Sleep Testing

There are more than 80 different sleep disorders, and each has different symptoms. You may have trouble falling asleep. Or you may wake up in the morning feeling sleepy — and stay that way all day. You may even nod off at work or in social situations.

You might punch, yell, kick, scream or curse at night. You might walk or eat in your sleep. Your partner may complain that you snore, gurgle or groan all night. Or you might wake up gasping for breath.

When you have symptoms like these, there’s a good chance you have a sleep disorder. Sleep testing helps pinpoint what’s going on and makes sure you get the best possible treatment. Our providers will ask you about your symptoms and how they’re affecting your life. And they may recommend sleep testing for things like:

• Sleep apnea.
• Narcolepsy.
• Idiopathic hypersomnia disorder.
• Parasomnias (disruptive sleep disorders).
• Circadian rhythm sleep disorders.
• Sleep-related movement disorders.

Sleep disorder questionnaire

We’ll ask you to track your sleep patterns for about a week before we start any sleep tests. You’ll log information into a special questionnaire that asks about your sleep habits, like:

• What time did you go to bed?
• What time did you wake up?
• Did you have trouble falling asleep?
• Did you wake up during the night?

Meet Our Sleep Testing Team

Our team of sleep specialists will help pinpoint the causes behind your sleep problems with the latest sleep testing. This team has providers from different practice areas, like:

• Neurologists.
• Neurophysiologists.
• Otolaryngologists (specializing in sleep surgery and upper airway assessments).
• Pulmonologists.
• Psychiatrists.
• Psychologists.
• Primary care providers.
• Nurse practitioners.
• Physician assistants.
• Dentists (skilled in oral appliance therapy).
• Sleep technologists.

Depending on your symptoms, your provider may recommend either testing done in one of our sleep labs or an at-home test. You may need to stop taking certain medications for at least 14 days before testing begins. Your provider will talk to you about this.

Sleep studies (polysomnogram)

We can best diagnose many sleep disorders with an overnight sleep study (polysomnogram or PSG test). We tailor testing to each person based on individual sleep patterns. If you’re a shift worker at night, we may do the tests when you usually sleep during the day.

You’ll sleep about eight hours in a private sleep room at one of our sleep labs. We’ll put painless electrodes on your head to track your brain and muscle activity and eye movements. We’ll place sensors around your nose, chest and belly (abdomen) and oxygen and carbon dioxide sensors to watch your breathing patterns.

Depending on your health history, we may also increase the number of sensors on your head to record an electroencephalogram (EEG) at the same time as your sleep study. This helps us monitor your brain waves to check for abnormal movements or behaviors while you sleep, like seizures or parasomnias. 

If you have symptoms of a REM sleep disorder, we’ll measure the amount of elevated (abnormal) muscle activity when you’re in REM sleep. If you have sleep apnea, we may start treatment with positive airway pressure (PAP) therapy or study the effect of your oral appliance or nerve stimulator on your sleep apnea.

Multiple sleep latency test

If you have excessive daytime sleepiness or have trouble staying awake during the day, we might do a multiple sleep latency test. This is often something people with narcolepsy have the day after an overnight sleep study. You’ll do this at the sleep lab. Our team gives you five chances to nap during the day at two-hour intervals. We’ll record your brain and chin muscle activity. And we’ll track your eye movements. We also measure how long it takes you to fall asleep with each nap.

Before we test for the excessive need to sleep, your provider will give you a small, watch-like device to wear, called an actigraphy sensor. It tracks your sleep-wake cycle.

Home sleep testing

When your providers suspect your symptoms point to obstructive sleep apnea (OSA), they may offer you sleep testing at home. You’ll use a portable sleep monitor to do this. This equipment includes a recording device, sensors and belts. And it runs on AA batteries. It records airflow, breathing effort, blood oxygen levels and snoring while you sleep.

Before you start this at home, you’ll watch an educational video, and your providers will show you how to activate the device. A sleep technologist will be available by phone to help you if needed. We want to be sure you’re comfortable using it on your own. You’ll return the equipment the day after your study. Devices are typically mailed to your home but can be picked up at one of our locations.

What To Expect After Sleep Testing at Cleveland Clinic

Once your care team has your sleep testing results, they’ll work with you to create a highly personalized treatment plan. They focus on you, your symptoms and your goals to make sure you get the best results — and a better night’s sleep.

If you do have OSA, we may have you use an oral appliance that helps hold your jaw and tongue in a position that keeps pressure off your windpipe. Or we might prescribe positive airway pressure (PAP) treatment to increase air pressure when you inhale. The most popular of these is the continuous positive airway pressure (CPAP) machine. If CPAP therapy isn’t effective, your provider may consider a stimulator that opens your airway when you sleep.

Treatments for other disorders can include:

• Lifestyle and sleep routine changes.
• Medications to help you sleep, improve daytime sleepiness and treat depression and anxiety.
• Cognitive behavioral therapy for insomnia or hypersomnia.
• Light therapy.
• Melatonin.
• Complementary medicine like meditation and relaxation.

Taking the Next Step

Everyone has a bad night’s sleep once in a while. But when it happens every night, you can feel anxious, irritable and overtired, or be at risk for serious brain, heart or metabolic problems. The good news is that you don’t have to live with it. Sleep testing can help you find out what’s causing your problems, so you can start personalized treatment right away. Cleveland Clinic was one of the first in the nation to specialize in sleep testing and disorders. And our skilled team is here to help you get back to sleeping soundly.