In our Sleep Laboratory unit, medical services are provided for the diagnosis and treatment of sleep disorders.
Services Provided and Tests Performed in Our Sleep Laboratory Unit
For which complaints are patients admitted to our hospital a sleep test?
The most common test in sleep laboratories is the sleep-apnea test. Those who have a story of snoring at night, waking up by suffocation, having frequent nightmares, “while snoring suddenly he/she stopped breathing, I woke him/her up with fear” (witnessed apnea), waking up without sleep and having a headache all day long, reading the newspaper, watching TV, watching the theater and cinema Those who fall asleep after a meal, while talking to someone, and most dangerously, sometimes at the wheel of traffic, in places like this, fall asleep (Epworth sleepiness scale) are tested.
Also in our laboratory;
For “Restless Leg Syndrome”, for those who feel restless in bed and need to move their legs in bed and close to bedtime, and therefore cannot sleep, or who feel the same uneasiness when they wake up again and get rid of this complaint by walking and moving their legs,
For Narcolepsy (Multiple Sleep Latency Test) characterized by excessive sleepiness, hallucinations before falling asleep and waking up and sudden loss of muscle strength, night grinding of teeth (bruxism), sleep walking and sleep terror (Arousal Disorders), those who cannot sleep enough (Insomnia) can also be tested to examine sleep architecture.
Why should I have my sleep test done in centers with a certified doctor?
Immediately after the test is done, the result can be obtained by scoring automatically from the computer. However, it has been found that automatic scoring is not always reliable. For this reason, it is recommended that the data of the sleep test results performed all over the world during the night are read by a knowledgeable sleep laboratory physician (Pthoracic Diseases Specialist in our hospital) and the report is given to the patient after making corrections.
What Causes Snoring and Breathlessness During Sleep?
Normally, the muscles surrounding the upper respiratory tract (throat and larynx) relax during sleep, but this relaxation does not cause a narrowing in the upper respiratory tract that prevents air in and out during breathing. If the relaxation in these muscles is too much and/or if structures such as the uvula and tongue root in the upper respiratory tract are larger than normal, or if the lower jaw bone is behind in the facial structure (retrognathia) or the neck diameter is large (loaded neck), the patient is overweight, there is a significant narrowing and a snoring sound occurs with the vibration of the air entering and exiting during breathing. Sometimes, the existing stenosis results in complete or partial obstruction (apnea and hypopnea) and the patient’s breathing stops.
In addition, respiratory arrests may occur as a result of the respiratory order from the brain to the respiratory muscles, which we call “Central Apnea”, which is rarer.
How Are Tests Performed?
In rooms where the patient can sleep comfortably and feel comfortable, sleep technicians will apply electrodes (skin contact receptors) to certain areas of the patient’s head before sleep (EEG: to see the brain waves), around the eyes (EOG: to see eye movements), to the chin (EMG: to see muscle movements), to the leg (for assessing leg movements during sleep), to the chest (to see the heart rhythm), finger (for monitoring oxygen level during sleep), and on various parts of the body (to see the lying position), chest and abdominal band (to evaluate respiratory muscle movements), and a cannula (to measure airflow while breathing in) in the nose. The placed electrodes do not cause pain and do not disturb the normal sleep pattern. While the patient sleeps in his/her room during the test, he/she is followed in the scan room by the sleep technician. There is an audio and video connection that will enable the patient to communicate between the two rooms when needed.
What should I do and what should I not do before undergoing the test?
The patient comes with his/her pajamas and personal belongings he/she wants. On the day of the test, one should not sleep during the day, consume excessive coffee, should not come hungry, should not eat heavy meals, and should have eaten dinner (main meal) at least 3 hours before. The patient should use the drugs he/she uses routinely during the day. (Except sleeping pills-sedative drugs) In addition, if there is a diuretic drug, it is recommended to take it during the daytime, not in the evening. Taking a shower before coming to the test may help the patient sleep more comfortably. (In our room where the Sleep Test will be conducted, there is a shower and toilet where you can take a shower.)
How is the Test Evaluated?
Dialogue and communication between the sleep technician and the sleep laboratory physician (Pthoracic Diseases Specialist in our hospital) is very important in the evaluation of the test. The data recorded on the computer during the night is delivered to the Sleep Laboratory physician by the sleep technician in the morning, together with the necessary information about the patient. The test, which is transformed into electrical waves through the electrodes, is displayed and evaluated on the computer for approximately 7-8 hours (the minimum effective sleepiness should be 6 hours) by the Laboratory Physician. In the test, data such as how often the patient stops breathing at night, in which position and in what stage of sleep this breathing pause is experienced, how the sleep architecture, oxygen level and heart rhythm are affected by these breathing stops, whether the breathing stops during sleep are due to upper airway narrowing or the result of not receiving the respiratory order from the brain are evaluated and the patient’s report is prepared accordingly.
According to the sleep test; Patients with Severe Obstructive Sleep Apnea (breathing stops frequently during sleep) are treated with special machines such as CPAP or BIPAP that can provide upper airway patency; The type of treatment is decided by reviewing the examination findings of patients with Simple Snoring, Mild and Moderate Obstructive Sleep Apnea and patients with Central Sleep Apnea; A dietitian, otolaryngologist or neurologist may be consulted, or in some cases, CPAP treatment may be considered appropriate.
Patients who need to be treated with machines such as CPAP (device giving constant compressed air during breathing) or BIPAP (device giving different compressed air while breathing in and out) are hospitalized for one more night in the sleep laboratory, by seeing which pressure can prevent breathing stops, and by making the right pressure settings, the machine is provided.