Patient Information About Sleep Studies

What is a Sleep Laboratory?

A sleep laboratory is set up to investigate and treat sleep disorders and disorders of wakefulness.

Sleep laboratories require a referral from a physician for a sleep study; otherwise OHIP will not cover the costs without one. You may obtain a copy of this form by downloading it from the ‘home page’ and or ‘how to contact us’ page on the website.

Laboratory tests may be preceded by a clinical evaluation including a medical history, physical examination, and a review of your medications and careful analysis of the sleep related questionnaires.

What do I do as a patient coming for a Sleep Study?

During your sleep study, we will be monitoring your brain wave activity, breathing patterns, leg and muscle activity, ECG heart monitor and blood oxygen level. All monitoring is done on the surface of the skin. There is no discomfort involved. There will be no smoking allowed in the facility.

In order to ensure that we are able to achieve the best possible results, please follow the instructions set out below.

• ARRIVE ON TIME (8:00pm) at the Laboratory
• There is ample FREE PARKING at the back of the building.
• BRING YOUR HEALTH CARD WITH YOU.
• Please be sure your HAIR is clean and free of hair oils or gels, and hair pieces (if applicable).
• Remove NAIL polish.
• BRING pyjamas or a 2 piece sleeping apparel, slippers, personal toiletry items and reading glasses (if needed).
• Dinner will not be served, so have your evening meal before you arrive. DO NOT consume any ALCOHOL.
• Please take your usual MEDICATIONS and bring any that you might need during your visit. Let the technologist know of you have any ALLERGIES to tape adhesives.
• Leave all VALUABLES at home.
• If you are currently on a CPAP device at home, please bring the machine, tubes and mask with you to the test.
• DO NOT CANCEL YOUR TEST. Sleep disorders can be serious. Your doctor requires the results to treat your problems. The tests are costly in time and expertise. This laboratory requires at least 48 hours (2 business days) notice of cancellation or you will be charged $200.00 dollars for a missed appointment.
• The test is fully covered by OHIP.

Your study will terminate at about 6:00 a.m. and you will be able to be on your way by about 7:00 a.m.

Due to the complexity of the test, it will take at least 3 weeks for the results to reach your doctor. If you have any unanswered questions or need assistance, please call Abby or Shelly @ (905) 566-1010. The technologists can be reached on the night of your study after 8:00 p.m. @ (905) 566-9666.

Current Facility Information

• The Tri-Hospital Sleep Laboratory West is located at Cooksville Colonnade Building,
• 3024 Hurontario Street, Suite 208 (Hwy 10 and Dundas—please see map below).
• There are 2 elevators in the building which are wheel chair accessible.
• There is ample free parking at the rear of the building.

Types of Sleep Studies

• Overnight Sleep Study (Polysomnograhy)
• Daytime Sleep Studies:
      A) Multiple Sleep Latency (MSLT) or
      B) Maintenance of Wakefulness Test (MWT)
• CPAP titration study
  

Overnight Sleep Study

The overnight Polysomnogram (PSG) is used to help pinpoint the cause of excessive daytime sleepiness and to diagnose some sleep disorders such as sleep apnea and restless legs syndrome. In most cases, you will be asked to come to the lab at 8:00pm. It will take the technologist about an hour to prepare you for the procedure. This is a simple process of attaching electrodes using removable cream/gel and tape. The electrodes do not pierce the skin. In the morning, you will be able to leave from a night study in time for your usual daily activities.

You can read or watch television until the technologist says its time for bed. At that time, the technologist will connect you to recording equipment. There is a control area, separate from each bedroom, where the technologist carefully monitors your sleep.

The technologist will do all she or he can to make your stay a pleasant one. Do not be afraid to ask questions. A staff member will have two to three patients to look after. You will have private rooms with a bathroom close by. If you have to go to the washroom during the night, just ring for the technologist who will disconnect your from the recording equipment. Cameras may be used to observe your sleep.

Daytime Sleep Study

The daytime study is usually given immediately after an overnight study while the patient is still connected to the electrodes. If you are staying for a day study, you will not be allowed any caffeine. If you get headaches from caffeine withdrawal, discuss this with you doctor. Only a light breakfast will be provided so please bring your lunch with you. The day study is usually finished around 3:00pm. However, if you have to stay for a fifth nap, it will be closer to 5:00pm.

