Going for a sleep study? Tips for getting the best answers to your sleep issues...

I recently had a sleep study (or if you'd like to get technical Polysomnography). It was horrible. I learned a lot. I've done a lot of research since I fired the so-called sleep specialist. Here are some things I've gleaned that may help you. I'll be popping back to this one, correcting any errors, adding info as I come across it. I will pop a new date on the title if I update the post.

• You will probably get a referral from your primary doctor. Do your own research. If the doctor doesn't have good reviews, isn't a good fit, ask for a different referral. Better yet, get an open referral so you can choose your own doctor.
• Before you go for your initial visit have in mind exactly which issues you have issues with such as:
• waking up frequently
• lack of deep and/or REM sleep (if you're able to track)
• feeling tired during the day, when you wake up, in the afternoon, etc.
• Do you doze off when watching TV? as a passenger in a car? at meetings? when reading?
• WRITE IT DOWN so you won't forget
• Tell the doctor what your goals are and be sure to discuss your expectations. 
• If you've been keeping a sleep diary (always a good idea if you're having issues), bring it.
• See if a home sleep study will work. If they say it depends on your insurance know they are hoping you'll do it at their office. Some insurances won't cover anything other than a home study. Home studies can't give as much data as one on-location --- however, if you're not going to sleep away from home you may want to push for a home study.
• If you do your study at their location, ask to see the sleep room. Make sure:
• it is dark, blackout curtains, no lights in the room
• the head of the bed raises if you're used to sleeping in that manner
• the walls aren't so thin that you can hear doors closing, people in the next room.
• it has a private bathroom (nothing like having to walk down a brightly lit hallway in the middle of the night...fluorescent or other bright lights that tell your brain "wake up"...)
• if you are going straight to work from the sleep study having a shower in the bathroom may be important to you
• the room has temperature controls (optimum sleep temps are anywhere from 60 - 67 degrees depending on which expert is giving the advice, but you may sleep better in warmer or colder temps) 
• Special needs children and smaller children can have a parent in the room. The rest of us sleep alone.
• Prep for the study (here's a great little video with https://youtu.be/6OjvRoYOcaM):
• Eat dinner if you normally eat.
• Don't drink any caffeine for 8 plus hours before the sleep study.
• Don't drink any alcoholic beverages or smoke any weed or take any mind-altering drugs (kind of laughing at that one...imagine your brain wave patterns if you popped certain pills...)
• No naps the day of the study no matter how tired you may get!
• Some places ask you not to polish your nails or wear fake nails. They put a finger monitor on one finger...for me it was the pointer on my left hand.  
• Wash your hair before your sleep study so the leads will stick. Don't put a lot of product on your hair as that kind of defeats the purpose...
• Don't put on any lotion or anything that can interfere with the pads sticking to your skin
• Wear loose clothing so they can get to the top of your chest, your back and the bottom of your legs. You will not be asked to get undressed.
• You will typically arrive between 8 and 10 p.m. and leave at 6 a.m. or after for a total of around 9 hours. They hope for 7 hours of sleep time so they can adequately assess your sleep. 
• You can bring your own pillow, blanket (weighted or your fave blankie), sound machine, books, tablet, snacks, toothbrush and toothpaste (you may want to brush your teeth before you leave) and pretty much anything within reason that will help you sleep. Some have fans in the rooms --- if you sleep with one ask if they have it, if not bring your own.
• Bring your medications. Let them know which ones you take.
• Wear comfortable clothes to sleep in or bring your sleep clothes. You may want to bring slippers or wear socks for walking around on public floors.
• When you get there you'll fill out more paperwork, then head to the sleep room. The tech will wire you up...nothing hurts but they do stick gunk in your hair so the leads will attach. 

• While you will have a lot of wires hanging off your body they won't hamper movement so don't worry about tossing and turning.
• If you have a reputable, good, clinic they will measure where they place the electrodes to ensure they get the best data. If they slap 'em on anywhere on your head raise an eyebrow and expect to get a CPAP recommendation...
• An oxygen monitor will be placed on a finger
• A plastic nasal tube monitors your breathing
• They monitor
• Brain activity
• Eye movements
• Heart rate
• Blood pressure
• Amount of oxygen in your blood
• the amount of air moving through your nose when you breathe
• Snoring
• Chest movements, breathing
• The room will have a camera so the tech can watch you at times and there will be a microphone so you can contact them. Yes, they'll hear you snore... :-). Some places, most I gather, video-tape you.

