify the presence and extent of sleep disorders, as well as to help adjust and prescribe a treatment plan if necessary. It can monitor your sleep stages and cycles, brain waves, eye and leg movements, heart rate, breathing pattern, blood oxygen levels, body positioning and movement, and snoring.
If you are undergoing a PSG in a sleep centre or hospital, you will usually be asked to arrive in the evening so that the centre can record and monitor your nighttime sleep patterns. The room will be similar to a hotel room, dark and quiet, and you will not be sharing it with anyone. A polysomnography technologist will assist you throughout the study, and there will be a video camera and speaker system in the room so that the technologist can observe and communicate with you.
If you are undergoing a home PSG, you will need to set up the portable monitors before you go to sleep. You will need to pick up the equipment from the sleep centre or your doctor's office and be trained on how to use it. A home PSG does not involve brain wave monitoring and cannot diagnose central sleep apnea. It is usually recommended for people with no other complaints suggesting another sleep issue.
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Home Sleep Apnea Test (HSAT)
A Home Sleep Apnea Test (HSAT) is a diagnostic test used to diagnose obstructive sleep apnea (OSA). It is a convenient alternative to the traditional overnight in-laboratory polysomnography (PSG) test. OSA is a condition characterised by an upper airway obstruction that reduces inspiratory airflow during sleep or repeated episodes of apnea.
The HSAT is a limited-channel sleep test performed at home. It uses sensors to detect breathing patterns and monitor various parameters such as oxygen levels, pulse rate, peripheral arterial tonometry (PAT), and sleep-disordered breathing patterns. The sensors may include a small probe over the finger to measure oxygen levels, tubes inserted into the nostrils, and sensors placed on the abdomen and chest to measure movements.
The HSAT is a simplified breathing monitor that tracks breathing, oxygen levels, and breathing effort. It does not capture all the data of an overnight sleep study, which is more thorough and captures many more signals, including brainwaves, muscle tone, and leg movements. However, the HSAT is more convenient and cost-effective, and it can provide accurate results, especially when performed in the patient's usual surroundings.
The HSAT is not suitable for everyone. It is not recommended for patients with certain medical conditions, such as significant cardiorespiratory disease, neuromuscular conditions, or severe insomnia. In such cases, an in-lab sleep study supervised by a sleep technologist may be more appropriate.
The HSAT is a valuable tool for diagnosing OSA, especially in patients with a high risk of moderate to severe OSA and no other significant health conditions. It offers benefits such as lower costs, convenience, and the absence of supervision requirements. However, it also has the disadvantage of offering fewer measurable variables than a PSG, which could lead to potential misinterpretation of results.
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Electroencephalogram (EEG)
Electroencephalography (EEG) is a test that can be used to detect sleep apnea. It involves measuring electrical activity in the brain using electrodes placed on the scalp. These electrodes detect electrical signals generated by the brain and send them to a machine that records them. This test can be done at home or in a sleep lab.
EEG is used to detect sleep apnea because it can show changes in brain activity that occur during sleep apnea episodes. These changes can include slowing of the EEG, which is reflected in increased activity in the delta, theta, and alpha frequency ranges. This slowing of the EEG has been linked to greater levels of sleepiness and fatigue, as well as lapses in attention and vigilance failure.
EEG can also be used to measure brain activity during different stages of sleep, such as REM sleep and non-REM sleep. During REM sleep, the EEG exhibits low-voltage, fast-frequency activity similar to that seen during wakefulness. Non-REM sleep is characterised by K-complexes and sleep spindles in the N2 stage, and high-voltage slow-wave activity in the N3 or slow-wave sleep stage.
EEG can also be used to measure the effectiveness of treatments for sleep apnea, such as continuous positive airway pressure (CPAP). Studies have shown that CPAP treatment can partially reverse waking EEG abnormalities and improve daytime functioning.
Overall, EEG is a useful tool for detecting sleep apnea and understanding its effects on brain activity and function. It can also help evaluate the effectiveness of treatments for sleep apnea.
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Electrooculogram (EOG)
EOG specifically records eye movements during sleep, which are important in determining the different sleep stages, particularly REM stage sleep. Electrodes are placed above and to the outside of the right eye, and below and to the outside of the left eye. These electrodes record the movements of the eyes during sleep, helping to determine sleep stages.
EOG is useful in diagnosing sleep apnea as it can indicate the sleep-wake state of the patient. It can be used in conjunction with other tests, such as EEG (electroencephalogram) and EMG (electromyogram), to measure brain wave activity and muscle activity, respectively.
Sleep apnea is a disorder that causes a person to stop breathing while asleep. This is either due to a blockage of the airway (obstructive sleep apnea) or because the brain doesn't correctly control breathing (central apnea). Sleep apnea disrupts the sleep cycle and can lead to serious or deadly complications if left untreated.
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Electrocardiogram (EKG)
An electrocardiogram (EKG) is a test that can be used to detect sleep apnea. It is a non-invasive test that records the electrical activity of the heart. During an EKG, small electrodes are placed on the skin of the chest, and the electrical signals are recorded and analysed to detect any abnormalities in the heart's rhythm and rate.
EKGs are often used as a screening tool for sleep apnea, as they can help identify changes in heart rate and rhythm that may be indicative of the condition. Transient changes in heart rate associated with obstructive apneas, for example, can be detected by an EKG and used to screen for sleep apnea. This is because sleep apnea can put stress on the heart and have potentially deadly consequences. Therefore, an EKG can be a useful tool to assess a patient's heart health and sleep quality.
The advantage of using an EKG for sleep apnea screening is that it is simple, cost-effective, and less resource-intensive than other methods. It also does not require multiple sensors or an overnight stay in a laboratory, making it more accessible for patients. The data from an EKG can be automatically analysed, providing an estimate of the Apnea-Hypopnea Index (AHI) and specific information about the severity of sleep apnea.
However, it is important to note that an EKG may not always be sufficient for a definitive diagnosis of sleep apnea. In some cases, further testing, such as polysomnography, may be recommended to confirm the presence of sleep apnea and determine the best treatment options.
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Frequently asked questions
Sleep apnea is a disorder that causes you to stop breathing while you are asleep. This happens either because of a blockage of your airway (obstructive sleep apnea) or because your brain doesn't correctly control your breathing (central apnea).
The symptoms of sleep apnea include:
- Feeling tired or even exhausted when waking up
- Daytime sleepiness
- Snoring
- Mood changes
- Disruptions in brain function
- Waking up repeatedly in the middle of the night
- Unusual breathing patterns
- Night sweats and feeling restless at night
- Waking up feeling short of breath or like you're choking
- Headaches, especially when waking up
The most common tests for sleep apnea include an overnight sleep study (polysomnogram) and a home sleep apnea test.
During a sleep study, surface electrodes will be put on your face and scalp and will send recorded electrical signals to the measuring equipment. You will also have belts around your chest and abdomen to measure your breathing, and a bandage-like oximeter probe on your finger to measure the oxygen in your blood.
