Herbie Murray
Sleep researchers use a variety of devices to monitor and study sleep patterns and disorders. Polysomnography, or PSG, is a common method that involves placing sensors on the body to track brain waves, eye movements, muscle activity, heart rhythm, and breathing. This technique is considered the gold standard in measuring sleep and is typically performed in a sleep lab. Other devices include actigraphy watches, which are worn on the wrist or ankle to track movements and sleep patterns, and consumer sleep-tracking devices, such as Fitbit, which have become popular for monitoring sleep. These devices provide insights into general sleep patterns and can help identify potential sleep disorders, but they have limitations and are not a replacement for professional medical evaluations.
| Characteristics | Values |
|---|---|
| Type | Polysomnography, Actigraphy, Sleep Trackers |
| Purpose | Monitor sleep disorders, diagnose and rule out conditions, track sleep patterns |
| Devices | Electroencephalography (EEG), Electro-oculography (EOG), Electromyogram (EMG), Electrocardiography (EKG or ECG), Pulse oximeter, Video and audio monitoring, Actigraphy watch, Thermistor, Pulse oximetry, Respiratory inductive plethysmography (RIP) belt, Thermocouple, Pressure transducer |
| Procedure | Sensors are attached to the patient's body to monitor brain waves, eye activity, muscle movement, heart activity, pulse, blood oxygen levels, etc. |
| Location | Sleep labs, patient's home |
| Accuracy | Polysomnography is considered the gold standard in measuring sleep |
| Limitations | Actigraphy is less costly than PSG but still expensive, sleep trackers are not FDA-approved for diagnosis and can worsen insomnia |
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What You'll Learn
Electroencephalography (EEG)
During a sleep study, patients may have several sensors attached to their bodies to monitor various body systems, including the brain, heart, and respiratory system. This is known as polysomnography (PSG) and is considered the gold standard in measuring sleep. EEG is a crucial component of PSG, providing insights into brain activity during sleep.
EEG sensors detect electrical activity in the brain, which is represented by brain waves. These sensors are coated with a sticky gel that helps them adhere to the patient's head. The gel is electrically conductive, facilitating the transmission of brain electrical signals to the sensors for recording.
The different types of brain waves detected by EEG sensors include delta, theta, alpha, and beta waves. Delta waves are associated with deep sleep, theta waves occur during the transition between wakefulness and sleep, alpha waves are present during relaxed wakefulness, and beta waves are linked to active thinking and concentration. By analyzing these brain waves, sleep researchers can identify abnormalities and diagnose sleep disorders.
In addition to EEG, other methods used in sleep studies include electrooculography (EOG) to monitor eye movements, electromyography (EMG) to measure muscle activity, and electrocardiography (EKG or ECG) to assess heart function. Together, these techniques provide a comprehensive understanding of an individual's sleep patterns and help identify any underlying sleep disorders or issues.
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Electro-oculography (EOG)
During an EOG test, adhesive sensors are placed on the skin around the participant's eyes. The sensors are placed 1 cm lateral to the left and right outer canthi, with one above the right outer canthus and one below the left outer canthus. These sensors detect and record eye movements, which can be used to determine the stage of sleep an individual is in. For example, rolling eye movements indicate the transition from wakefulness to light sleep, while rapid eye movements characterize REM sleep.
EOG is often used in conjunction with other techniques, such as electroencephalography (EEG) and electromyography (EMG), to collectively form polysomnography. Polysomnography is a comprehensive recording of the biophysiological changes that occur during sleep, including brain activity, eye movements, muscle activity, and heart rhythm. Sleep studies are typically conducted in a laboratory setting and are used to diagnose or rule out various sleep disorders, such as narcolepsy, periodic limb movement disorder, and sleep apnea.
EOG signals have a good signal-to-noise ratio due to their large amplitude and sensitivity in detecting saccades and blinks. However, they can be contaminated by physiological artifacts, such as electromyography (EMG) signals, which are detected when the participant moves their facial muscles or body during the recording.