Red Flags

• A Physicians Assistant does your assessment and you never see the doctor. That's not necessarily an issue but it seems that talking with the doctor on your initial appointment is a reasonable expectation. (On a number of sites they said to expect to meet with the doctor...)
• They start talking C-Pap before the sleep study expect that they have pre-determined your diagnosis.
• If you mention other option possibilities, such as Inspire, or other sleep aids and they keep talking C-Pap you may want to try another sleep doc. That's not to say C-Pap isn't a good option for some...but if that's their agenda then they may have blinders on, or worse, get a kick-back from or own a C-Pap company :-). I have NO earthly idea if that's possible, but given my recent experience, it had me wondering...
• The doctor or PA has a set agenda, doesn't listen, dismisses your concerns and/or questions. You may want to say thank you but no thank you.
• If you know more about a good sleep environment than the sleep doc... (For instance, when I walked into the sleep room the wall was a full-length window with blinds. Outside the window there were parking lot lights that kept the room bright all night and hit my eyes. The tech said she'd been asking for over a year to get black-out curtains, everyone complained...and then said it was a good thing it wasn't a garbage pickup night as it was right outside my window and always startled her...)
• They don't give you a sheet explaining what to expect during or as you leave your initial appointment
• Bad reviews
• Even good reviews can be misleading. The doctor I went to for my sleep study had great reviews, even impressive reviews. However, after the sleep study, I went back and took a second look. All of the reviews were from people who saw him in his pulmonary practice. I did not find any reviews on the sleep center portion of his practice. So, lack of pertinent reviews may also be a "tell".
• If their sleep rooms are not conducive for promoting a good night of sleep. I listed things to look for above under "Ask to see the sleep room".
• If they have wonky sleep-study times, like arrive at 9 and leave at 5 in the morning and you normally sleep until 8 you may want to have someone drop you off and pick you up. Or find a place where their hours better fit your normal sleep schedule if possible. If they tell you all they need is 2 hours of good sleep to do an assessment know you are probably going to get a C-Pap recommendation from them...
• I'm not 100% sure about the requirements for sleep techs but mine had a musical degree and was "trained" to do the job after she was hired. I did not delve into requirements while there and given she'd been doing it for over a year I opted to let it slide (after all, she just stuck some leads on my head and unplugged me). I pegged it in my mind to do a bit of checking after the study. I would "guess" that certification probably varies from state-to-state. Here's a link to requirements from one school: https://study.com/articles/Become_a_Sleep_Technologist_Step-by-Step_Career_Guide.html. Per their site "To become a sleep technologist, you'll need an associate's degree in polysomnography technology. Also, certification is required and you should be detail oriented and able to communicate with patients."  
• I just found this: Sleep technologists, also known as polysomnographic technologists, are the ones keeping you company during your sleep study, monitoring all of your vital signs while you sleep. They will have one or more of the following certifications: Certified Polysomnographic Technician (CPSGT), Registered Sleep Technologist (RST), Registered Polysomnographic Technologist (RPSGT), and Sleep Disorders Specialist (SDS). https://www.tuck.com/sleep-clinics/

Suffered through a sleep study

Around 12:45 this morning I told the sleep tech I didn't know if I would make it, might go home. I told her I felt like I was in a torture chamber. I was pleasant, was not bitchy, we were laughing...but I was serious.

There were three sleep-study rooms. The walls were so thin I could hear the TV in the other room, I heard the lady in the other room snoring and coughing, I heard the doors open and close and could hear the tech on the intercom in the room next to me... Every time I would think I MIGHT fall asleep the coughing would start in the next room. My heart graph is going to be interesting --- I know my heart raced every time something caught me as I was trying to get to sleep.