• The lab includes nine independent bedrooms with comfortable beds and a monitoring room.
• The lab also has three independent bathrooms with a shower, sink and toilet.
• All bedrooms have a home-like atmosphere.
• Housekeeping provides linen, towels and cleans the rooms daily.
• Each bedroom has a smoke detector and alarm.
• Noise is minimal from outside or from the corridor.
• The lab also contains a fire extinguisher and a detailed evacuation route in case of a fire.

There are two types of day studies:

1. Multiple Sleep Latency Test (MSLT)

You will have at least four, 20-minute nap opportunities during the day to determine the severity of sleepiness and the onset of the dream state during sleep. The latter is used to diagnose a sleep disorder called narcolepsy, along with the overnight study.

2. Maintenance of Wakefulness Test (MWT)

You will be seated in a darkened room and will be requested to stay awake for
40-minute time periods. This will occur every two hours, four times during the day.
This test measures your ability to remain awake.

CPAP Titration Study

What will be done?
Bring your CPAP device along with your tubes, mask and headgear along with your health card, comfortable night clothes, toiletries and your usual medications. Leave all valuable belongings at home.

You will be set up for a sleep study with your own mask. When you sleep, you will be monitored for the quality of your sleep, oxygen levels, heart activity, body position and movements, breathing problems, awakenings and snoring. The airflow will be increased gradually until these events are normalized. The optimal pressure is determined and your machine may be adjusted in the morning or at the follow up visit with the sleep specialist.

Quality of Sleep
It is normal to encounter some discomfort the first time you use a CPAP machine and it may take a few weeks, sometimes longer, to get used to sleeping with a mask on your face.
There is no single mask that works the same for everyone, so finding the right mask for you may be a challenge, and takes time. Some masks are more suited to sleeping on the sides; others are better for less pressure on the face or persons with claustrophobia; and others are suite for persons with abnormal nasal passages requiring a full face mask.

You may be aware of more awakenings during the night and the quality of your sleep usually starts improving within a few nights. There will be more normal deep sleep as well as significant improvements in your energy, alertness, wakefulness in the morning, moods, concentration and memory. You may also experience pleasant dreams as compared to the distressing dreams you had before using CPAP while you were struggling to breathe in sleep.

The Future
Sleep apnea is closely associated with a number of serious diseases including heart problems such as hypertension, heart attacks, irregular heart rhythms; and brain problems such as strokes, memory loss, poor concentration, daytime sleepiness, and depression.

Regular use of the CPAP reduces these additional risks and their consequences, in the comfort of your bed. The benefits to your daytime activities, energy and wellness are immeasurable and irreproducible by any drug or known treatment. You can improve your health profile if your apnea is well treated. If you already have one of these conditions your chances of becoming disabled or dying early will be significantly reduced if your apnea is well treated.

Strengthening your breathing muscles with regular cardio exercises helps improve breathing during sleep, and reduces the resistance to airflow in the upper airways. As your energy level improves, so will your motivation to be more active and independent.

Please be aware that some masks lose their efficiency after a period of 6 months to one year, and may require replacement periodically.

Follow-up care
We will call you over the coming year to see if things are going well, and to help if they are not. If you do not hear from us at these times, please call us. In a busy office, unfortunately, people are sometimes missed. We do want to know how you are, and would appreciate a call from you.

Let us know if you notice a return of your symptoms, especially daytime sleepiness. Sleep apnea does tend to get worse over time as our body’s strength changes. New medications, weight gain, new illnesses, surgeries or just the passage of time can lead to a worsening of the apnea. If you notice changes, discuss them with your family doctor. The symptoms could be caused by many factors. If you family doctor thinks they might be from a worsening of your apnea, then a referral back to the Lab will be arranged and you can be tested again. A small change in your CPAP pressure may be all that is necessary. A significant weight loss may lead to your pressure level being too high. You may need to be retested and have a lower pressure prescribed.

If you experience significant discomfort, please consult your respiratory supply company. This laboratory is also available for advice if you continue to have any difficulty. We are here to help you

I know this machine will be of great help to you and that any discomfort it brings is far outweighed by the benefit it confers.

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