About The "Sleep Test (Polysomnography - PSG)"

Polysomnography - PSG

Sleeep Test - Polisomography - PSG / Image source: World Chronicle Polysomnography Market Research Report Analysis

A diagnostic test used to evaluate sleep apnea syndrome when patients are asleep. This is a test that measures your breathing, brainwaves, heartbeats, body movements, snoring, blood oxygen levels throughout the night. This requires electrodes to be placed in some parts of your body. Small receivers are placed on your head, mouth and nose, chest, neck, fingertips and legs. This is a painless procedure. After the receivers are placed, you are expected to go to bed and sleep according to your normal sleep time.

When Sleep Test (Polysomnography - PSG) Is It Done?

In patients with symptoms of sleep apnea (daytime sleepiness, wake up tired in the morning, insatiable sleep feeling, witnessed breathing arrest during sleep, night sweats ...), it is desirable to diagnose sleep apnea syndrome, to evaluate disease cipitation and to provide appropriate treatment.

Indications of Sleep Test?

Polysomnography is a test for the diagnosis of sleep disorders. Often; Although it is used to investigate the presence of sleep breathing disorders observed during sleep arrest and snoring, it is also used in the detection of rare conditions such as sleep movement disorders, sleep terror, sleep paralysis, narcolepsy, parasomnia. Your physician will ask for polysomnography if you suspect you have sleep apnea syndrome.

Contratindications of Sleep Test?

Polysomnography (sleep follow-up test) should not be performed in patients with severe psychiatric disorders, people with intellectual disabilities and high fever.

Sleep Test (Polysomnography - PSG) Centers in Istanbul

There are "Private Sleep Laboratories"  where sleep tests are performed in Istanbul and which also perform sleep tests in hospitals. Other than these, there are centers where patients come to their homes and perform sleep tests ("Home Sleep Test").

What Data are Looked For In a Sleep Test (Polysomnography - PSG)?

It is used in the diagnosis of snoring, sleep apnea, periodic leg movements in sleep, heart rhythm disturbances, sleep quality and other sleep disorders. (EMG), measurement of cardiac functions, and determination of the position of hospitalization can be recorded simultaneously and continuously over a period of overnight.

Sleep Test (Polysomnography - PSG) Stages

What Should Patients Do Before Sleep Test (Polysomnography - PSG)?

The patient, who is going to have a sleep test, goes to the sleep center recommended by his doctor and prepares for the test. In the sleep test, it is recommended that the patient take a shower to provide better adhesion of the electrodes to be adhered to the body. In the shower on the day of the sleep test, alcohol should not be taken, do not sleep during the day, such as tea, etc. to impair the quality of sleep. Drinks should not be consumed and drugs that bring sleep should not be taken.

Before The Sleep Test (Polysomnography - PSG)

After resting for a while, the patient comes to the sleep center and is taken to the room where the test will be performed. The patient then wears his own sleeping clothes. The sleep technician begins to connect the electrodes after explaining the procedures to be applied to the patient. The electrodes are attached to the scalp, behind the ear, close to both eyes, chin and chest. Sensors are attached to the fingertips to measure the amount of oxygen in the blood, and to the nose to examine snoring and breathing. All of these electrodes and sensors are then connected to a device. At this stage, it is recommended that male patients come to the sleep center where the test will be performed for shaving and that the electrodes give more healthy results. Once the sensors and electrodes are connected to the device, the technician is drawn into the monitoring room and begins to monitor the signals from the electrode and sensors on the computer. It is convenient to bring your own pajamas and slippers for a comfortable sleep.

After the sleep technician tells the patient about the procedures, he starts to connect the electrodes required for recording. During recording, electrodes are attached to the scalp and earlobe to monitor brain waves, close to both eyes to examine eye movements, to the jaw to monitor muscle movements, and to the chest to obtain heart electrodes. The fact that male patients come to the center as a beard shave facilitates the adhesion of the electrodes. Sensors are attached to the fingertip to measure the amount of Oxygen in the patient's blood, to the neck to monitor snoring, and to the nose to monitor breathing. All of these glued electrodes and sensors are designed so as not to interfere with patient comfort. When you sleep, our technician turns off the lights and starts your sleep.

In addition, the patient's image is recorded with a camera in the bedroom.

The technician to follow the examination is drawn to the monitoring room and starts to monitor and record all the signals of the patient obtained via electrodes via computer. In addition, a video camera is used to record images from the patient all night.

No medication is given to the patient to sleep, ie the patient is not anesthetized and recorded during his natural sleep. Again, no electrical current is given to the patient with the electrodes connected during the test.

