Sleep Disorder Testing: What to Expect

Some sleep disorders, such as sleep apnea, require overnight observation in the sleep laboratory. During an overnight sleep testing (polysomnogram), electrodes are placed to record brain activity, eye movements, and muscle activity. Additional sensors are placed around the nose, chest, and abdomen to record breathing patterns. On the night of the study, you will be asked to report to the sleep laboratory between 6:30 p.m. and 8:30 p.m. to prepare for the test. You will be allowed to go to sleep at your usual bedtime in a private sleep room. If no other tests are scheduled, you will be free to leave the laboratory in the morning between 6 a.m. and 8 a.m.

People with excessive daytime sleepiness in whom narcolepsy is suspected are typically given a multiple sleep latency test (MSLT) on the day following the overnight polysomnogram. During the MSLT, you will be given 5 opportunities to nap throughout the day at 2-hour intervals while electrical activity is recorded from the brain, eyes, and chin muscles. The time it takes to fall asleep during each nap is measured. The test provides an objective measure of daytime sleepiness.

Depending on your clinical history, additional parameters can be recorded during the overnight study. More extensive recording of muscle and brain activity is performed in patients with unusual behavior or excessive movements in sleep. Esophageal pressure monitoring, involving the placement of a sensor through the nose and into the esophagus, is performed to evaluate for abnormal breathing patterns that may be missed on the routine polysomnogram.

As part of your sleep evaluation at the Cleveland Clinic Sleep Disorders Center, you will be asked to complete a sleep disorders questionnaire and maintain a sleep log for at least one week before your appointment. These items will be mailed to you in advance. This will provide us with more information about your sleep problem(s) and usual sleep patterns so that we can better serve you.

Overnight Sleep Testing

Polysomnogram (PSG) Test

In preparation, please read the following instructions carefully.

• Avoid napping the day of the study.
• Avoid alcohol, caffeine, sedatives, and stimulants for 24 hours, unless otherwise directed by your physician.
• Eat your regular evening meal before you arrive to the Sleep Disorders Center. Breakfast is provided to those patients required to stay for daytime testing. Notify us in advance of any special dietary needs.
• On the day of the study, make sure that your hair is free of oil, hair spray, and other products.
• Bring your regularly scheduled medications and plan to take them as you normally would unless your physician instructs otherwise.
• Bring comfortable sleep attire (avoid silk). Shower facilities are provided.
• Bring your sleep questionnaire and sleep log along with a list of your regular medications, including dose strength, and dosing schedule.
• If you are using positive airway pressure therapy (CPAP/BILEVEL), bring your mask and headgear.
• If you are under 18 years of age, a parent or guardian is required to stay with you in the Sleep Disorders Center for the entire duration of testing.
• Notify us if you have a disability that requires special assistance. You may be required to have a caregiver present during testing.

Daytime Sleep Testing

Multiple Sleep Latency Test (MSLT)/Maintenance of Wakefulness Test (MWT)

In preparation, please read the following instructions carefully.

• Eat normally the night before and the morning of the study.
• Breakfast and lunch will be provided if you stayed overnight for the polysomnogram. If you are scheduled for the day study only; please eat a normal meal the night before and the morning before coming to your appointment. Please notify us in advance if you have any special dietary needs.
• Wear comfortable clothing.
• On the day of the study, make sure that your hair is free of oil, hair spray, and other products.
• Bring your regularly scheduled medications and plan to take them as you normally would unless your physician instructs otherwise.
• Bring reading materials or other activities to occupy free time.
• Avoid naps, smoking and physical exertion on the day of the test.
• If you are under 18 years of age, a parent or guardian is required to stay with you in the Sleep Disorders Center for the entire duration of testing.
• Notify us if you have a disability that requires special assistance. You may be required to have a caregiver present during testing.
• Avoid alcohol, sedatives, stimulants, and caffeinated beverages (coffee, tea and cola) for 24 hours before the study.
• If you are scheduled for MSLT, please check with your physician regarding changes in medications. Your doctor might advise you not to take any stimulant medication for two weeks prior to the test
• If you are scheduled for MWT, please check with your physician regarding changes in medications. Your doctor might advise you to continue to take the stimulant medications on the day of the test.

Home Sleep Testing

What is home sleep testing?

Home sleep testing is a diagnostic test that helps confirm whether you have obstructive sleep apnea (OSA) – a potentially serious sleep disorder that occurs when a person’s breathing is interrupted during sleep. The testing is done in the comfort of your home, instead of a sleep laboratory, using a portable sleep monitor.

How do I know if it is right for me?

If you suspect you have OSA, talk to you your primary care physician or sleep medicine provider about an evaluation to see if you have a high probability of having moderate to severe OSA.

Your symptoms and risk factors will be assessed using the following “STOP-BANG” criteria:

• Do you SNORE loudly (louder than talking or loud enough to be heard through closed doors)?
• Do you often feel TIRED, fatigued or sleepy during the daytime?
• Has anyone OBSERVED you stop breathing during your sleep?
• Do you have or are you being treated for high blood PRESSURE?
• Is your BODY mass index more than 35 kg/m2? Calculate your BMI.
• Is your AGE over 50 years old?
• Is your NECK circumference more than 40 cm (15.75 inches)?
• Are you of Male GENDER?

Having at least three positive responses to these questions suggest a high risk for OSA. Based on your score, your provider may order home sleep testing to determine whether you indeed have OSA.

Learn more about Home Sleep Testing Services