What Happens During a Sleep Study

Here is the complete process from beginning to end for a patient when a doctor refers for a sleep study:

  1. Referral is sent from your doctor’s office to a sleep lab
  2. The sleep lab then obtains the authorization from the insurance company to bill your insurance for the study
  3. The sleep lab will call you to schedule a time to come in for a consulatation
  4. After the initial consultation with the sleep doctor, they will schedule you to come back for the full overnight sleep study
  5. You go back for the actual study and sleep in a bed in a room, with an overnight lab technician watching you
  6. They connect you to 12 or more nodes on different points on your body to monitor many different “channels”
  7. If you show signs of having a sleeping disorder called sleep apnea, they will wake you up halfway through the night
  8. At this point, they will give you CPAP equipment to test if that helps your sleep apneas
  9. In the morning, you are able to go home
  10. Next, the sleep doctor comes into work, and reads the report that was recorded from your sleep and interprets the data
  11. The sleep study results are then sent back to your primary care physician

I know this sounds like an awfully long and drawn out experience, AND IT IS.  But it relatively inexpensive, only about $3,000-4,000 usually, sometimes as high as $7,000 or maybe more at places like big University Hospital Sleep Labs or large medical foundations, but that is only because they want to bill your insurance as much as possible to increase their revenues.  Especially watch out if you have a PPO plan, in that case the sleep labs are likely to bill you for as many office visits as they can, and they may want you to actually spend two nights at the lab.  One night for the initial test, and the second one for using the CPAP therapy equipment.  I know this all sounds much like some type of medical insurance scam, and unfortunately it has somewhat turned into that for the sleep medicine world, and the sleep doctors in particular who own sleep labs themselves.  But after reading this, please know that you are at least warned of what is going on out there.  Best of luck and sweet dreams.

Having a Hard Time Sleeping at Night

Maybe you are having a hard time sleeping at night.  Or maybe you are finding yourself waking up for no apparent reason and your heart is racing in the middle of the night?

Or maybe you know somone or sleep next to someone who is always waking up and snoring during the night? Is that you?

If the answer is yes, you are first off not alone.  Many millions of people all over the world suffer from all types of sleeping disorders.  Some can be dangerous to one’s health, others not so much.

One of the most common sleeping disorders is Obstructive Sleep Apnea(OSA).

What you should do if you are finding yourself in this situation, is talk to your doctor or do some other research on the internet to gain a better understanding of what OSA is and how it is treated.  When left un-treated, it can lead to many health problems down the road, and it could very well be the direct cause for your current state of tiredness, high blood pressure, or even erectile dysfunction.

But the best news is that it can be treated, and it doesn’t have to be the end of the world for anyone.

Cardiologists Have Alot to Learn about Sleep Apnea

Why is it that when you walk into most cardiologist’s doctor offices, they rarely will admit that their patients have sleep apnea?

This is a question that most people should be wondering about.  It’s just like walking into a endocrinologist’s office and he/she tells you they never see obese patients.

When you look at all of the clinical data, it all suggests that patients who have cardiovascular disease also have a very likelihood of having sleep apnea.  Or at a bare minimum, this is a very high risk group for having OSA.  When you think about the physics here, it just makes sense.

When you have sleep apnea, you are snoring usually much of the night, your airway is closing, and your body is not getting much oxygen.  And when the airway is clear, your heart starts pumping like crazy to make up for lost time, and lost oxygen in your system.  This nasty combination which can happen over and over again all night long leads to heart problems in many.  Heart attacks, and also strokes.

So why?  Why cardiologists would you think that your patients for some reason don’t have sleep apnea.  Or why would you think that sleep apnea is something that you should not worry about?  Is it because you don’t care about your patient’s health?  I don’t think that is the answer.  Or is it because you went to medical school so long ago that they didn’t have any of the current studies available for you to read?  Why?  What’s the reason.  Especially when recent studies show how roughly 50% of congestive heart failure patients have obstructive sleep apnea!

