Wednesday, August 4, 2021

How To Survive A Sleep Study

 From the website of the Sleep Foundation we learn:

A sleep study is a non-invasive, overnight exam that allows doctors to monitor you while you sleep to see what’s happening in your brain and body. For this test, you will go to a sleep lab that is set up for overnight stays—usually in a hospital or sleep center. While you sleep, an EEG monitors your sleep stages and the cycles of REM and nonREM or NREM sleep you go through during the night, to identify possible disruptions in the pattern of your sleep. A sleep study will also measure things such as eye movements, oxygen levels in your blood (through a sensor—there are no needles involved), heart and breathing rates, snoring, and body movements.

Sleep studies are used to diagnose many sleep disorders, including:

From the same site we learn there are a number of different versions of sleep study, e.g.: Polysomnography, Multiple Sleep Latency text, and CPAP Titration.  The test I had Monday night is the first and described thus:

In polysomnography, a sleep technician monitors a patient who stays overnight at a specialized clinic. A variety of functions1 are measured throughout the night, including eye movements, brain and muscle activity, respiratory effort and airflow, blood oxygen levels, body positioning and movements, snoring, and heart rate .

The test was prescribed over a month ago after pulmonary fibrosis had been tentatively diagnosed by a pulmonologist who suspected the condition adversely affected my sleep. (A   CT scan pointed to a different condition, bronciectasis, but I still have sleep issues).

Anyway I reported to the Penrose- St Francis Sleep Disorder Center at 7:15 Monday night, to spend a night in a sleep lab - wired up - and monitored throughout.   The "lab" is actually a very comfortable hotel-style room featuring a queen-size bed, wall TV, private bathroom and plenty of drawer space.   But you can't be lulled into thinking this is just a night for lollygagging and watching the tube. Doesn't work like that.

So after arrival, I spent at least 20 minutes filling out a spate of forms, then I got to kick back and relax (I chose to read the new book by Carol Leonnig and Philip Rucker,  I Alone Can Fix It,  )  At around 8:20 the tech, 'Kosh' came in to wire me up.   This took around 50 minutes given there were like a hundred electrodes and wires which had to be attached to the scalp, legs, abdomen, neck, chest.   The time for this passed nicely given that Kosh was highly intelligent and academically inclined - interested in quantum physics and math as well- so we talked easily as he connected one electrode after the other.  By just after 9:00 I was all hooked up and my head felt like it had a bird nest on top of it what with all the wires hanging off which then needed to be fitted into a portable panel, with the other wires. (The portable panel allowed one to use the rest room at night without having to detach all the wires.)

Why the need for all the  wires and electrodes?   According to the Sleep Lab Info sheet, these were needed to monitor:  brain waves (EEG),  respiratory flow and effort, oxygen levels, muscle tone, leg movements, snoring, heart rate (EKG), and eye movements.

 Mindful of all this, by 9:10 I slid carefully into the bed, taking care not to jolt the wires loose. Kosh, meanwhile, went into the control room where he did a number of baseline tests.  These included having me move eyes up and down, side to side,  blink, then cough, then breathe deeply and hold breath for ten seconds, then cough again etc.   By this time, many people would be getting freaked out, and Janice told me when she had her own sleep test done a few years earlier, all the wires, electrodes etc. proved just too much.  She ended up failing the sleep test after being unable to get a wink - and that was all night - at least 8 hours.  (You need to get at least  6 hours to pass it).

Anyway, unlike Janice, I had the good fortune of being able to take a low dose Ambien, and this helped me to get to sleep and stay asleep until 2:15 a.m. when Kosh came in to attach an oxygen delivery tank to allow O2 to flow into my nose tubes.  (Perhaps the most annoying contrivances to me)

By 5:30 I was wide awake, so Kosh arrived to disconnect the 'ton' of wires and electrodes.  With the 'electrode fastening' paste still in my hair it was a no brainer to get a quick shower  after which I caught an Uber and came home to a splendid home-cooked breakfast of English muffins, bacon & scrambled eggs.  Janice asked how I got through and I replied that I "passed" with 6 hours total sleep.  She was impressed.

How to survive  a sleep test in a sleep lab?  I'd say the key is to detach and look at the experience as being part of a scientific experiment.  In this frame of mind it's easier to accept being hooked up with endless electrodes and wires like a human guinea pig (not to say you won't feel like one at some point!).  'Surviving' means not freaking out and suddenly calling it quits, demanding to be unplugged and then bolting out at 2 in the morning.  It means instead remaining for the full duration, whatever the final result. If you fail and have to repeat the test, so be it.  You do better next time.  

As for me, I will find out the full verdict tomorrow after seeing the pulmonologist again.  Also, whether I will be stuck having to wear one of those damned CPAP masks or not.

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