What happens during a sleep study??

Those who have participated in a sleep study know that many devices are used but may not be sure what these things do. 

This article details all of the machines and devices used on a person during a sleep study.

Breaking a complex test down in to parts makes it understandable.

JR

Have you ever had a sleep study done?

Perhaps you or a loved one has been referred to a sleep clinic for insomnia, apnea, narcolepsy, or restless legs syndrome. Maybe you've participated in a sleep research study.

The hallmark of getting a sleep study done is—well, looking something like this: 

Looks rather scary, right? Fear not—each component has a very simple purpose.

The snore mic is the first piece of equipment I'll put on a participant. It's simply a sensor I tape over the hollow of the participant's throat that lets us know whether they're snoring. This is interesting to note, especially for what our laboratory studies, because snoring may indicate obstructive sleep apnea—cessation of breathing due to some sort of blockage.

Next, I'll apply two sticky pads attached to wires (one on the chest and one on the lower rib). These electrodes are used in electrocardiography (EKG), allowing us to monitor heart rate and rhythm.

I'll then place two sticky electrodes on the shins, which will detect leg movement. In research studies, this helps us determine whether the participant wakes and moves around in the middle of the night (an "arousal"); in the clinic, uncontrollable leg movements may be indicative of restless legs syndrome (RLS).

Two Velcro straps, called strain gauges, are then placed snuggly around the chest and abdomen. These monitor the rise and fall of the torso while breathing.

Then comes the fun part: head electrodes! The principle behind electroencephalography(EEG) is to measure the brain's "electrical activity"—a simple way of describing voltage fluctuations caused by ion flow in the brain's nerve cells (neurons).

To create a tight seal and promote conductance, I'll first rub the scalp with an abrasive lotion, then scoop wax onto each electrode before placing them in precise locations. I'll then cover the head in gauze to keep everything in place during sleep.

Using many electrodes means we can study electrical activity from different parts of the brain. Since each brain region shows us characteristic wave patterns, we know what stage of sleep the participant is experiencing; we even know when they're dreaming! (But don't worry—we don't know what they're dreaming about—nor do we particularly want to!)

I'll then place a nasal cannula in the participant's nose to measure airflow from both the nose and mouth. Studying one's breathing using both the cannula and strain gauges is very important; if we see that the participant's torso is rising and falling but there is no nasal airflow, this may indicate obstructive sleep apnea.

Lastly, I place an oximeter on the participant's finger just before they go to bed. This device uses infrared light to measure the level of oxygen in the blood. "Normal" levels are between 95-99% saturation; anything lower may indicate breathing abnormalities.

Wires from all sensors and electrodes plug into a small headbox linked to an amplifier, which is connected to the computer. (Fear not—if you have to go to the bathroom in the middle of the night, we can simply unplug the headbox and you can trudge your way to the bathroom, looking like a mix between a mummy and Medusa.)

Oh, and one last thing—like Santa Claus, “we see you when you’re sleeping, we know when you’re awake…” There’s a camera on you all night, so we know when you pull out that pesky cannula…and we’ll wake you up to fix it!

Read more here

Sleep Apnea May Be Tied to 'Silent' Strokes, Study Finds

Other research also suggests rapid memory loss may be linked to a fatal brain attack

URL of this page: http://www.nlm.nih.gov/medlineplus/news/fullstory_121447.html (*this news item will not be available after 05/01/2012)

Wednesday, February 1, 2012

WEDNESDAY, Feb. 1 (HealthDay News) -- Sleep apnea, the disorder marked by abnormal pauses in breathing during sleep, is already known to boost the risk of stroke. Now, a new study links sleep apnea to so-called silent strokes, in which there is tissue death in the brain without symptoms.

In another new study, researchers found that rapid memory loss before a stroke boosts the risk of the stroke being fatal.

Both studies are slated for presentation Wednesday at the American Stroke Association's International Stroke Conference in New Orleans.