You don’t need to be a rocket scientist mr. cardiologist.  You just need to smell some coffee every once in a while.  Start screening your patients for sleep apnea.  If you want to learn how to do that, just go and read the information on how to screen for OSA.

Where to Get a Sleep Apnea Test

If you have just finished a doctor’s visit and the doctor tells you that you might have sleep apnea.

You should get a sleep apnea test done.

A sleep apnea test sometimes is called a sleep study, it just depends on what your local doctors use.  But this is a test which is going to monitor your sleep to find out if in fact you have sleep apnea or OSA as its also called.  The OSA stands for Obstructive Sleep Apnea.

What is a Sleep Study:

A sleep study is where you either spend the night at a sleep lab and get connected to twelve or more nodes, and they monitor your oxygen, pulse, breathing, air flow, body movement, and your brain waves, or you can actually also have a sleep study done in your home by wearing a tiny device on your arm or on a headband type thing.  Once you have spent the night at a sleep lab, the doctors will read the data sometime over the next few weeks hopefully and tell you the results.  If you stop breathing many times during the night for example, you just might have obstructive sleep apnea.

Local Sleep Doctors:

Many towns or cities might have a local sleep doctor.  This is someone who is a member of the Board of Sleep Physicians and has been trained in understanding how important sleep is to the human body and they are usually pretty good in figuring out if somebody has a sleep disorder.  Some local sleep doctors own their own sleep labs.  It sometimes is like a hotel environment, where you have several different “beds” as they are called, with private rooms that have all the monitoring equipment.  Usually if you have a sleep test at one of these places, there will be an overnight medical technician type person who will be there with you checking up on you throughout the night too.

The much cheaper and usually easier option that these labs might offer is for you to take home the home testing equipment.  But beware, the sleep labs make much more money if you spend the night there, which also means you pay much more, so I would opt for the home test if it was me, obviously.

HMO and Sleep Studies for Sleep Apnea:

Many HMO groups also own their own sleep labs.  Some of these labs also offer home testing.  Since the home testing is so much cheaper, they usually ask that the HMO patients who need sleep studies use a home test.  What you want to watch out for is if you are a PPO patient and need a sleep study, you still have a choice as to where you and how you want to get your sleep test.  Some medical foundations that own their own sleep labs try to have their HMO patients do the home test to save on costs, while asking their PPO patients to complete a full in lab overnight study so they can charge the insurance a much higher amount.  When I say higher amount, we easily could be talking about the difference between a charge of $750 for a home test compared to over $5000 for an in lab test if you are a PPO patient.  So yes, its very substantial.

Sleep Studies are Very Expensive What About Home Testing for Sleep Apnea?

That’s right, going to an overnight polysomnography(PSG) sleep test in a lab or hospital can be a very expensive event.  It can be so expensive that patients many times cannot afford the copay that is required.  This is a problem with in lab sleep studies.

For many people, when a doctor tells them they have symptoms of obstructive sleep apnea, they really don’t know what to think.  Some people go home and look on the computer for information about sleep apnea or snoring.  Some people even go the extra mile and look into treatments and cures for sleep apnea.  But, before anyone can really understand how bad their potential obstructive sleep apnea really is, they need to be tested.  There are just a few different ways to have a full sleep study.

Sleep Lab Testing Method for Diagnosing Obstructive Sleep Apnea (OSA)

The sleep lab is the older or old fashioned way to test for sleep apnea.  This involves a patient spending the night away from home and being monitored for how many apnea events they have throughout the night.  There is diagnostic equipment attached to the patient that is reading many different channels which will uncover if a patient really has obstructive sleep apnea.  Channels like pulse, oxygen, air flow, brain waves, body movement, apneas, hypopneas, and upper airway resistance is all measured.  The only potential problems are that patients are connected to many different nodes or wires, and in an enviornment which is not very similar to their home.  For this reason along with the fact that there is an overnight sleep tech person from the sleep lab watching you sleep all night, its hard for people to create a realistic night of sleep to be monitored.  And of course, the costs for all of this are very very expensive.  Many times, the costs for an overnight sleep test to diagnose obstructive sleep apnea can cost over two-thousand dollars ($2000).

