What will happen during laboratory sleep testing?

DEAR DOCTOR K:

My doctor thinks I may have sleep apnea, and he wants me to go to a sleep lab to be tested. What will happen during the testing?

DEAR READER:

Sleep apnea is a serious health condition in which breathing stops or becomes shallower. In the most common form, obstructive sleep apnea, the tongue or throat tissues temporarily and repeatedly block the flow of air in and out of your lungs. This can happen hundreds of times each night. Laboratory sleep tests are the most reliable way to diagnose this problem.

When you spend the night in a sleep laboratory, you’ll wear your own nightclothes, and you can use a pillow from home. You can take your regular medications, but the clinicians will need to know what they are. The lab usually provides a regular bed in a private room with a bathroom attached. The room is kept as quiet as possible.

A technician will first set up the sleep-monitoring equipment. Then you’ll be left alone to relax until bedtime. Throughout the night, laboratory staff will monitor you from a nearby control room. Procedures used to diagnose sleep apnea usually include a test called polysomnography, as well as audio and video recording.

POLYSOMNOGRAPHY: In this procedure, small electrodes and other sensors are pasted on specific parts of your body to take a variety of readings during the night. Some things they may track include your brain waves, muscle tension, eye movements, airflow, heart rate and rhythm, breathing, and the amount of oxygen in your blood.

The readings are collected on a printout called a polysomnogram. This is analyzed by a technician and physician. If a breathing problem is detected early on during testing, you may be awakened and given treatment during the second half of the night. This allows the sleep experts to monitor how well the treatment works for you. Sometimes this process requires two nights.

AUDIO AND VIDEO RECORDING: Audio equipment may be used to record snoring, talking during sleep or other sounds. A video may also be taken to compare with the polysomnogram. This may show, for example, that you snore (a sign of sleep apnea) only when in a certain position, as when you’re lying on your back instead of on your side or stomach.

The American Academy of Sleep Medicine has a listing of more than 2,500 accredited sleep disorder centers and more than 5,600 board-certified sleep specialists. Staying overnight in a sleep laboratory usually costs between $800 and $1,500. In advance of the test, ask your health insurance company if it will pay for the test. Reimbursement varies, and may depend on your diagnosis.

If not properly diagnosed and treated, sleep apnea can cause problems with a person’s mood and ability to think clearly. These, in turn, can cause serious problems both at work and at home. In addition, by interrupting deep sleep, sleep apnea may increase the risk of obesity, diabetes and other diseases.

Sleep laboratory testing is a painless procedure, and I wouldn’t hesitate to have the testing done.