Stroke affects 795,000 Americans annually, according to the association.

In one study, Dr. Jessica Kepplinger, a fellow at the University of Technology in Dresden, Germany, and her colleagues evaluated 56 patients who had a stroke. They knew that silent strokes had been linked to an increased risk of strokes. However, "there are barely any studies that have investigated the relationship between sleep apnea and the so-called clinically silent strokes," she said.

To look at the relationship, they first gave patients in-hospital testing for apnea. "We found an overall high frequency of sleep apnea, 91 percent, in our study population of acute stroke patients, which underlines the importance of this stroke risk factor," Kepplinger said.

The team also performed brain-imaging studies. Those with sleep apnea were more likely to have the silent strokes, as evidenced on the brain scans, the researchers found. Having more than five episodes a night was linked with having silent strokes. The higher the severity of the apnea, the more likely these silent strokes were found on brain imaging.

The more severe the apnea, the less favorable the outcome when the patient was discharged.

The patients were on average 67 years old, and just over half of them were women, the study authors noted.

While the study found an association between sleep apnea and stroke, it did not prove a cause-and-effect relationship.

In the second study, Qianyi Wang, a graduate student at the Harvard University School of Public Health, and colleagues evaluated nearly 12,000 men and women, all above age 50, enrolled in the U.S. Health and Retirement Study.

All were stroke-free at the start. The men and women were given memory tests every two years for up to 10 years.

Over time, 1,820 strokes were reported, including 364 people who died after the stroke.

The others were stroke-free for the entire follow-up period, the study authors noted.

The research looked at the memory declines over time. Those who later survived a stroke "had memory decline that is nearly twice as fast as stroke-free individuals, even before their stroke," Wang said.

"For people who do not survive stroke, this difference is even more striking," said M. Maria Glymour, an assistant professor of society, human development and health at Harvard and a study co-author. "Prior to stroke, people who later died shortly after stroke were declining three times as fast as the stroke-free."

The study was funded by the U.S. National Institute on Aging and the American Heart Association.

"Our study is the first national picture of how memory changes over the long-term before and after stroke onset, compared to individuals who do not have a stroke," Glymour said.

Both studies provide some valuable information, said Dr. Ralph Sacco, chair of neurology at the University of Miami Miller School of Medicine and past president of the American Heart Association. He reviewed the findings.

"It's been mainly in smaller studies that sleep apnea has been shown to be a risk factor for stroke," Sacco said. The new research, he noted, goes even further by linking sleep apnea with the milder "silent" strokes.

"There are many reasons to treat sleep apnea, including reducing the risk for clinical and now silent stroke," Sacco said.

The memory-loss study, he said, "is telling us that those who have the worst memory loss may have a greater death rate when they have the stroke." Those with more memory loss in the study may also have had more risk factors for stroke, Sacco added.

Even so, he said, the message seems to be that taking care of brain health may help us in several ways. "What is good for our memory may also be good for surviving a stroke," Sacco said.

Because these studies were presented at a medical meeting, the data and conclusions should be viewed as preliminary until published in a peer-reviewed journal.

Article Here

SOURCES: Jessica Kepplinger, fellow, University of Technology Dresden, Germany; Ralph Sacco, M.D., chair of neurology, University of Miami Miller School of Medicine; M. Maria Glymour, S.D., assistant professor of society, human development and health, Harvard School of Public Health; Qianyi Wang, graduate student, Harvard School of Public Health; Feb. 1, 2012, presentations, International Stroke Conference, New Orleans

HealthDay

Copyright (c) 2012 HealthDay. All rights reserved.

Related MedlinePlus Pages

• Sleep Apnea
• Stroke

Page last updated on 02 February 2012

How To Beat Sleep Apnea? Cut It Out (Surgically)
by Patti Neighmond
March 14, 2011

At 32, it just didn't make sense that Daniel Sheiner was exhausted literally from the moment he woke up. "It didn't get any better over the course of the day, and I knew that was not normal," Sheiner says.