Since the video recordings taken during the night are monitored from the technician's room, the technician will come to the room and assist him / her in case the patient arises or wakes up in case of any need.

In this way, when the patient wakes up in the morning, the electrodes will be removed by the technician and the test will be terminated.

Recordings taken all night will be analyzed by the physician on computer and the results are reported to the patient. The results are analyzed by computer all night and the results are given to the patient.

When the patient wakes up in the morning, all connections are disconnected and the patient can return home or work. Then the records are examined by the doctor and a polysomnography report is prepared. The required treatment method will be determined according to the test result.

If you have a sleep problem and your doctor has advised you to have a polysomnography, you can find out the cause of your sleep disorder by having this test and have a healthy sleep as a timely treatment. A healthy sleep means a healthy life.

Healthy Sleep is Very Important!

Sleep, which constitutes an average of one third of human life, is of great importance for a healthy life. Although a good quality sleep has the property of repairing the damages in the body, hormones such as secreted growth, seratonin and melatonin, which are secreted in deep sleep, are either not secreted or under secreted from the body's needs.

Problems such as snoring during the night, difficult breathing, and waking up from sleep reduce the quality of your sleep, and these symptoms can be symptoms of sleep apnea or sleep disorder. Untreated sleep disorders may increase the risk of heart attack, high blood pressure and stroke.

Sleep can be defined as a state of unconsciousness in which the person can be awakened by appropriate stimuli such as heat, light, sound, contact, odor, or spontaneously terminates when sufficient time is complete.

The effects of healthy sleep can be summarized by body regeneration, growth, preservation of metabolic energy, rest, preservation of intellectual performance, fitness, neuronal maturation, learning and memory development.

Test Your Sleep Apnea!

1. Do you snore more than 3 nights a week? Yes 2, No 0

2. Is your snoring too noisy? Yes 2, No 0

3. Have you been told that you seem to suffocate in sleep or that you have stopped breathing? Occasionally 3, Often 5, No 0

4. How many cm is your neck circumference measured from the most protruding area?

Male: Thin than 43 cm: 0
Male thicker than 43 cm: 5
Female Slimmer than 40 cm: 0
Female 40 cm thick: 5

5. Have you received treatment for high blood pressure? Yes 2, No 0

6. Do you occasionally fall asleep while sitting in a quiet place? Yes 2, No 0

7. Do you fall asleep while driving or waiting at the red light? Yes 2, No 0

If you have a score of 9 or more: You may need a sleep test, be sure to consult a sleep clinic.

6-8 points: Consult a physician. At the end of the examination may suggest a sleep test.

5 points and less: Low probability of sleep apnea.

Sleep Apnea Treatment

This disease, which causes many problems and even life risk; increases the risk of developing heart attacks, strokes, diabetes and cancer. According to the severity of the disease is being treated. The device is used for treatment. Personalized oral tools are prepared by dentists. Surgical method is applied.

Sleep apnea can be prevented by simple considerations. Obesity is the most important changeable risk factor for the disease. Sleep apnea can be reduced by 50% by losing weight. In addition, avoiding alcohol and sleeping medicines, quitting smoking and not lying on your back will reduce the discomfort.

In the treatment of sleep apnea, the first thing to be done is to overcome this condition. If there are significant anatomic stenosis in the upper respiratory tract, the patient should be evaluated by the Otorhinolaryngologist for surgical intervention.

CPAP (continuous positive airway pressure) should be given to patients with severe, moderate and concomitant disease or mild sleep apnea with significant symptoms. According to the treatment effect and the patient's preference, the patient should be monitored by making adjustments in automatic settings or switching to constant pressure device. In cases of difficulty or mild use of the CPAP device, the mouth can be prevented from falling back and obstructing the upper airway by placing the lower jaw forward with the intraoral apparatus.

The unique treatment of sleep apnea is provided by the use of devices that provide compressed air to keep the airway permanently open. CPAP devices prevent sleep apnea by keeping the upper airways open during sleep.

The patient is asked to use the device at home every night and during the whole sleep. The use of CPAP eliminates breathing stops in sleep and restores sleep phases to normal. CPAP treatment improves not only breathing stops but also snoring and oxygen drops. As a result, since the patient sleeps continuously with CPAP, all complaints related to poor sleep, especially daytime sleepiness and tired waking, are eliminated. However, if he does not use the device or uses it irregularly, his complaints will return.

It is recommended to pay attention to weight control after treatment and to avoid habits such as alcohol and smoking. Appropriate use of the device is recommended in patients recommended for treatment with regular physician checks.