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Electromyogram (EMG)
Electromyography (EMG) is a test that measures muscle response or electrical activity in response to a nerve's stimulation of the muscle. The test is used to help detect neuromuscular abnormalities. EMG and nerve conduction studies check how well muscles and nerves work together. These nerves control muscles by sending out electrical signals to make the muscles move. As the muscles react by contracting, they give off electrical activity, which can then be measured.
EMG tests look at the electrical signals muscles make when they are at rest and when they are in use. A healthy muscle should not give off any electrical signals when it is not being moved. If a muscle is damaged, it may show electrical activity while at rest or activity that is abnormal when in use. During an EMG test, small needles, also called electrodes, are inserted through the skin into the muscle. The electrical activity picked up by the electrodes is then displayed on an oscilloscope, a monitor that displays electrical activity in the form of waves. An audio amplifier is used so the activity can be heard. EMG measures the electrical activity of the muscle during rest, slight contraction, and forceful contraction.
During a sleep study, EMG sensors are attached to the skin, usually on the face and a leg, to track muscle movement. EMG tests may be performed on an outpatient basis or as part of a hospital stay. The EMG is performed by a neurologist, although a technologist may also perform some portions of the test. The EMG is usually performed immediately following a nerve conduction study.
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Electrocardiography (EKG or ECG)
Electrocardiography, also known as an electrocardiogram (EKG or ECG), is a simple, quick, and painless test used to evaluate the heart's health. It is a diagnostic procedure that measures how electricity is functioning in a person's heart. It can be used to identify issues with the heart's rhythm and internal electrical system.
During a sleep study, a person wears a single EKG sensor on their chest to pick up the electrical activity of their heart. This sensor is connected to an ECG machine by lead wires. The electrical activity of the heart is then measured, interpreted, and printed out. The test can show how fast the heart is beating, the rhythm of the heartbeats, and the timing of the electrical impulses as they move through the heart.
Healthcare professionals may use EKGs to check for heart attacks, including "silent" heart attacks that do not present with obvious symptoms. They can also be used to assess the overall health of the heart before procedures or after treatment for a heart attack or other conditions. An EKG can also be performed as part of a physical exam to get a baseline tracing of the heart's function, which can be compared with future ECGs.
An EKG is typically performed with the person lying flat on a table or bed. It is important to lie still and not talk during the test to ensure accurate results. If the person has hairy skin where the electrodes will be placed (chest, arms, or legs), the technician may shave or clip small patches of hair so that the electrodes will stick properly. Once the test is complete, the technician will remove the electrodes, and the person can usually resume their normal activities and diet.
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Wearable sleep trackers
Wearable sleep-tracking devices are becoming increasingly popular. These include wristbands, armbands, smartwatches, headbands, rings, and sensor clips. Many of these devices were originally designed as fitness trackers but now offer to measure several bio-signals such as heart rate, skin conductance, and temperature, in addition to motion.
These devices are easily accessible, user-friendly, novel, and affordable, which has led to their widespread use. They are also convenient for monitoring and analyzing sleep. They can be used to monitor sleep stages, respiratory rate, and other health factors. They can also be used to detect sleep apnea, although this is controversial, and it is recommended that they are not used as a replacement for professional treatment.
The American Academy of Sleep Medicine found that a third of Americans have used these electronic sleep-tracking devices. An example of a Multiple Sleep Latency Test is the use of an actigraphy watch to ensure that a patient does not arrive at the lab sleep-deprived, which would affect test results. Actigraphy can also be used to monitor the treatment of insufficient sleep syndrome and sleep disorders in children, although more research is needed.
Despite their popularity, there are questions over the validity, accuracy, and reliability of these devices in measuring the various sleep parameters and other indices that they report on, such as those reflecting cardiac function. They also require clarification and standardization for evaluating their accuracy and reliability.
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Frequently asked questions
Electroencephalography (EEG) sensors are used to monitor brain activity during sleep. These sensors have a sticky, electrically conductive gel coating that helps them stick to the head while they detect and record the electrical activity of the brain, known as brain waves.
An electromyogram (EMG) is used to monitor muscle movement during sleep. These sensors are attached to the skin, usually on the face and a leg, to track muscle movement.
Electro-oculography (EOG) is used to monitor eye activity during sleep. This involves placing adhesive sensors on the skin around the eye to detect eye activity.