Sheiner is a software designer and programmer. His job suffered as a result of his fatigue.

"I would miss conversations," Sheiner says. "I would ask a question that had already been answered."

Sheiner suspected he had sleep apnea because it ran in his family. But he was not overweight, which is the biggest risk factor for the disorder — some 60 to 90 percent of patients diagnosed with apnea have a body mass index, or BMI, over 28.

A sleep study confirmed Sheiner had one of the worst cases of apnea his doctors had ever seen. After trying a number of different treatments, his doctors finally tried a surgery using robots to treat his stubborn apnea — with positive results.

Read or listen to the rest of the article here.

Say Aaa! Then Zzz: Tonsillectomy Helps Kids Sleep
by Nancy Shute


March 14, 2011 Getting your tonsils out used to be just part of childhood — a rite of passage for children in the 1950s and 1960s. Then it fell out of favor.

But tonsillectomy is back.

Today, the most common reason for the surgery is "sleep disordered breathing," a broad diagnosis that includes sleep apnea and snoring. About 10 percent of elementary-school-age children snore.

Doctors say snoring can cause bed-wetting, behavior problems, short stature and poor school performance. That's a far cry from the 1950s and 1960s, when tonsillectomy was used to fight frequent sore throats.

Read the rest of the article or listen to the story here.

Kids urged to study less, sleep more
March 10, 2011 - 12:25PM

Stressed ... new documentary questions the value of pushing kids too hard.

Maybe kids don't have to take several extra-curricular classes, do hours of homework every night, excel at a sport or two, join a bunch of clubs - and then, of course, get into a top university - to be successful.

Maybe parents and teachers can let students discover what they enjoy and do well, then have them pursue that, instead of joining a bunch of activities just because they think it will look good on their college applications.

Across the nation, parents, teachers and kids may be ready to embrace the idea that kids can take many paths to success - if the popularity of the US education documentary Race to Nowhere is any indication.

Advertisement: Story continues below "There's a perception that there is a magical path, and there really isn't," said Laurie Lam, a mother of two in Thousand Oaks, California, where the film has been shown several times. "Competition is healthy, and hard work is healthy. But we need to think about how we do it."

In the documentary, several students talk about how miserable the pressure to succeed is making them. They talk about headaches, eating disorders, cheating, even suicide. Parents, too, talk about the stress that homework and over-scheduling puts on families.

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Don't Lose Sleep Over Daylight Savings Time

Chicago - It’s once again time to “spring forward” and change the clocks as Daylight Savings time takes place at 2 a.m. central standard time on Sunday, March 13. While the lost hour of sleep may cause some people to feel sluggish on Sunday and Monday, most will quickly adjust. Unfortunately, for a significant number of Americans, losing just one hour of sleep and having to wake up when the timing of your biological clock has not yet adjusted can affect performance and safety.
“Sleep problems are widespread and on the rise, yet many people dismiss the issue and don’t realize the consequences that can result,” said Northwestern Medicine neurologist Hrayr Attarian, MD. “Even one hour of lost sleep can take a toll on one’s health and many individuals experience grogginess, difficulty focusing, irritability and more seriously, drowsy driving. Statistically in the days following Daylight Savings there are more car accidents due to the lack of alertness.”

Read the rest of the article here.

It's National Sleep Awareness Week!
By: Michele R. Berman, MD March 08, 2011

National Sleep Awareness Week®, which takes place March 7-13, 2011, is an annual public education and awareness campaign to promote the importance of sleep sponsored by the National Sleep Foundation. The week begins with the announcement of the Foundation’s Sleep in America Poll results and ends with the clock change to Daylight Saving Time, where Americans lose one hour of sleep.

This week we will run a series of articles on our parent site, Celebrity Diagnosis, revealing the results of the Sleep Foundation’s poll results, along with information about sleep and sleep disorders from the National Institute of Neurological Disorders and Stroke (NINDS).