Sleep Disorders

Sleep is defined as a golden chain that links the body to health. Sleep disorders cause health disorders. The International Classification of Sleep Disorders has been made to use a common language to describe sleep disorders and to establish diagnostic and therapeutic standards worldwide. These:

1-Insomnias: Difficulty in starting sleep or maintaining sleep despite the availability of conditions and conditions for sleep

2-Sleep Respiratory Disorders

3-Central diseases with hypersomnia: excessive day and night drowsiness

4-Circadian rhythm sleep disorders: sleep-wake phase disorder (Jet lag, shift work, irregular sleep-wake rhythm disorder, etc.)

5-Parasomnias: Walking during sleep, wetting diapers, nightmare disorders, sleep terror,

6-Sleep-related movement disorders: restless legs, periodic leg movements, leg cramps,

7- It is classified as other sleep disorders.

The most common sleep disorders are respiratory disorders during sleep is "Obstructive Sleep Apnea Syndrome".

Obstructive Sleep Apnea Syndrome

It is a syndrome characterized by stopping or superficial breathing as a result of repeated upper respiratory obstructions during sleep, accompanying snoring and a decrease in blood oxygen value. It is a disease of middle-aged and overweight men in terms of gender. It is most commonly seen between the ages of 40-60. It can also be seen at other ages. 4% in males, 2% in females. Although there are many complications, the diagnosis is not known by doctors and the public.

Obesity is the most important risk factor in this syndrome. It is known that the incidence and severity increases with increasing weight and decreases with weight loss. It is especially common in people with central obesity, that is, increased waist circumference and apple-type fat. However, it should be remembered that only 40-60% of sleep apnea patients have obesity and can be seen in non-obese patients. If one family member has sleep apnea syndrome, the risk of occurrence in others increases. Facial and jaw structural disorders and upper respiratory tract stenosis may cause sleep apnea syndrome in non-obese people. The most important of these is that the chin is small and behind. Another important risk factor is that the neck is short and thick and the neck circumference is measured as 43 cm in men and 40 cm in women. Smoking, alcohol, the use of some sleep medications and lying in the supine position in some patients also increase the number and duration of breathing. Also sleep apnea syndrome; chronic bronchitis, asthma, hypothyroidism, coronary artery disease, hypertension, stroke, diabetes, and reflux.

Complaints; It is an indication of sudden waking, snoring and narrowing of the upper respiratory tract. Severe and persistent snoring may be a leading symptom of sleep apnea syndrome; snoring and other symptoms should be present. The most important finding is the sleep arrest described by his spouse or relatives, which we call witnessed apnea. The patient sleeps poorly because the sleep is interrupted by repeated apneas, sometimes 300-400 times during the night. He is often unaware that he wakes up after apneas, sweating while sleeping (especially in the head and neck), frequent urination, dry mouth, waking tired in the morning, lack of attention, inability to do his work, forgetfulness, irritability, night coughing, reflux, dry mouth, hearing loss, sexual reluctance and impotence, headache, drowsiness during the day, forgetfulness

Findings; People with symptoms of sleep apnea may experience many serious conditions during the day. Sudden death in sleep, stroke, heart attack and heart failure, if the patient is obese, weight loss, respiratory failure in lung patients, uncontrolled diabetes can be shown as examples of these problems. In addition, sleep apnea can lead to constant fatigue and lack of concentration during the day, resulting in traffic and occupational accidents.

There is no diagnostic finding of sleep apnea syndrome. In other words, it is unlikely to be diagnosed by examination findings or blood and urine tests. Polysomonography test (PSG) should be performed for definitive diagnosis.

Grading of obstructive sleep apnea syndrome with sleep test

In order to diagnose sleep apnea syndrome, the patient's physician reviews the records taken all night. Determines whether sleep stops, snoring, and oxygen drop. Breathing stops over ten seconds are considered apnea, sometimes apneas lasting 1-2 minutes. Sleep apnea syndrome is classified according to the number of breath stops and decreases per hour. If the number of breath stops or decreases in one hour is less than 5, Simple Snoring is considered as mild sleep apnea syndrome between 5-15, moderate sleep apnea syndrome between 16-30, and severe sleep apnea syndrome over 30. Accordingly, the patient's treatment is regulated.

Similar links >> Treatment Success in Snoring and Obstructive Sleep Apnea Syndrome! / How is Sleep Apnea Revealed When Lying On The Back in Deep Sleep? / Treatment of Snoring and Sleep Apnea / Obstructive Sleep Apnea Syndrome and Snoring

Source links >> Polysomnography - WikipediaWhat is polysomnography (PSG)? / [Clinical use of polysomnography (PSG)]. - NCBI

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul

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