The top half of the wall next to the bed was a window with blinds. No blackout curtains. A full array of parking lot lights shining through the sides and slats. The room was barely dim. I finally took my light coat and wrapped it around my head like a turban, covering my eyes. I tried pillows, the thin blanket...

The lights in the room? Those great blue-light emitting bright-white curly bulbs and fluorescent in the ceiling. No way reading was going to help put me to sleep even though I brought my blue-blocking glasses. They are made for the computer, not for blocking around the edges of the lens.

The bed was horrible. It didn't elevate at all. One of the sleep study ladies left in the middle of the night because she couldn't sleep --- her back was hurting too much. She had to sleep sitting up as they didn't have a way to raise the mattress. I grabbed four pillows and made a kinda-sorta chair back and slept semi-sitting up.

The bathroom was down the hall. I heard everyone who went to the bathroom. To get to the bathroom I had to walk out into bright lights. Guess what that does to a brain? Wake up li'l brain, time to get up!

It's hard enough to sleep in a strange place with things stuck to your body...but add all those factors and it is impossible.

They had a TV in the room. Every sleep expert tells you to stay away from the TV if you're trying for quality sleep. Although --- the TV screen was slightly smaller than my laptop screen so binoculars were needed to see it. Not that I turned it on. I don't like watching TV. Period.

I showed up with comfy clothes, my pillow, my sound machine (truly thankful I brought it...not that it was louder than the coughing and opening/closing door noises), a book, my tablet, chargers, toothbrush and toothpaste for the morning, heartburn antacids (a last-minute toss in that I am glad I had given I couldn't sleep with the bed elevated), earbuds so I could listen to a binaural beat meditations (3 times before the night finally ended...), and I also brought a small cooler with water and my health smoothy.

The only reason I knew to bring all of that was because I did some research on-line to see what was allowed. I certainly didn't get any info from this group.

My Fitbit registered 47 minutes of sleep. Light sleep. I actually did get more sleep it's just that I confused my poor Fitbit with all the long times awake, getting up to go to the bathroom (when I'm awake the urge strikes...when I sleep well it doesn't). I managed to get the minimum required two hours of sleep. I think I might have gotten just over three hours.

I am prepared to be disappointed in the results when I go for the follow-up doc appointment.

I wanted to find out if my Fitbit was correct in showing that I didn't get but a minuscule amount of REM and deep sleep. I wanted someone who would help me increase those numbers.

I mentioned in a previous blog that they seemed to be pushing C-Pap machines when I had my initial appointment. I suppose most people go in to determine whether they have sleep apnea, snoring issues, or other physical issues that lead to poor sleep.

I use a snore app and know I don't snore much if any. I have yet to register on the app. I asked the sleep tech if I snored, she said no. Then she backtracked and said "well, I can't say"...'cause they're not allowed to say :-).

I do wake up anywhere from 2 to 4 each night and often can't get back to sleep. My normal bedtime is around 10. Last night I was in the sleep-study bed all hooked up with the door closed by around 10:15 pm. However, I tossed, turned, put pillows over my head, adjusted the bed, played games on my phone, listened to meditations to no avail, propped up the head of the bed, and I read for a bit with my phone light and blue-blocker glasses until 12:45. Sigh.

I finally forced myself to go to sleep.

I doubt I'll find out anything about my deep and REM sleep. How could they begin to know how much I might get based on 3-3 1/2 hours or so of disrupted sleep?

Add a bed and a wall of blinds and you'll know what I thought
of the sleep study and environments :-)

The place is part of a pulmonary practice. They have great reviews. I did some research before going, I just didn't know enough to do the right kind of research. I "assumed" that finding out about deep and REM sleep would be one of the priorities.

When they schedule your sleep around their schedule, end it at 5 a.m. whether you're ready to get up or not (I was already awake so it didn't bother me), when they don't know anything about great sleep environments, when they only need two hours of sleep to get results I don't think they are after anything other than selling those C-Paps!


I'll let you know how it goes when I go for the follow-up, get the results. I would really like to be proven wrong in thinking this was just a C-Pap pushing exercise...

Side note: This is my second sleep study. The other study was at least 15 years ago and it was great. Nothing at all like this experience.