Sleep Disorders Center
Faculty:
Fellows:
- Mohammad Hasnain, MD
- Scott Geisler, MD
Technologists:
- Christine Glenn, RPSGT, R. EEG T. (Coordinator)
- Zong-Ying Ren, RPSGT
- Linda Bachmann, RPSGT, R. EEG. T.
- Virginia Boshart, RPSGT
- Kristin Bellach, RPSGT, R. EEG T.
- Paula Clausen, RPSGT
- Donald McKinney
- Tim Bringman
- Elizabeth Follmer
- Susanna Lahann
Services:
Sleep Disorders
The National Sleep Foundation estimates that 40 million Americans suffer from a sleep disorder. There are over 80 differential diagnostic categories of sleep problems in the International Classification of Sleep Disorders. Some of the more common referrals for sleep analysis include obstructive sleep apnea, periodic limb movements in sleep, parasomnias (undesired body movements associated with sleep), seizures in sleep, and narcolepsy. Formal sleep studies routinely include polysomnography and multiple sleep latency testing.
Polysomnography (PSG)
A polysomnogram is a non-invasive all night monitoring of a patient’s sleep. Variables routinely monitored are EEG (brain waves), EOG (eye-movements), and chin EMG (muscle activity), for sleep staging, and ECG, nasal and oral airflow, respiratory effort, and oxygen saturation to address sleep related breathing disorders, and EMG of the limbs to monitor for abnormal body movements such as periodic limb movements. Split-screen video-monitoring is also routinely performed to help differentiate problems such as parasomnias and seizures.
CPAP/Bi-level PAP Titration
Continuous Positive Airway Pressure (CPAP) is the most widely used treatment for obstructive sleep apnea. CPAP provides a gentle flow of positive pressure air that holds the airway open during sleep. A CPAP trial is performed with the same recording parameters as used during a PSG with the addition of the CPAP machine. While the patient sleeps, a trained technologist determines the appropriate amount of pressure needed to split the patient’s airway open.
Bi-level Positive Airway Pressure (Bi-Level PAP) also delivers a positive pressure flow but with differing inspiratory and expiratory pressures. Bi-level PAP trials are performed with the same parameters as used during a CPAP trial with the technologist adjusting both inspiratory and expiratory pressures. Bi-level PAP is most commonly indicated for patients with obesity-hypoventilation syndrome, COPD, CHF, a variety of neuromuscular disorders, and those that are intolerant of CPAP therapy.
Portable Polysomnography
When patients are deemed too ill to leave their unit, a portable PSG or CPAP/Bi-level PAP titration can be performed at the bedside. This study will be performed using the same recording parameters as used during a routine PSG including video monitoring. The most common indication for a portable PSG would be for suspected sleep apnea.
Multiple Sleep Latency Test (MSLT)
The MSLT is indicated in the evaluation of patients with suspected narcolepsy and to objectively study patients who complain of daytime hypersomnolence. This test routinely follows the overnight PSG and consists of 5 attempts at napping at 2-hour intervals during the day. Using parameters necessary for sleep staging (EEG, EOG, EMG), the test objectively assesses sleep tendency by measuring the number of minutes it takes the patient to fall asleep.
Additional Information:
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