A sleep study is the monitoring of your brain waves and several other body functions while you are asleep. Sleep studies are standard tools in the diagnosis and treatment of sleep apnea and other sleep disorders. Usually when people say “sleep study” they mean a study at a sleep lab that records an entire night’s sleep. The technical term for this kind of study is an “overnight polysomnogram.” Other, less common, studies where your sleep is monitored are the MSLT and MWT.

Sleep studies are used to diagnose several different sleep disorders. The most common of these disorders is Obstructive Sleep Apnea.

A sleep study looks for things that hamper sleep’s ability to work correctly. In other words, if you sleep fairly well but are still tired in the morning, or struggle to stay awake later in the day, a sleep study discovers if something is sabotaging the quality of your sleep. To better decide if a sleep study is appropriate for you, click here.

Falling asleep is only the first part of good sleep. If you are still tired after a full night’s sleep, or have trouble staying awake during the day, chances are something is happening while you were asleep that is decreasing the quality of your sleep. For help in deciding if a sleep study is a good idea for you, click here.

Obstructive Sleep Apnea (OSA) is a serious condition in which a person stops breathing periodically throughout the night. The loss of airflow is caused by the airway closing off; the chest and abdomen go up and down, but no air is moving. When a person who has OSA falls asleep, the soft tissues in of the upper airway, usually in the back of the throat, begin to lose tone and collapse, partially or completely blocking the flow of air. This partial or complete obstruction usually lasts for 10 to 30 seconds, at the end of which time the person will awaken for a brief period, gasping, snoring, or snorting. This can happen dozens or hundreds of times during the night. These repeated interruptions during sleep typically leave the person tired and sleepy during the day.

Snoring, morning headaches, waking up gasping for breath, irritability, decreased concentration, impotence, and especially excessive daytime sleepiness (EDS) are possible symptoms of obstructive sleep apnea. Few people have all the symptoms of OSA. Snoring and excessive daytime sleepiness are the most commonly reported symptoms. Excessive daytime sleepiness means that you are often struggling to stay awake. This could be during the day at work or when you come home in the evening.

Excessive Daytime Somnolence, or Sleepiness, means that one struggles to stay awake throughout the day. The person with EDS is often able to stay awake if active, but easily nods off when sitting still. The person who falls asleep in meetings and the person who falls asleep right after sitting down on the couch both probably have EDS. More severe examples of EDS include falling asleep at stop lights or in the middle of a conversation. Chronic or prolonged EDS may be a symptom of Obstructive Sleep Apnea, Narcolepsy, or Periodic Limb Movement Syndrome.

OSA is a serious medical condition. Untreated OSA substantially increases a person’s risk of heart attack, high blood pressure, stroke, and motor vehicle accident. This is in addition to the chronic fatigue and sleepiness which are the hallmarks of the disorder and which can severely impair the quality of a person’s life. Fortunately, OSA can be treated and controlled.

Many people, including doctors and sleep professionals use the terms interchangeably. Technically, sleep apnea means a cessation of breathing while a person is asleep. Obstructive sleep apnea is a specific type of sleep apnea and the most common.

Not necessarily. It is a peculiarity of human memory that if we are awakened from sleep, and are awake for less than about two to five minutes, that awakening will not be saved in long-term memory. Consequently, many people who suffer from OSA or PLMs are not aware of the vast majority of the awakenings they experience during a typical night.

Because we need not only a certain amount of sleep during any 24-hour period (an amount that varies from person to person), but also continuity of sleep. This fact has become clear over the past 30 years or so of sleep research. For example, 200 10-second awakenings might leave you just as tired as one 2000-second awakening, although, as pointed out above, you would remember the latter but none of the former.

Not really. The drive to breathe is, not surprisingly, extremely strong, and unless a person has other severe health problems, particularly heart or lung problems, then OSA is rarely immediately dangerous.

The preferred treatment for OSA is CPAP (pronounced “see-pap”), which stands for Continuous Positive Airway Pressure. CPAP is a device which provides a steady stream of filtered, high-pressure air through a small mask that you wear over your nose when you are asleep. CPAP works by using the pressure of the incoming air to support the soft tissues in your upper airway and preventing their collapse, so that you can then breathe normally.

