I think that I have a sleep disorder. How do I get tested?
A sleep study requires a physician order (just like a blood test, EKG or X-Ray). You may get this order from your own doctor or you may call Alexian Connects* for a referral to a physician. Another option is to make an appointment with one of our board-certified sleep doctors and we can provide you with their names and phone numbers.
I snore. Is that bad?
Snoring affects approximately 90 million American adults — 37 million on a regular basis. Two-thirds of partnered adults say their partner snores, while 6 out of 10 of all adults (59%) say they snore. More than one-half (57%) of those who snore say their snoring bothers others. Many times people decide to come for a sleep study because their family or friends simply can not take the noise (or waking up from it) any more. Snoring is an actual sleep disorder. It can be a marker of sleep apnea. It is also a risk factor for hypertension. Snoring causes disruption, or fragmentation, of our sleep which can result in fatigue during the day. It also can cause headaches, difficulty in concentration and reduced work performance. Snoring may occur due to any of a variety of causes, from the common cold to sleep apnea. Obesity and a large neck can contribute to snoring. People who drink alcohol before bedtime may snore more than usual. Some people only snore on their back or worse when on their back, that is why bed partners often utilize "the elbow jab" to get the patient to turn on their side.
My doctor wants me to have a sleep study, but I sleep fine. I can sleep anywhere, anytime. I don't understand why I have to have this test done.
We often don't know exactly what we do at night because we are sleeping. In some cases, we may have a spouse or family member who can inform us that we are restless, kicking, snoring, making funny noises, or even appear to stop breathing when we sleep. On the other hand, it's possible that our spouse is sleeping deeply, or that other family members have no real chance to observe our sleeping habits overnight. That's why a sleep study is so helpful. The technicians who do the test will attach different leadwires to monitor your brainwaves, heart rate, leg movements, oxygen level and other activity. There will be no question of how you slept and what you did during your sleep.
The doctor that has asked you to have the sleep study may have done so because you have risk factors such as hypertension, heart disease, asthma, diabetes; or because you meet certain criteria: you have frequent sinus infections or colds, are overweight, have a large neck circumference, use the bathroom often at night or have a family history consistent with sleep apnea. Patients who say that they can sleep anywhere, anytime are very likely to suffer from a sleep disorder.
My doctor wants me to have a sleep study, but I never sleep. I don't understand how you can do this test if I don't sleep. I'm up all night.
Many of our patients who tell us that they don't sleep, do actually sleep. After the test has started, there are times when we enter a patient room to check something and are very quiet so that we won't wake up our sleeping patient. Yet, when we walk into the room, the patient wakes up and informs us that they have not slept yet and are concerned about not being able to sleep for the study. Some patients have "sleep state misperception." They think that they are awake but are sleeping. If you or your doctor thinks that you may have insomnia, an evaluation can be done by one of our sleep specialists. An overnight sleep study is not done to evaluate someone who has been diagnosed with insomnia.
Is the sleep study painful?
No, it is not painful. The technician applies some leads to different places to monitor different signals. Many of these leads are EKG-type stickers which peel off easily in the morning. There are no needles used.
How will I be able to fall asleep with those wires on?
Many people take a few extra minutes to get comfortable with the leads on. Once the patient preparation is complete, you may watch tv or read a book to relax. Most people fall asleep within 30 minutes of their usual time. If being unable to sleep is a major concern, talk to your physician about it. He may wish to prescribe a mild sleep aid for your study night.
What happens if I have to go to the bathroom? Do all of the wires have to be removed?
No. We do have many patients who go to the bathroom several times throughout the study and it is not a problem. Simply let your technician know. All of the wires are plugged into a small jackbox. This is simply detached from the wall cable, we hang the box around your neck or shoulder and you are able to move about freely. Once you are done and back to bed, the jackbox is simply plugged back in.
Can I bring my family with me?
Family members can accompany you to the sleep center and stay for a short period of time, but they are not allowed to stay late or to stay overnight. The exception is for parents of children under 18 years of age who must stay all night; or for patients with special needs. The sleep center staff can be contacted directly for assistance in identifying the special needs patient. Please also note that animals such as pet dogs or cats are not allowed in the sleep lab except for assistance animals (guide dogs, etc).