At Home Portable Sleep Testing for Obstructive Sleep Apnea

The other option that patients have is wearing a small testing device for one night in the patient’s home to diagnose obstructive sleep apnea.  This sleep testing device will also measure all of the same channels that are measured in a sleep lab, but, the patient can be tested for OSA in their own home.  The costs for portable sleep testing for OSA are only a fraction of the costs compared to having a sleep test in a lab or hospital, and for that reason alone, many patients opt for this type of test.  As the years have moved on, home sleep testing has began to gain huge popularity with both patients and physicians all over the world, and is expected to eliminate the need for in lab sleep testing for obstructive sleep apnea in the near future.


I Stop Breathing During My Sleep

Stopping breathing during sleep is one of the most common signs of some type of breathing problem.  This is what many husbands and wives notice from their sleeping partner, especially when there are other symptoms associated when breathing stops.

Most importantly, this is something that should be taken very seriously, and looked into further.  When breathing stops during sleep, it is instantly slowing down or even stopping the flow of oxygen to the body.  This means that when the flow of air stops, the heart, brain, and every other body part are getting less oxygen than they deserve.  This can lead to all sorts of medical problems and even death.

Many people who stop breathing during sleep, have a sleeping disorder that is called Obstructive Sleep Apnea.  This breathing disorder is so common, that there is a good chance that everyone on this planet knows several people who have the disorder, but who are currently undiagnosed.  When our bodies are asleep, they should not be going through all of the punishment that is happening due to a lack of air in the lungs.  This is causing all sorts of side effects like high blood pressure, and even stroke.

If you stop breathing during your sleep, don’t just wait around for it to change.  If someone says that you stop breathing during your sleep, its time to fix your problem.  Fixing sleep apnea is not rocket science.  There are many different ways to combat this sleeping disorder without having to go through medications or surgery.  Ask your local physician what he or she recommends to get help with this.  Fixing sleep apnea will have a very positive effect on your life. For Sure!

CPAP Machines for Sleep Apnea

Continuous Positive Airway Pressure is one of the most popular forms of treatment for patients who suffer from OSA.  It is also one of the oldest forms of therapy as well, as it has been out on the market for several decades now.  CPAP is pretty simple, it is a glorified air blower that all night long(continously) blows air into your throat and down into your lungs.  This allows people to sleep better for many different reasons.

How does CPAP Work:

- A CPAP machine is placed next to the bed of the person who has obstructive sleep apnea.

- All night long, the machine will blow out air into a tube at a continous air pressure.  Something like the air pressure you feel when you put your head out the window at 15 miles per hour

- The individual using the CPAP machine will also connect the hose that is blowing air to a mask

- This mask with take the air pressure, and force it into the patients nose or possibly the nose and mouth(depending on what type of mask is being used)

Common Questions about CPAP machines:

1.  Can you take it off during the night if you need to use the bathroom? Most definitely, there are easy ways to take the mask off in just seconds

2.  Do CPAP machines make alot of noise?  Yes and NO, it really depends on how old the machine is and what pressure it is on.

3.  Do you have to wear CPAP your whole life?  That depends on if your body changes to the point where you can sleep without any respritory problems throughout the night without it. Most CPAP users use the CPAP their whole life.

4.  What happens if you forget to use your CPAP machine one night?  You will just go back to the symptoms you had prior to using CPAP.  Most people for some reason forget to use CPAP when they are strating out by accident.

5.  Do you snore when you use CPAP?  No, CPAP has the remarkable ability to eliminate snoring right away, it’s truly amazing.

My Wife Snores

My Wife Snores all night long, what can I do?

First off, don’t worry too much, there are about 15 million other husbands dealing with the exact same thing as you.  Most of the time, it is because your wife has a case of Obstructive Sleep Apnea (OSA).  If your wife is someone who is tired much of th time, pauses or chokes in her sleep, and has no recollection of this behavior, that might just mean she has sleep apnea. It is totally treatable.  But get started contacting someone either by phone or through the internet that can help out.  There should be all types of local companies who specialize in helping patients just like your wife, many of them are probably related to sleep medicine organizations or medical groups.  Some of the side effects of un treated sleep apnea can lead to health issues down the road, so that is why you should get started with this right away.  It is never too late.