The Scope of the Problem
•Some 70 million people in the United States have a sleep problem. About 40 million adults suffer from a chronic sleep disorder; an additional 20 – 30 million have intermittent sleep-related problems.
•Effects of sleep loss on work performance may be costing U.S. employers some $18 billion in lost productivity.
•America’s adults average 6.9 hours of sleep each night, slightly less than the range of seven to nine hours recommended by many sleep experts.
•Three-quarters of America’s adults, (75%), said they frequently experience at least one symptom of a sleep problem in the past year.

Read the rest of the article here.

Waiting to Exhale (and Inhale) Treatment for sleep apnea can save lives— as well as some marriages
Symptoms of sleep apnea
By Dr. Cynthia Paulis

If you wake up in the morning exhausted and find yourself drowsy, unable to concentrate and irritable during the day, you may be experiencing sleep apnea.

Sleep apnea occurs when a person's breathing is interrupted during sleep. The word apnea comes from the Greek language and literally means "without breath." People with sleep apnea stop breathing repeatedly during their sleep, sometimes hundreds of times during the night and often for a minute or longer.

Read the full article here.

Sleep Tight: Three Ways To Get Better Sleep Now
Posted 1 hour ago by Allison Kade




We spend roughly 30 years of our lives sleeping, which means we could have spent all that time traveling, building empires, or eating watermelon.

For the overachievers whose immediate instinct upon hearing that is to cut back on their sleep so they can start on some of the foregoing activites, we promise you: This time is all very well spent.

It’s National Sleep Awareness Week, and here’s why good sleep is so important:

It improves our memory (our brain doesn’t shut down during sleep but rather goes into overdrive, like a computer sorting through its memory).
It has the potential to double our problem-solving skills.
It increases our ability to empathize with others.
It heightens our sex drive.
It’s associated with a higher IQ in kids.

Read the rest of the article here.

STUDY: Sleep Deprivation Makes You Super Optimistic
Courtney Comstock Mar. 9, 2011, 9:38 AM

Sleep deprivation makes you... optimistic?

We're not sure what to make of the latest study done on the effects of sleep deprivation on the minds of gamblers, but here's what it concludes, according to the Daily Mail:

Sleep deprivation encourages the sleepless to concentrate on ‘positive outcomes’ in any situation.
Brain scans showed lack of sleep increased activity in parts of the brain that deal with ‘positive outcomes’, but reduced activity in regions that handle negative results.
It could explain why traders and late-night gamblers make reckless decisions.
Of course, take the research with a dose of skepticism. An earlier study concluded that dopamine-driven traders were borderline psychopaths.

Read the rest of the article here.

Sleep-deprived Americans nap in some strange places, survey says
By Diane Mapes

We nap in restaurants, at the movies, in doctors’ offices and even in church. David Wayne, a 50-year-old telecommunications manager from Seattle, says he’s even seen a coworker nod off in the middle of a customer call.

“We had a recognition program which included a ‘Way to go!’ note that you could fill out and give someone for going above and beyond,” he says. “I gave him one that said, ‘Way to go … to sleep.’”

But Wayne’s log-sawing coworker is hardly the first person to nap in an inappropriate place. According to a recent (if somewhat silly) survey by Tempur-Pedic, more than half of the 1,000 people surveyed admitted they’d accidentally fallen asleep in some strange spot, including 12 percent who ponied up to sleeping at their desk or computer at work and 11 percent who confessed they’d dozed off in church.

Read the rest of the article here.

Dangers of sleep deprivation

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Why naps make you smarter

A good night's sleep is crucial to storing knowledge learned earlier in the day — that much was known. Now, a new study finds that getting shut-eye before you learn is important, too.

Volunteers who took a 100-minute nap before launching into an evening memorization task scored an average of 20 percentage points higher on the memory test compared with people who did the memorization without snoozing first.

