Sleep is essential to our overall health and well being and for us to perform both physical and cognitive tasks. A "biological clock" regulates body functions for a smooth sleep cycle. A common example of a sleep disorder is Insomnia, where the individual has difficulty initiating sleep, and waking earlier than desired that results in poor sleep that affects daytime functioning. Individuals suffering from episodes of Insomnia are irritable, anxious, and forgetful. Causes of insomnia include a condition called sleep-apnoea syndrome, which is a structural etiology that causes a significant decrease in airflow causing breathing difficulties. It is characterized by recurrent episodes of upper airway collapse called apnoea and hypoapnoea episodes. Other central causes of lesser contribution include thyroid disorders, kidney diseases, heart disease, history of alcoholism, and smoking.
In children, conditions that affect sleep include obstructive sleep apnoea (OSA), adenoids, tonsillar enlargement, syndromic causes such a Pierre-Robin Syndrome in which facial bone developmental deformities are present. In adults, the most common cause is nasal obstruction (caused by polyps, deviated nasal septum, trauma, and tumor, etc.,.). The resulting symptoms are excessive daytime sleepiness and fatigue, morning headaches, cognitive deficits, hypertension, cardiac failure, depression, sexual dysfunction, and gastro-esophageal reflux.
These symptoms require proper investigation of the upper airway, nose and throat, measurement of body mass, measurement of blood pressure, and apnoea-hypoapnoea index. This is done by a sleep study, which monitors the sleep stages, heart activity, breathing cycles, and muscular systems. Depending on the results of the sleep study, we grade OSA into mild, moderate and severe. Based on the grading of OSA, surgical treatment can be used to reduce the airway collapse, and pressure devices to keep the airway patent during sleep, so that one can lead a normal, healthy, cognitively intact life.
SLEEP LAB
A definitive diagnosis of sleep apnea can be made only with a sleep study conducted during a visit to a sleep lab, usually overnight, or a home study performed with special equipment. A sleep study generates several records of activity during several hours of sleep. These include an electroencephalogram, electro-occulogram, electrocardiogram, chest bands that measure respiration; and additional monitors that sense oxygen and carbon dioxide levels in the blood and record leg movement.
SLEEP STUDY MACHINE:
The Embletta MPR PG adds more channels to measure additional parameters. Combining the Embletta MPR PG with the ST Proxy provides the following additional parameters resulting in a total of 20 collected channels. The TX Proxy uses Blue Tooth technology to connect to the MPR unit and adds 7 additional collected data channels including the following:
Number of channels: 12
Sampling rate: up to 500 Hz
Powered sensor inputs to XactTrace belts
Stainless steel Luer Lock
The following parameters can be recorded:
Abdominal Effort
Thoracic Effort and Nasal Pressure
Nasal Flow
Snore
SpO2 and Pulse Rate
1 x ExG
Position
Activity
1 x DC channel
Microphone (optional)
6 EEG
2 EOG
Tri-polar chin EMG
ECG
2 x leg EMG
Differential pressure
6 x DC (±5 V)
Ambient light
Questionaire to evaluate yourself at home:
Epworth Sleepiness Scale:
How likely are you to doze off or fall asleep in the following situations, in contrast to feeling just tired? This refers to your usual way of life in recent times. Even if you haven’t done some of these things recently try to work out how they would have affected you. Use the following scale to choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
It is important that you answer each question as best you can.
Situation Chance of Dozing (0-3)
Sitting and reading
Watching TV
Sitting, inactive in a public place (e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances permit
Sitting and talking to someone
Sitting quietly after a lunch without alcohol
In a car, while stopped for a few minutes in the traffic
Good sleep is critical to your health and well being. We understand the frustration and health risks that come with having a sleep problem such as sleep apnoea or snoring. We will work closely with you to understand and treat your particular sleep issue, so you can get the rest you need. We take a multi-disciplinary approach to all sleep disorders.
Visit www.beirc.net for further information regarding sleep related disorders and sleep study services.
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