Some women, especially overweight women might tend to have a more moderate to severe case of sleep apnea.  But don’t worry, again, it is totally treatable.  You just want to get the ball rolling ASAP.  Plus, if it means your wife isn’t going to keep you awake all night long with her dreadful snoring, get started contacting someone right now.  There should be tons of places you can go online or in the phone book.  There are so many doctors you can call to get started with treating this its amazing these days.

Good luck, and just realize that your wife may be having a total closure of the airway which is causing oxygen to NOT get into her body.   This causes bad things down the road, and bad side effects daily like fatigue for example.  So don’t wait, get started with helping her out.  She will be very thankful.  Oh, and a side benefit is reduced sexual disfunction… Most of us like that part.

Insomnia

What is insomnia?
Great question.  It’s simple.  It’s what you say you have when you aren’t having a good night’s sleep.  What can be difficult is to figure out why you aren’t getting a good night’s sleep.  Simply asking your doctor for some sleeping pills is like putting a band aid on the problem.  As much as the drug companies who are making billions from selling the sleeping pills don’t want to publish, there are ways to fix your sleeping problem without taking medications or paying a single penny to anyone. So, the great mystery is to understand what is causing the insomnia in the first place.

Sometimes or Always

If you are the type of person, who every single night can’t fall asleep and you are getting just a couple of hours of sleep per week…there is very few of you and you should see a sleep doctor right away.  But, the large mass of people who complain of insomnia do so for a few days here and there, or for a week or two and it comes and goes.  For this group of people, first and foremost realize that this is a huge percentage of the population and most people experience something like this in their lifetimes.  You are not alone.

Some of the Causes of Insomnia

-Stress- very demanding periods in someone’s life can effect all aspects, including sleep.  Although the body wants to drift off into sleep, sometimes its just not possible.  So much action is taking place in the brain, that the need for sleeping can be avoided.  The side effects of not having sleep are going to remain with that person though, tiredness, not thinking clearly, irritable etc…
-Caffeine- this is a powerful drug and one that most people use to some extent.  It has the ability to keep people from sleeping for several hours or much more depending on the amount consumed.  If you are having difficulty sleeping, many people find relief if they remove caffeine from their intake several hours prior to going to sleep.
-Strange Surroundings- sometimes it is difficult for people to find sleep when they are in an unusual setting.  This is nothing new, but it can create difficulty for lots of people.  Usually, this is something that goes away when the unusual place is more usual or someone is back home.  No major suggestions here other than explaining that this is normal

Restless Leg Syndrome

What is Restless Leg Syndrome(RLS)?
This sleep disorder is one which can affect not just one person but also the whole family.  Or whoever else is sleeping in the same bed as the RLS person.  The reason is that if you suffer from restless leg syndrome, you are having restless limbs all through the night.  This can be quite annoying because it can wake up the person with the sleeping disorder, as well as anyone else who is sleeping next to that person.

How Do You Know if you have RLS?
If you are the type of person who feels horriblly strange pains in your legs at night or throughout the day.  Also, if you get relief by stretching out these limbs, its very probably you have restless leg syndrome.  It is very common, however very rarely diagnosed and treated because physicians often overlook this sleeping disorder.

What is Causing Restless Leg Syndrome?
This is a question that the medical world has still not figure out.  Stay tuned I guess.

How Can you Fix Restless Leg Syndrome?
Usually, the person with RLS fix the problem with certain medications prescribed by your doctor.  When treated with medications, it can usually be close to 100% relieved.

Curing Restless Leg Syndrome

Once you have taken care of your restless leg syndrome, you will quickly see a change in life for yourself and your bed partner(s).  This is because now you will not have all of those arousals all night long, and have the chance to finally sleep through everything.  Something you have not had for potentially years.