"It really seems to be the first evidence that we're aware of that indicates a proactive benefit of sleep," study co-author Matthew Walker, a professor of psychology and neuroscience at the University of California, Berkeley, told LiveScience.

Read the rest of the article here.

Tips for getting your ZZZZs
Published : Tuesday, 08 Mar 2011, 8:32 AM EST

• Go to bed at the same time each night and wake up at the same time each morning, including weekends.
• Take a warm bath, drink a cup of warm milk or read a book before bedtime to help you relax.
• Leave worries at the bedroom door. If you’re concerned about something, make a list of the steps you’ll take to solve the problem before going to bed.
• Don’t take naps longer than 20 minutes or on a regular basis, and avoid naps after 5 p.m.
• Create an environment that is conducive to sleep – quiet, dark and comfortable.
Don’t read, watch TV or do work in bed for an extended time.
• Finish eating at least 2-3 hours before your regular bedtime.
• Exercise regularly. Finish at least 3 hours before bedtime.
• Avoid caffeine, nicotine and alcohol close to bedtime.

Read the rest of hte article here.

Happy Sleep Awareness Week!

Hawaii has most number of sleep deprived Americans
Written by: David Castillo on March 8th, 2011

Hawaii has been found to be home to the most sleep deprived people in the entire U.S. territory, with most of its inhabitants sleeping less than seven hours each day as told by results of a survey conducted by the Center for Disease Control and Prevention (CDC).

Meanwhile according to the Unhealthy Sleep-Related Behaviours report which CDC published on their site, Hawaii was able to get to the top of the survey on sleep deprivation by having the most number of adults that snore loudly, fall asleep all of a sudden during daytime, and nod off into slumber while behind the wheel of a vehicle.

On the other hand, Sleep Center Hawaii’s sleep medicine doctor Ford Shippey, who also happens to be a hospitalist at Queen’s Medical Center, says that Hawaii inhabitants have to work more hours to be able to afford the high costs of living. Thus, the people of Hawaii have less time to rest.

Read the rest of the article here.

Happy Sleep Awareness Week!

11 Surprising Health Benefits of Sleep

1. Improve memory
Your mind is surprisingly busy while you snooze. During sleep you can strengthen memories or "practice" skills learned while you were awake (it’s a process called consolidation).

2. Live longer
Too much or too little sleep is associated with a shorter lifespan—although it’s not clear if it’s a cause or effect.

3. Curb inflammation
Inflammation is linked to heart disease, stroke, diabetes, arthritis, and premature aging. Research indicates that people who get less sleep—six or fewer hours a night—have higher blood levels of inflammatory proteins than those who get more.

4. Spur creativity
In addition to consolidating memories, or making them stronger, your brain appears to reorganize and restructure them, which may result in more creativity as well.

5. Be a winner
A Stanford University study found that college football players who tried to sleep at least 10 hours a night for seven to eight weeks improved their average sprint time and had less daytime fatigue and more stamina.

6. Improve your grades
Children between the ages of 10 and 16 who have sleep disordered breathing, which includes snoring, sleep apnea, and other types of interrupted breathing during sleep, are more likely to have problems with attention and learning, according to a 2010 study in the journal Sleep. This could lead to "significant functional impairment at school," the study authors wrote.

7. Sharpen attention
A 2009 study in the journal Pediatrics found that children ages seven and eight who got less than about eight hours of sleep a night were more likely to be hyperactive, inattentive, and impulsive.

8. Have a healthy weight
Researchers at the University of Chicago found that dieters who were well rested lost more fat—56% of their weight loss—than those who were sleep deprived, who lost more muscle mass. (They shed similar amounts of total weight regardless of sleep.)

9. Lower stress
When it comes to our health stress and sleep are nearly one and the same—and both can affect cardiovascular health.