Other treatments for OSA include surgery, and oral appliances. As the effectiveness of these treatments is less than CPAP, most insurers require a trial of CPAP before paying for other approaches. Kiron recommends consulting with an ENT specialist to thoroughly understand the potential risks and benefits of surgical treatment.

If you are overweight, losing weight will likely decrease the severity of OSA. Not everyone who has OSA is overweight, however. Also, many people with OSA experience such severe, uncontrollable sleepiness that they are unable to maintain the level of activity needed to lose weight. Furthermore, no weight loss program will immediately reduce you to your ideal weight. For these reasons, many doctors who have overweight patients with OSA like to treat the OSA first, or concurrently with the weight loss program, rather than have the patient try to lose weight only.

CPAP (pronounced “see-pap”), stands for Continuous Positive Airway Pressure. CPAP is a device which provides a steady stream of filtered, high-pressure air through a small mask that you wear over your nose when you are asleep. CPAP works by using the pressure of the incoming air to support the soft tissues in your upper airway and prevent their collapse, so that you can then breathe normally.

Surprisingly well. Sleeping and breathing at the same time is habit forming. Remember that CPAP is not given to people who sleep or breathe normally. It’s given to people who can’t sleep because they can’t breathe. Once they are able to breathe with CPAP, many people with OSA are able to sleep soundly the whole night through. Most users do go through an adjustment period before becoming truly comfortable with CPAP. The trick is to get a well-fitting mask and the correct pressure, and to give the person the opportunity to get used to CPAP.

CPAP is the preferred treatment for OSA, and it has the best success rate of the available treatments. For most people with OSA, CPAP is the best available treatment. However, a small percentage of people can’t tolerate CPAP. Even people who will eventually tolerate CPAP take some time to get used to it, and that time is completely unpredictable. Some people fall asleep two minutes after putting CPAP on and never have a minute’s trouble with it. Some people aren’t really comfortable with it until they’ve been using it for a few weeks.

It’s hard to say. CPAP is a long-term treatment and people will usually need to use it for several years, at least. CPAP is a very effective treatment for OSA, but isn’t a cure. Treating OSA with CPAP is like treating diabetes with insulin; the insulin doesn’t make the diabetes go away, just controls it. It may be possible for overweight persons with OSA to reduce or eliminate their need for CPAP by reducing to a healthy weight. We are aware of some individual cases, but there is not a great body of research on this subject.

Call Kiron during office hours and the staff here will help get things started. We may well be able to schedule you directly for a study. Depending on the complexity of your symptoms and your insurance requirements, we may suggest you see a physician, first. If that is the case, you can either see your regular physician or we can arrange for an appointment with Kiron’s medical director, Dr. Michael Soo. We accept both self-referrals and referrals from outside physicians.

Maybe. Kiron does not require a referral in order to schedule you for a sleep study. Some insurance plans, however, require a referral from the primary care physician. If your policy requires you to obtain a referral from your PCP before going to a specialist, the same is likely the case with Kiron. If you are not sure, call Kiron and our staff will find the answer for you.

While you may not have to see a physician before having a sleep study, you will need to work with a physician to review the results and decide on a course of treatment should you have a sleep disorder. The physician could be a doctor you already see or you could have Kiron schedule an appointment with the center’s medical director, Dr. Michael Soo.

An overnight sleep study is a standard medical procedure covered by most insurance plans, including Medicare. Whether or not the entire cost is covered varies from company to company and policy to policy. Kiron’s reimbursement specialists can help you learn more about your insurance benefits for sleep studies.

No. Kiron will first bill your insurance company. You will receive a bill only after your insurance benefits have been processed.

If you are paying for the study yourself, and not using any insurance benefits, discuss payment arrangements with the office staff when you are scheduling your study. Kiron offers a discount for net zero payment, of which you will wish to take advantage.

Yes. To get an accurate and complete measure of your sleep, so that your sleep problem can be correctly diagnosed, we need to record as much of your sleep as possible. In practical terms, this means six to seven hours from Lights Out to Lights On. Most patients should be finished with the whole process and ready to leave the lab by 6am.

If you normally work at night and sleep during the day, Kiron can accommodate your sleep schedule and perform your study during the day.

