Caller to sleep clinic: “I want to buy one of those CPAP machines.”
Sleep clinic: “Have you had a sleep test and has the doctor given you a prescription for one?”
Caller: “No. But I snore so loudly I wake myself up. I need one of those machines so I can get some sleep…”
Most people who come to our clinic for sleep testing hope that the sleep test will show that they don’t have sleep apnoea.
But for some folk, everyone from their partner to their neighbour two houses down tells them they snore, so it gets hard to deny. They’ve checked the symptoms on Dr Google, and they wake up in a fog every morning. They are convinced they have it. All they want is to get hold of a CPAP machine and make their snoring stop!
However, the majority of visitors to the clinic suspect they might have some sleep issues, but they really aren’t sure what’s going on. They might be a bit sleep-deprived, they might have other issues that impact on their sleep health.
Many people delay getting a test because they can’t believe that poor sleep could have such a big impact on their health.
The main thing to remember is – healthy sleep is essential for your overall health. If you suspect that you are not sleeping as well as you should be, getting a sleep test is a smart move.
So why bother doing a sleep test?
Firstly, there can be a number of reasons we snore, and not all of them mean you have sleep apnoea. Allergies, deformities in the nose, problems with tonsils or adenoids and even pregnancy are just some of the reasons people snore.
That’s why it’s important to visit your GP, so that any other causes of snoring can be ruled out. If your GP thinks you might have sleep apnoea, he or she will refer you to a sleep clinic and sleep specialist who can conduct further tests as well as any physical examination to ensure there are no other underlying conditions that might need to be investigated.
In Australia, if you want to receive the government rebate for a sleep test, your GP will need to either carry out further tests on you, or refer you to a sleep specialist directly. The sleep specialist will review your case, and decide whether you are eligible to have a Medicare subsidised sleep study.
Home sleep test or lab sleep test?
There are two ways for sleep technicians and physicians to analyse your sleep.
In the past, the only option was to spend a night in a sleep lab, often in hospital, with monitoring through the night by sleep technicians.
New technologies have revolutionised the way we analyse sleep data. These days you can do a sleep test in the comfort of your own home. This is the most common way sleep tests are administered and will probably be the first type of test offered to you.
Home sleep tests are the most convenient way to have a sleep test, and they are suitable for most people. Most people sleep better at home, in their own bed. While wearing electrodes on your face and a cannula in your nose is probably not how you would usually sleep, it is still preferable to the noises, lights and unfamiliar environment of a hospital.
To be ‘set up’ for a home sleep test, you will be referred to a sleep clinic by your doctor.
You may have a consultation with the sleep specialist, who will explain some aspects of the test to you, and decide whether you are an appropriate candidate for the test.
After this, you should expect that a sleep clinician will explain the sleep test process, and give you a kit to take home. They will often set up the test on you, as part of the ‘dress rehearsal’ for the actual test, and then send you home with full instructions on how to prepare for the test.
Once you are at home, you can take your time to set up the test, prior to your usual bedtime routine.
What does a sleep test measure?
Sleep tests, whether done at home, or in the lab, measure quite a few things. You may have seen pictures or shows on television with someone’s head covered in wires, in preparation for a sleep test in a sleep lab. These wires are connected to electrodes that are attached to the scalp, and are used for an electroencephalogram (EEG) test.
When you do a home sleep test, you will have a reduced number of wires and electrodes, but there will still be a few electrodes stuck to your face, under your chin and on your chest. These electrodes measure your brain activity, and in particular any sleep disorders. You will be given a surgical wipe to clean the area prior to attaching the electrodes.
The electrodes also measure your heart rate, your eye movements and jaw movements.
Your oxygen levels will be monitored with a finger oximeter. The oximeter can show whether you are receiving adequate oxygen while you sleep. A nasal cannula is used to measure your breathing, and two bands around your chest measure the depth and rate of your breathing through the night.
All of these parts are connected to a central recording monitor, about the size of a small radio, which is positioned on your chest.
While some people struggle with the apparatus of a home sleep test, most people manage to sleep quite well. Supporting yourself with pillows, and taking your time to relax and fall asleep can help you forget that you are wearing quite a bit more than your usual pyjamas!
Remember too that sleeping in hospital is often difficult, and if you can manage one night of sleep at home with wires attached, you may save yourself the greater complications of a hospital stay.
The morning after…
You will need to peel off the sticky electrodes, remove the cannula, undo the chest bands and remove the finger oximeter.
Your clinician should have advised you to throw away all sticky electrode pads and the nasal cannula. The remaining equipment, including electrode wires, chest bands, oximeter and the recording device will need to be packed away for return to the clinic.
The sleep test monitors will usually be pre-programmed by your clinician to start and stop at the appropriate time, so you will not need to press any stop-start buttons.
You will, in most cases, need to return the sleep kit to the clinic as soon as possible. They will download the data, check that enough of your sleep was recorded, then send it to sleep technologists for analysis.
Shortly afterwards, depending on the clinic’s turnaround times, you will have a consultation and the results of your sleep test will be explained to you.
It is essential that your sleep test results are analysed by a sleep physician. A specialist sleep doctor can consider all aspects of your health, and ensure that there are no other health issues that need to be considered.
A sleep test can reveal sleep disorders, but also heart problems, brain problems and more. Snoring might indicate sleep apnoea that can be treated easily, but only a full medical review of the results of the test can ensure that other conditions are not missed.
To sum up:
Sleep disorders are very common. Having impaired sleep can lead to increased risk of car accident, heart attack, stroke, depression, diabetes and more. Taking the time to visit your general practitioner and discuss any concerns you have about your sleep is a wise move. Getting your sleep tested is easy, and if any irregularities are found, are in most cases easy to treat.