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VA Eastern Kansas Health Care System

 

Sleep Center

What are Sleep Disorders?

Sleep problems can be due to a number of factors so it is important to consult with a specialist to determine the cause of your sleep problems. Factors can include medication side effects, medical conditions like sleep apnea or restless leg syndrome, chronic pain, the effects of shift work, as well as anxiety and other psychological difficulties.

About the Program

The Colmery-O'Neil VA Medical Center in Topeka and Dwight D. Eisenhower VA Medical Center in Leavenworth, each contain state-of-the-art 4-bed sleep diagnostic facilities located in the main hospital building on A-3.  Sleep testing using state-of-the-art equipment is conducted under the guidance of Registered Polysomnographic Technologists. 

Contacting the Sleep Center:

Telephone:  Topeka     785-350-3111 | 800-574-8387,   Leavenworth    913-682-2000 | 800-952-8387

Sleep Study (Polysomnogram)

Sleep studies (polysomnograms) generally take place in a sleep lab during a person's normal sleeping period. The study records brain waves, breathing and body activity that occur during sleep with the purpose of diagnosing and treating various sleep disorders.  A trained sleep technologist will be with you in the sleep lab during the testing period. A Physician trained in sleep medicine evaluates test results to determine a course of action and resolve sleep related issues.

Why do you need a sleep study?

There are over 80 different types of sleep disorders, some common reasons for a sleep study include:

  • excessive snoring
  • sleep apnea (periods where the breath stops during sleep)
  • daytime sleepiness
  • narcolepsy (sudden onset of sleep)
  • abnormal movements during sleep- including kicking legs during sleep, sleepwalking, epilepsy, abnormal acting out of dreams etc.

Are there any risks with the procedure?

There are no known risks for a sleep study other than possible skin irritation due to the attachment of the electrodes to the skin.

Before the Procedure

  • Your physician will explain the procedure to you and offer you the opportunity to ask questions.
  • You will be asked to complete a sleep questionnaire or sleep diary to be completed ahead of time.  Do your best to provide the most accurate responses. 
  • Please remember to bring any medical records and reports (such as sleep study report, notes from other physicians, etc)
  • You may be asked to restrict your sleep before the study, avoiding naps for example.
  • Notify your physician of all medications (prescription and over-the-counter) and herbal supplements that you are taking, as they may alter test results.
  • Avoid caffeine-containing products for several days before the testing as they may cause you to take longer to fall asleep.
  • Sedatives may not be allowed during the sleep study, unless prescribed by the sleep physician, as they can alter the results.
  • Showering before going to the sleep lab may be helpful; however, avoid using lotion or oil on your skin because the electrodes may not adhere to the skin.
  • You may bring your own pajamas or gym shorts, tee shirt and pillow.
  • If needed, you may be able to shower and dress for work the morning after the sleep study.
  • Based on your medical condition, your physician may request other specific preparation.

During the Procedure

A sleep study is generally performed on an outpatient basis at night. Procedures may vary depending on your condition and your physician's practices.

Generally, a sleep study follows this process:

  • You will be asked to remove any jewelry or other objects that may interfere with the procedure.
  • You will need to turn off your cell phone or pager for the duration of testing.
  • You will be asked to change into pajamas or other night attire.
  • Small metal discs, or electrodes, will be positioned on your head and body to measure brain activity, eye movements and leg movements.
  • Pulse oximetry, which measures the oxygen level in the blood vessels, and air flow monitors at the nose as well as belts around the chest and abdomen, which measure breathing will be used.
  • The temperature of the room may need to be maintained at a certain level, but blankets can be adjusted as needed.
  • Lights will be turned off and monitoring will begin before you fall asleep.
  • For multiple sleep latency testing (MSLT), five short daytime nap periods will be assigned at specific intervals, following the previous night's sleep study.
  • For maintenance of wakefulness testing (MWT), you will be asked to try and stay awake for certain periods of time during the day.
  • When the study has been completed, the electrodes and other devices will be removed.
  • On certain occasions, you may be required to follow-up in the sleep clinic the day after your test.
  • CPAP study: For some patients who have sleep apnea, the effects of continuous positive airway pressure (CPAP) are evaluated. Patients, who have been diagnosed with sleep apnea during the initial part of the sleep study or on a prior sleep study, undergo a CPAP study. During the CPAP study, a mask is fitted around the nose and pressurized air is used to keep the airway open during sleep. The pressure level that holds the airway open during sleep and allows the patient to get a good night's sleep is the prescribed CPAP pressure. 

What is recorded in a sleep study?

The term "polysomnogram" indicates that there are multiple tests in a sleep study. Measurements may include:

  • Eye movements- to identify wake and different stages of sleep  
  • Brain activity (EEG)  - electrical currents of the brain
  • Limb movement - number and intensity of movements
  • Breathing patterns - number and depth of respirations. A sensor is placed by the nose and mouth for measurement of airflow. Belts are placed around the rib cage and abdomen for measurement of breathing movements. 
  • Heart rhythm (ECG) - electrical activity of the heart
  • Oxygen saturation - percentage of oxygen in the blood
  • Sleep latency - time it takes to fall asleep
  • Sleep duration - period of time a person stays asleep
  • Sleep efficiency - ratio of the total time asleep to the total time in bed

After the Procedure

  • The results of the study may take several days to process. 
  • The results and specific recommendations will be forwarded to your referring physician through the VA electronic medical record system. 
  • If you have obstructive sleep apnea, you will be notified a Respiratory Therapist from your local VA Medical Center to pick-up your CPAP machine and receive training on how to use the machine. 
  • Follow-up care will be arranged by the Respiratory Therapist or Sleep Center staff. 
  • Patients should bring their CPAP machine, mask and compliance card with them for all follow-up visits.