What is a Sleep Laboratory?
Sleep is the restructuring of the physical and mental state of the body, which is tired during the day, by taking a break from daily work and by means of its biological and chemical functions during the night. Considering that a third of our lives are spent in sleep, it can be understood how important it is. Because the body finds the opportunity to renew itself by resting thanks to sleep.
Sleep disorders, oversleeping or not being able to sleep at all, disorders that occur during sleep and cause deterioration of wakefulness functions, and other diseases that affect sleep state constitute the main field of study of sleep medicine. There are more than 80 different sleep and waking problems. All of these problems negatively affect people's quality of life. The most common sleep disorders are as follows:
•Breathlessness during sleep (sleep apnea),
•Excessive daytime sleepiness,
•Restless legs syndrome,
•Insomnia due to adjustment disorder
What Diseases Does the Sleep Laboratory Examine?
Problems that should be evaluated in the sleep laboratory are as follows:
•Shortness of breath during sleep
•Nocturnal heart rhythm irregularities
•Complaints of inadequate and interrupted sleep
•Dryness of the mouth
•Neck sweating during sleep at night
•Periodic leg movements that cause daytime fatigue and sleepiness.
Obstructive Sleep Apnea (OSA)
It is one of the most common sleep disorders. Obstructive sleep apnea is a condition in which airflow from the mouth and nose is interrupted, although abdominal and thoracic respiratory effort is normal. After a period of apnea, the patient breathes loudly and begins to snore with a flutter-like movement.
The most common symptoms of sleep apnea are as follows:
•Excessive daytime sleepiness
•Atypical chest pain
•Rhythm disorders in the heart
•Feeling of drowning in sleep
•Headache on waking
•Memory impairment and forgetfulness
•Loss of sexual desire
•Decreased decision-making ability
•Depression and psychosis
•Dryness of the mouth
•Mental and physical deterrioration
Sleep Apnea Treatment
A multidisciplinary approach is determined for the diagnosis and treatment of obstructive sleep apnea (OSA). General treatment methods can be divided into medical treatment and surgical treatment methods.
Medical treatment methods mostly proceed within the scope of general precautions. Especially excessive weight is a factor that worsens sleep apnea syndrome. Therefore, providing weight control is an important part of the treatment. Apart from this, sleeping on the side should be preferred instead of lying on the back. Although it is an old method, sewing a hard ball on the back of the pajamas is a method that remains valid today. Thus, since it will be difficult to sleep on your back, the problem of snoring and apnea is tried to be reduced. In some cases, mechanical tools are used. CPAP, BIPAP, oral or intranasal instruments are useful because they apply positive airway pressure.
Surgical treatment methods have an important place in the treatment of snoring and obstructive sleep apnea. Surgical interventions are used for methods that bypass the obstruction. The most common surgical interventions are as follows:
•Tongue base surgery,
•Soft palate and tonsil operation,
•Nasopharyngeal surgery such as adenoidectomy,
•Nose operations such as Concha reduction, polypectomy, septum or valve surgery.
Sleep Laboratory Process
For the polysomnography test to be performed in the sleep laboratory, patients bring their own pajamas and personal belongings. The patient who arrives before the bedtime needs to arrive a few hours before the normal sleep time in order to get used to the environment and stick the electrodes that will record the findings. The patient is prepared together with the technician and when he wants to sleep, he is told to go to bed and sleep.
Technicians monitor the patient from another room and assist the patient in case of need. The patient may wake up frequently due to the cables in his body, who know that he is being watched during the night. However, even in the most unfavorable situations, the individual's sleep efficiency can be observed.
Polysomnography results are evaluated and reported by an experienced physician. According to the results of the report, the most appropriate treatment method can be easily determined. Although polysomnography is a test that is initially shunned by patients, it is a simple test for the patient that provides a lot of data to the physician.
Tests Applied in the Scope of Sleep Laboratory
Sleep Test (Polysomnography)
One of the important tests for detecting sleep disorders is polysomnography. It is usually the definitive diagnosis method for problems such as snoring and sleep apnea. With polysomnography, sensors are placed in various areas of the body and monitored while the patient sleeps through the night. The more sensors used and the greater the sensitivity of the sensors, the more information can be obtained about the extent of the problem.
With the polysomnography performed in the sleep laboratory, it is determined that the respiratory pauses and their duration during sleep, the level of oxygen decrease, the irregularities in the heartbeat and the extent to which sleep is affected by all these. With the help of the findings obtained by polysomnography, the severity of the disease is determined and appropriate treatment planning is made.
EEG is the detection of the electrical activities of the nerve cells in the brain by means of electrodes attached to the scalp and recording by increasing the voltage with computers. While recording, wave vibrations are used and electrical activity becomes visible. The EEG is taken while the patient is sitting in a semi-sitting position in the awake state, with the eyes closed. EEG is a simple test that does not cause discomfort to the person. It is completed in 10-15 minutes on average. EEG is used as a reliable and informative research method in progressive or non-progressive diseases of the central nervous system.
EMG test consists of two parts. The first is electroneurography (ENG), and the second is electromyography (EMG). The single method covering both stages is called EMG. The purpose of the EMG test is to give low-voltage electrical stimulation to some specific areas, based on the fact that certain nerves pass through certain points. The test is based on obtaining the sensory or motor electrical responses of the nerve fiber together with the stimuli. In the second stage, special electrodes are applied to certain striated muscles. Thus, information is obtained about the functioning of both the muscle and the nerve coming to the muscles, and the junctional regions between the relevant nerve and muscle fibers. The tests take an average of 20 to 30 minutes.