polysomnography

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Polysomnography

 

Definition

The word polysomnography, derived from the Greek roots "poly," meaning many, "somno," meaning sleep, and "graphy" meaning to write, refers to multiple tests performed on patients while they sleep. Polysomnography is an overnight test to evaluate sleep disorders. Polysomnography generally includes monitoring of the patient's airflow through the nose and mouth, blood pressure, electrocardiographic activity, blood oxygen level, brain wave pattern, eye movement, and the movement of respiratory muscle and limbs.

Purpose

Polysomnography is used to help diagnose and evaluate a number of sleep disorders. For instance, it can help diagnose sleep apnea, a common disorder in middle-aged and elderly obese men, in which the muscles of the soft palate in the back of the throat relax and close off the airway during sleep. This may cause the person to snore loudly and gasp for air at night, and to be excessively sleepy and doze off during the day. Another syndrome often evaluated by polysomnography is narcolepsy. In narcolepsy, people have sudden attacks of sleep and/or cataplexy (temporary loss of muscle tone caused by moments of emotion, such as fear, anger, or surprise, which causes people to slump or fall over), sleep paralysis or hallucinations at the onset of sleep. Polysomnography is often used to evaluate parasomnias (abnormal behaviors or movements during sleep), such as sleep walking, talking in one's sleep, nightmares, and bedwetting. It can also be used to detect or evaluate seizures that occur in the middle of the night, when the patient and his or her family are unlikely to be aware of them.

Precautions

Polysomnography is extremely safe and no special precautions need to be taken.

Description

Polysomnography requires an overnight stay in a sleep laboratory. During this stay, while the patient sleeps, he or she is monitored in a number of ways that can provide very useful information.
One form of monitoring is electroencephalography (EEG), in which electrodes are attached to the patient's scalp in order to record his or her brain wave activity. The electroencephalograph records brain wave activity from different parts of the brain and charts them on a graph. The EEG not only helps doctors establish what stage of sleep the patient is in, but may also detect seizures.
Another form of monitoring is continuous electro-oculography (EOG), which records eye movement and is used to determine when the patient is going through a stage of sleep called rapid-eye-movement (REM) sleep. Both EEG and EOG can be helpful in determining sleep latency (the time that transpires between lights out and the onset of sleep), total sleep time, the time spent in each sleep stage, and the number of arousals from sleep.
The air flow through the patient's nose and mouth are measured by heat-sensitive devices called thermistors. This can help detect episodes of apnea (stopped breathing), or hypnopea (inadequate breathing). Another test called pulse oximetry measures the amount of oxygen in the blood, and can be used to assess the degree of oxygen starvation during episodes of hypnopea or apnea.
The electrical activity of the patient's heart is also measured on an electrocardiogram, or ECG. Electrodes are affixed to the patient's chest and they pick up electrical activity from various areas of the heart. They help detect cardiac arrythmias (abnormal heart rhythms), which may occur during periods of sleep apnea. Blood pressure is also measured: sometimes episodes of sleep apnea can dangerously elevate blood pressure.
In some cases, sleep laboratories monitor the movement of limbs during sleep. This can be helpful in detecting such sleep disorders as periodic limb movements.

Preparation

The patient may be asked to discontinue taking any medications used to help him/her sleep. Before the patient goes to sleep, the technician hooks him or her up to all of the monitors being used.

Aftercare

Once the test is over, the monitors are detached from the patient. No special measures need to be taken after polysomnography.

Normal results

A normal result in polysomnography shows normal results for all parameters (EEG, ECG, blood pressure, eye movement, air flow, pulse oximetry, etc.) monitored throughout all stages of sleep.

Abnormal results

Polysomnography may yield a number of abnormal results, indicating a number of potential disorders. For instance, abnormal transitions in and out of various stages of sleep, as documented by the EEG and the EOG, may be a sign of narcolepsy. Reduced air flow through the nose and mouth, along with a fall in oxygenation of the blood, may indicate apnea or hypopnea. If apnea is accompanied by abnormalities in ECG or elevations in blood pressure, this can indicate that sleep apnea may be particularly harmful. Frequent movement of limbs may indicate a sleep disorder called periodic limb movement.