What do I need to bring with me the night of my study?
Please bring comfortable sleeping clothes: pajamas, nightshirt, shorts and a shirt, or sweatpants. We recommend layers for those who get cold at night. We have pillows and blankets (including heated blankets), but some patients prefer to bring their own pillow for maximum comfort. Be sure to bring any medications that you take at night or in the morning as the Sleep Health Center has no medications available. Every patient room is a private room with a bathroom. There are shower facilities for those who need to wash up prior to going to work.
Why Do I Need Sleep?
Sleep is not merely a "time out" from our busy routines; it is essential for good health, mental and emotional functioning and safety. For instance, researchers have found that people with chronic insomnia are more likely than others to develop several kinds of psychiatric problems, and are also likely to make greater use of healthcare services. People suffering from sleep apnea are at risk for high blood pressure, heart attacks, stroke and motor vehicle crashes if left untreated.
Even occasional sleeping problems can make daily life feel more stressful or cause you to be less productive. Those who say they have trouble getting enough sleep report a greater difficulty in concentrating, accomplishing required tasks and handling minor irritations. Overall, sleep loss has been found to impair the ability to perform tasks involving memory, learning, and logical reasoning. This may contribute to mistakes or unfulfilled potential at school or on the job and strained relationships at home. In fact, sleeplessness has been found to be a significant predictor of absenteeism. The direct and indirect impact of daytime sleepiness and sleep disorders on the national economy is estimated to be $100 billion annually.
Insufficient sleep can also be extremely dangerous, leading to serious or even fatal accidents. The National Highway Traffic Safety Administration has estimated more than 100,000 auto crashes annually are fatigue related. These drowsy driving crashes cause more than 1,500 deaths and tens of thousands of injuries and lasting disabilities. This problem has been found to affect drivers aged 25 or under more than any other age group.
How Much Sleep Is Enough?
Sleep needs vary. In general, most healthy adults need seven to nine hours of sleep a night. However, some individuals are able to function without sleepiness or drowsiness after as little as six hours of sleep. Others can't perform at their peak unless they've slept ten hours. And, contrary to common myth, the need for sleep doesn't decline with age(although the ability to get it all at one time may be reduced).
So, how do you measure how much sleep you truly need? If you have trouble staying alert during boring or monotonous situations when fatigue is often "unmasked" you probably aren't getting enough good-quality sleep. Other signs are a tendency to be unreasonably irritable with co-workers, family or friends, and difficulty concentrating or remembering facts.
Is All Sleep the Same?
It may surprise you to learn that during the hours you seem to be "out cold," a lot is actually happening. Normal sleepers have a relatively predictable "sleep architecture," the term used to describe an alternating pattern of REM (rapid-eye-movement) and non-REM sleep. REM sleep is when you dream, and is characterized by a high level of mental and physical activity. In fact, your heart rate, blood pressure and breathing are similar to what you experience when you are awake.
Scientists define the best sleep as having the right mix of REM and non-REM sleep. Getting enough sleep without interruptions from your environment or from internal factors such as your breathing is more likely to maintain your natural sleep architecture and result in restful and restorative sleep.
Who's At Risk For Poor Sleep?
Virtually everyone suffers at least an occasional night of poor sleep. However, as the list of "sleep stealers" implies, certain individuals may be particularly vulnerable. These include students, shift workers, travelers, new parents, and persons suffering from acute stress, depression, or chronic pain. Also employees working long hours or multiple jobs may find their sleep less refreshing.
Older adults also have frequent difficulty with sleep problems, but inadequate sleep is not an inevitable part of the aging process. The total amount of sleep needed isn't reduced. However, many of the sleep stealers can combine in the elderly including impaired health, pain and increased use of medications.
Teenagers can have difficulty falling asleep until late at night and awakening early in the morning.
Many young adults keep relatively irregular hours and as a group they report higher rates of dissatisfaction with the sleep they are getting.
Being overweight increases the risk for sleep apnea.
What are the biggest "Sleep Stealers"?