A technician will attach a number of electrodes to your skin with tape or with paste. The electrodes are simply wires with sensors on the ends of them. Most of these electrodes go on your face or on your scalp. If you’ve ever had an EEG or an EKG, these types of electrodes will be familiar to you. These electrodes pick up the minute electrical signals generated by your heart, your brain, your muscles, and your eye movements. Other sensors measure aspects of your respiration: the effort you expend to breathe; the airflow from your mouth and nose; your snoring; and the amount of oxygen in your bloodstream. All the signals are processed and displayed by specialized computer equipment. By looking at all these signals the sleep professionals at Kiron can tell when you are awake, when you are asleep, and which of the different types, or Stages, of sleep you’re in at any given time.

Yes. There are a lot of sensors, but they are quite lightweight, and most patients report that they get used to them very quickly. Most of our patients are extremely sleepy, and fall asleep pretty quickly. A few patients do take a while to get used to sleeping in a strange room with wires on their heads and, therefore, take a while to fall asleep. In the rare instances that someone takes more than half an hour to fall asleep, we have a sedative (Ambien) and standing orders from Dr. Soo to offer it to a patient who would benefit from it. A patient is never required to take Ambien. Even if you don’t sleep as much in the lab as you would have at home, that shouldn’t interfere with the study. The disorders we see most often at Kiron (OSA and PLMS) occur every night and seem to be roughly the same severity (with minor variations) every night. So, if you sleep an hour less in the lab than you would have at home, but you have OSA, we will still get ample evidence of it for your physician.

No. None of the electrodes, or any of the other sensors, penetrate the skin. We do have to scrub the skin at each electrode site to remove any oil or soap or shampoo residue which may be on your skin. These substances, even the microscopic amounts of oil our skin produces naturally to keep itself from drying out, can interfere with the electrical signals we are trying to record. To scrub the skin we use a mildly abrasive detergent gel, rather like a cosmetic exfoliation gel. While skin sensitivity does vary from person to person, most people experience no discomfort from this scrubbing process. Some people may experience dryness, mild itching, or slight irritation at the electrode sites. We use hypoallergenic medical tape for some sensors. As tapes go, it is quite comfortable. There may, of course, be some irritation when the tape is removed in the morning, depending on how hairy the site it’s removed from is.

Yes. There will be at least one tech for every two patients staying in the lab all night. The techs are there to monitor the equipment, attend to the patients’s needs during the night, and perform various other functions.

No. Many patients worry that they will pull the electrodes loose if they move, but the sensors are more secure than they appear. A patient should be able to sleep in any position, and to change positions without great difficulty. We do discourage patients from sleeping sitting up, as this can mask the presence of Obstructive Sleep Apnea.

Should a sensor be dislodged or damaged during the night, the tech will be able to tell by monitoring the signals on the computer screen. Replacing a sensor usually takes only a minute or two.

Many of our patients report difficulty sleeping on their backs. Often this is because they have difficulty breathing on their backs. To document this phenomenon, techs will often request patients to sleep on their backs for part of the night. We do not require that the patients do so for the whole night, however.

There is a microphone in every sleep room at Kiron. Should you need to get up during the night, you may call for the tech, or rap your knuckles on the headboard of your bed, and the tech will come into your room and help you get up. It only takes the technician a moment to disconnect the sensors from the wall so you can go to the bathroom.

That’s okay. Even if you don’t have a great night’s sleep, there will be enough data for the sleep study to be useful. In the thousands of sleep studies conducted at Kiron, only two or three times has a person slept so poorly that little could be l earned from the study.

All of Kiron’s sites are located in professional office parks. Patients can park directly in front of the building; no annoying parking decks to deal with. Each patient at Kiron has a private room with a full-size bed. Each room has individual climate control. Towels, washcloths, and bed linens are provided by Kiron. Showers are available for patient use at the Durham and Chapel Hill locations. Patients are welcome to bring pillows, teddy bears, and the like, but not pets or bed partners.

Yes. All of the sleep rooms at Kiron are private. Check here for more detail.

Kiron facilities are equipped with fire and intruder alarms, sprinkler systems, and emergency call systems. All Kiron personnel are qualified in Basic Cardiac Life Support. In addition, many of our technologists are Licensed Respiratory Care Practitioners. Staff members are monitoring your heart rate, EKG, and blood oxygen level all night long. Few people are this carefully looked after at home.