10. Avoid accidents
The National Highway Traffic Safety Administration reported in 2009 that being tired accounted for the highest number of fatal single-car run-off-the-road crashes due to the driver’s performance—even more than alcohol!

11. Steer clear of depression
Sleeping well means more to our overall well-being than simply avoiding irritability

Read the full article here.

Logging on Near Bedtime Affects Sleep, Study Finds
By Daniel Ionescu, PCWorld Mar 7, 2011 6:17 AM

If you're not getting a good night's sleep, your laptop, smartphone or tablet are to blame, according to a study from the National Sleep Foundation (NSF). The survey found that 95 percent of those polled use devices with bright screens in the hour before bed, while 60 percent of them say that they have sleep-related problems such as snoring or still feeling tired in the morning.

"Unfortunately, cell phones and computers, which make our lives more productive and enjoyable, may be abused to the point that they contribute to getting less sleep at night, leaving millions of Americans functioning poorly the next day," said Russell Rosenberg, Vice Chairman of the NSF.

The NSF poll found Americans report very active technology use in the hour before trying to sleep, whether it's using a laptop, smartphone or tablet. "Artificial light exposure between dusk and the time we go to bed at night suppresses release of the sleep-promoting hormone melatonin, enhances alertness and shifts circadian rhythms to a later hour -- making it more difficult to fall asleep," said Charles Czeisler, Ph.D., MD, Harvard Medical School and Brigham and Women's Hospital.

Read the rest of the article here.

Wake up! It's sleep awareness week.
By Jennifer Huget

New data released by the CDC to coincide with National Sleep Awareness Week -- which begins today -- paint a less-than-ideal picture of Americans' relationship with sleep. More than 35 percent of nearly 74,571 people surveyed in 2009 reported getting less than 7 hours' sleep a night. (We're supposed to get 7 to 9 hours of sleep daily; children need 10 or 11 hours.) Almost 38 percent admitted to having unintentionally dozed off during the daytime during the 30 days before the survey. Worse yet: Nearly 5 percent of those surveyed had done so while driving.

Though the specific number of hours of sleep we need varies from person to person, getting less than we should can contribute to all manner of health ills:

Insufficient sleep is associated with a number of chronic diseases and conditions -- such as diabetes, cardiovascular disease, obesity and depression -- which threaten our nation's health. Notably, insufficient sleep is associated with the onset of these diseases and also poses important implications for their management and outcome. Moreover, insufficient sleep is responsible for motor vehicle and machinery-related crashes, causing substantial injury and disability each year. In short, drowsy driving can be as dangerous -- and preventable -- as driving while intoxicated.

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ABSTRACT: Influence of Continuous Positive Airway Pressure on Outcomes of Rehabilitation in Stroke Patients With Obstructive Sleep Apnea.
Stroke. 2011 Mar 3.
Ryan CM, Bayley M, Green R, Murray BJ, Bradley TD.


BACKGROUND AND PURPOSE: In stroke patients, obstructive sleep apnea (OSA) is associated with poorer functional outcomes than in those without OSA. We hypothesized that treatment of OSA by continuous positive airway pressure (CPAP) in stroke patients would enhance motor, functional, and neurocognitive recovery.

CONCLUSIONS: Treatment of OSA by CPAP in stroke patients undergoing rehabilitation
improved functional and motor, but not neurocognitive outcomes.

Read the full abstract here.

Keeping sleep apnea sufferers' airways open
There are bulky machines and small devices, but there's no cure-all.

As Americans' waistlines continue to grow, so does the number of people who aren't getting a good night's sleep.

About 2% of women and at least 4% of men suffer from obstructive sleep apnea, a condition in which the airway collapses and blocks breathing for 30 seconds or even up to a minute or two. The brain senses that it isn't receiving enough oxygen and sends a signal to the person to wake up. The awakenings are brief enough that people usually are not aware of them, but sleep is disrupted continually throughout the night, leading to daytime fatigue and drowsiness.

Read the rest of the article here.