Stress is considered by most sleep experts to be the No. 1 cause of short-term sleeping difficulties. Common triggers include school- or job-related pressures, a family or marriage problem, and a serious illness or death in the family. Usually the sleep problem disappears when the stressful situation passes. However, if short-term sleep problems such as insomnia aren't managed properly from the beginning, they can persist long after the original stress has passed.
That's why it's a good idea to talk to a physician about any sleeping problem that recurs or persists for longer than one week.
Your doctor can help you take steps early to control or prevent poor sleep. Since insomnia can also be brought on by depression, evaluation by a healthcare professional is essential.
Without realizing it, you may be doing things during the day or night that can work against getting a good night's sleep. These include drinking alcohol or beverages containing caffeine in the afternoon or evening, exercising close to bedtime, following an irregular morning and nighttime schedule, and working or doing other mentally intense activities right before or after getting into bed.
If you are among the 17 percent of employees in the United States who are shift workers, sleep may be particularly elusive. Shift work forces you to try to sleep when activities around you — and your own "biological rhythms" — signal you to be awake. One study shows that shift workers are two to five times more likely than employees with regular, daytime hours to fall asleep on the job.
Still another sleep stealer is jet lag, an inability to sleep caused when you travel across several time zones and your biological rhythms get "out of sync."
A distracting sleep environment such as a room that's too hot or cold, too noisy or too brightly lit can be a barrier to sound sleep. Interruptions from children or other family members can also disrupt sleep. Other influences to pay attention to are the comfort and size of your bed and the habits of your sleep partner. If you have to lie beside someone who has different sleep preferences, snores, can't fall or stay asleep, or has other sleep difficulties, it often becomes your problem too!
A number of physical problems can interfere with your ability to fall or stay asleep. For example, arthritis, fibromyalgia and other conditions that cause pain, backache, or discomfort can make it difficult to sleep well. Sleep apnea, which is recognized by snoring and interrupted breathing, causes brief awakenings (often unnoticed) and excessive daytime sleepiness.
Disorders that cause involuntary limb movements during sleep, such as periodic limb movement disorder, break up the normal sleep pattern and are also likely to make sleep less refreshing and result in daytime sleepiness.
For women, pregnancy and hormonal shifts including those that cause premenstrual syndrome (PMS) or menopause and its accompanying hot flashes, can also intrude on sleep.
In addition, certain medications such as decongestants, steroids and some medicines for high blood pressure, asthma, or depression can cause sleeping difficulties as a side effect.
So, What's The Secret To Good Sleep?
If you are having a sleep problem or feel sleepy during the day, your doctor will first want to ascertain whether some health problems are contributing to or causing your sleep issues.
In many cases, your doctor will tell you that what works for some individuals may not be effective for you. In general, try to achieve at least 8 hours of sleep per day, including weekends.
When Do You Need to Seek Help?
If your sleep problems persist for longer than a week and are bothersome, or if sleepiness interferes with the way you feel or function during the day, a doctor's help may be needed. To get the most out of your doctor's visit, you'll find that it is often helpful to keep a diary of your sleep habits for about ten days to identify just how much sleep you're getting over a period of time and what you may be doing to interfere with it. It can help you document your problem in a way that your physician can best understand. If the problem is the time it takes to fall asleep, staying asleep or waking up unrefreshed, your doctor may recommend lifestyle changes or behavioral approaches to treating the problem. However, lifestyle changes alone may not be enough. Treating insomnia with medication is the most common treatment for these sleep problems. In most cases, medication is only used until the immediate stressor is under control or lifestyle changes have had a chance to work.
While many individuals will try an over-the-counter medicine to help them sleep, these should be taken with caution. Your physician or pharmacist can help inform you about the different types of medications available and which would be most effective for you. Alcohol should not be used as a sleep aid.
For sleep apnea or other sleep disorders, your doctor may want to do a sleep study that will provide more information about your sleep pattern and whether you are breathing regularly while you sleep.
The bottom line is this: Adequate sleep is as essential to health and peak performance as exercise and good nutrition. If you aren't getting enough, talk to your physician. You deserve it.