The gold standard of sleep medicine is to use one study to get a clear picture of any sleep problems a person may have. Then, if the person has OSA, he or she has a follow-up study with CPAP. This study will be much like the first study, except that the patient will sleep with a CPAP mask on. This is called a “titration study.” The goal is to discover what pressure best controls the sleep apnea and allows the patient to sleep comfortably. Throughout the night, the technologists monitor and adjust (titrate) the pressure. Spending a whole night on CPAP, in a controlled environment, and in the care of experienced sleep professionals, gives the patient time to get used to CPAP.

Sometimes it is possible to combine the diagnostic and titration studies into one night. This commonly called a “split study”. A split study is generally more practical for patients with more severe OSA and clear symptoms. Insurance concerns are often a determining factor in whether or not a split study is performed. Kiron staff will be glad to discuss this with you when you schedule your appointment.

No. The record needs to be carefully scored by a Registered Polysomnographic Technologist and then interpreted by physician specializing in sleep. To avoid the risk of providing anything other than perfectly accurate results, the night techs will not be able to give you any results in the morning.

Kiron has a very fast turn around time from completion of the study to final report. In most cases, the final report is complete in two to three business days and very rarely any later than five business from the completion of the study.

If you were referred to Kiron by a physician, Kiron will automatically send results to that doctor. If you provide the contact information, Kiron will send the results to any other physician you wish.

Usually your referring physician will discuss the results of the study with you. If you are a self-referral, you will probably want to schedule an appointment to see a specialist at Kiron.

Yes, unless you are very sensitive to getting less than 8 hours of sleep. The usual study allows the patient to get 6.5 to 7 hours of sleep.

Yes, unless your physician directs you to do otherwise.

Yes. All the sleep rooms at Kiron have cable television. We do ask that you turn off the television when we begin the sleep recording. Doing so provides for the most accurate results.

You may still be able to have your sleep study. Please call Kiron if you have a cold and have a sleep study scheduled in the next 48 hours.

If you cancel your study without giving Kiron 24 hours notice, you will be charged a $50 cancellation fee. You may also be required to make a $250 deposit before being allowed to reschedule your appointment. Exceptions to this policy may be made at Kiron’s discretion in the case of certain specific emergencies.

No. You are welcome to have a visitor until shortly before lights out, however no one other than patients are allowed to stay after lights out. The only exception Kiron can make to this rule is for patients who are minors or who have a disability that requires the presence of a care giver.

OSA stands for Obstructive Sleep Apnea.

MSLT stands for Multiple Sleep Latency Test. It is a daytime study used in the diagnosis of Narcolepsy and a few other sleep disorders. It provides some measurement of how sleepy a person is during the day. Some people with DOT certificates are required to have an MSLT or MWT on a yearly basis.

MWT stands for Maintenance of Wakefulness Test. It is a daytime study that provides some measurement of a person’s ability to stay awake in sleep inducing conditions. Some people with DOT certificates are required to have an MSLT or MWT on a yearly basis.

Narcolepsy is a neurological disorder typically characterized by severe daytime sleepiness or by sleep attacks, events in which a person falls asleep uncontrollably and with little warning. It is caused by a dysfunction in the section of the brain which controls when a person enters a stage of sleep called Rapid Eye Movement (REM) sleep. It is controllable and is usually treated with medication. More information can be obtained from your physician or the American Sleep Disorders Association .

A person with Periodic Limb Movement Syndrome suffers from repetitive, involuntary twitches or jerks of a person’s legs, or, rarely, arms, which occur during sleep. The twitches are called periodic limb movements (PLMs). These twitches can awaken a person, usually for only a few seconds at a time, over and over throughout the night. In some cases, a person may awaken dozens or even hundreds of times a night. These disruptions in sleep can then leave a person tired or sleepy all day, as though he hadn’t slept at all. PLMs are treatable with various medications.

“Kiron” is a phonetic spelling of Chiron, the centaur. According to myth, it was Kiron who taught the healing arts to mankind. It is nowhere near as strange as some of the other names we considered.

It rhymes with “pie ron”.