Resources

Organizations

National Heart, Lung and Blood Institute. P.O. Box 30105, Bethesda, MD 20824-0105. (301) 251-1222. http://www.nhlbi.nih.gov.

polysomnography

 [pol″e-som-nog´rah-fe]
the polygraphic recording during sleep of multiple physiological variables that are directly or indirectly related to the state and stages of sleep; done to assess possible biological causes of sleep disorders.

pol·y·som·no·gra·phy

(pol'ē-som-nog'ră-fē),
A sleep study that measures multiple physiologic variables associated with sleep. Includes oxygen saturation, electrocardiography, air flow, respiratory effort, limb movement, eye and jaw muscle movement, and brain electrical activity.

polysomnography

/poly·som·nog·ra·phy/ (pol″e-som-nog´rah-fe) the polygraphic recording during sleep of multiple physiologic variables related to the state and stages of sleep to assess possible biological causes of sleep disorders.

polysomnography

[pol′ē·som·nog′rə·fē]
Etymology: Gk, polys, many + L, somnus, sleep + Gk, graphein, to write or record
the polygraphic recording during sleep of multiple physiological variables, both directly and indirectly related to the state and stages of sleep, to assess possible biological causes of sleep disorders.

polysomnography

Cardiopulmonary sleep study, sleep apnea study Sleep disorders The continuous and simultaneous recording of multiple physiological variables during sleep–ie, EEG, EOG, EMG–the 3 basic stage scoring parameters, EKG, respiratory air flow, respiratory excursions, lower limb movement, and other electrophysiologic variables, and electrooculography; a polysomnograph uses noninvasive sensors for nasal airflow–thermocouple, oral airflow–end-tidal CO2 gauge, tracheal sounds–microphone, thoracic and abdominal respiratory effort–inductance plethysmography, oxyhemoglobin–finger-pulse oximeter Indications Monitor defects in respiratory control–sleep apnea disorders, COPD, restrictive ventilatory disorders

pol·y·som·no·gra·phy

(pol'ē-som-nog'ră-fē)
Simultaneous and continuous monitoring of relevant normal and abnormal physiologic activity during sleep.
[poly- + L. somnus, sleep, + G. graphō, to write]

polysomnography

The simultaneous monitoring, during sleep, of a number of parameters in a patient. These include electroencephalogram, electrocardiogram, electromyogram, rapid eye movements, chest excursion, mouth and nose air entry rates, blood oxygen saturation and the frequency and loudness of snoring.

Patient discussion about polysomnography

Q. Could someone please explain about the Fibromyalgia and sleep studies? My cousin who is 15 yrs old is suffering from sleep related problems. Should I suspect that he have fibromyalgia syndrome? Could someone please explain about the Fibromyalgia and sleep studies?

A. You could have given more details about your cousin’s sleep related problem. I could not say anything directly for your cousin as I don’t know about his actual problem. But generally saying, Individuals who have been diagnosed with fibromyalgia/who suspect they have fibromyalgia syndrome, sometimes submit themselves to sleep studies. Sleep studies can provide confirmation of a patient's sleep related problems by monitoring brain wave activity. By monitoring such neural activity, information can be gleaned regarding the quality and nature of sleep that a fibromyalgia patient experiences. Recent evidence indicates that fibromyalgia may be related to insufficient amounts of deep level delta wave sleep. Delta wave sleep is the level of sleep at which a person's body both recuperates and regenerates. Failure to reach or maintain deep level sleep may have something to do with the pain that is experienced by those who have fibromyalgia.

More discussions about polysomnography
References in periodicals archive ?
Terzano, "Distinctive polysomnographic traits in nocturnal frontal lobe epilepsy," Epilepsia, 53, 2012, 1178-1184.
Endocrinological and polysomnographic findings in Kleine-Levin Syndrome: no evidence for hypothalamic and circadian dysfunction.
The complete polysomnographic investigation included electroencephalography, chin and leg electromyography, airflow monitoring, thoracic and abdominal respiratory effort, and pulse oximetry.
Figure 2A shows typical polysomnographic 30-second epochs, from the DSI group, scored as SWS.
The study subjects (cases) were screened and consecutively selected from middle-aged adults (25-65 yr) of either gender referred for overnight polysomnographic study (PSG) to the Sleep Laboratory of All India Institute of Medical Sciences, New Delhi, India.
Subjects then completed a complaint checklist, and a two-night polysomnographic investigation and RNase L analysis was performed.
Anethesia Technician Biomedical Engineer Technician Caridiac Technician Cardiac Catheterization Technologist Cytogenetic Technologist Enterostomal Therapist Genetic Counselor Hyperalimentation Technician Interventional Radiological Technician Mammography Technologist Polysomnographic Technician Vascular Technician
These hallucinations were not clearly associated with fragmented sleep, but lacking polysomnographic evidence of REM rebound or intrusions during his period of overt psychosis, it is difficult to either refute or substantiate sleep deprivation.
Conclusion: Polysomnographic findings of patients with LSC demonstrated that sleep structure is disturbed by arousals and awakenings related to scratching bouts during sleep.
We make our living by watching people sleep, says Debbie, a polysomnographic technologist in Savannah, Georgia.
The investigators analyzed polysomnographic data, history of stroke, and known confounding variables in 1,475 subjects who ranged in age from 30 to 60 years.
Chapter topics for the last section include polysomnographic evaluation of sleep disorders, electrophysiologic evaluation of patients in intensive care, and electrophysiologic evaluation of brain death.