REM Diagnostics

Sleep Studies

At REM Diagnostics, we perform several types of sleep studies and diagnostic tests:

  • Diagnostic Polysomnogram (PSG) – This test provides general evaluation and monitoring of your sleep.
     
  • Split-night Sleep Study – This test is a combination of a diagnostic PSG and PAP titration if the sleep lab’s protocols are met.
     
  • Full-night PAP (positive airway pressure) titration – If you are diagnosed with sleep apnea, your health care provider may have you return to the lab on an ensuing night to determine the proper pressure needed to treat your apnea.
     
  • Home Sleep Testing (HST) – In some cases, a home sleep test may be ordered by your health care provider, providing you meet certain criteria that quality you for this type of test. We are also available to evaluate transportation professionals with HSTs.
     
  • Multiple Sleep Latency Testing (MSLT) – This test is a series of naps during the day used to diagnose Narcolepsy and/or excessive daytime sleepiness. It is almost always preceded by a diagnostic PSG the night before.
     
  • Maintenance of Wakefulness Test (MWT) – Similar to an MSLT, but the MWT is designed to determine your ability to stay awake. This, too, is a daytime test.
     

What should you expect during your sleep study?

You should have received some paperwork and questionnaires from us prior to arriving for your sleep study. This information will help us and our physicians understand some of your sleep and health history. If you have not received this paperwork, you may download it here.

Please refrain from activities that may affect your sleep, such as the intake of caffeine or alcohol, and heavy exercise, starting in the afternoon of your sleep study. Please continue to take any medications prescribed by your physician and bring with you any medications you need to take during the night. If you have any questions on your medications, please contact your physician. Avoid taking a nap on the day of your sleep study.

Bring your pajamas and any other personal items that will make your stay more comfortable. Our queen-sized beds and pillows are very comfortable, but you may bring your own pillow if you wish.

When you arrive, our technologist will greet you and show you to your bedroom. You may pass through the control room in some of our labs. After you have changed into your pajamas, our technologist will explain the hook-up procedure to you and begin that process, either in the bedroom or in the control room.

The hook-up process takes 30 to 45 minutes, and involves placing electrodes and other sensor devices on you. Don’t worry, everything involves surface monitoring and is not painful at all!

  • The electroencephalogram (EEG) will monitor brain wave activity that enables us to determine what stage of sleep you are in.
     
  • The electro-oculogram (EOG) monitors your eye movements during your sleep, giving us more information on your sleep stages, especially REM (rapid-eye movement sleep).
     
  • The electromyogram (EMG) monitors your muscle movements throughout the night, providing information on leg movements, teeth grinding, and assists us in determining when you are in REM sleep.
     
  • The electrocardiogram (EKG) monitors your heart rate and rhythm throughout the night.
     
  • A flow thermister measures the airflow out of your nose and mouth through the night.
     
  • Chest and abdomen belts are elastic belts that measure your breathing effort.
     
  • A pulse oximeter slips over the end of your finger to measure the level of oxygen in your blood.
     
  • A snore microphone, place over your trachea, measures the amount and intensity of snoring through the night.
     
  • A monitor will enable us to determine which body position you are in while you sleep.
     

You will be fitted for a nasal mask prior to going to bed in case you meet our protocols to begin a PAP titration.

And now you are ready for bed. The procedure may sound daunting and uncomfortable, but it is not. Most of our clients fall asleep quite easily. Our technologists are knowledgeable and friendly and will answer any questions you may have.

We provide you with cable television, and you may bring a book or magazine with you if you wish, but we don’t want you to stay up too late, we have a lot of information to gather!

Our technologist will be monitoring all of the signals produced by the electrodes and is in the control room throughout the night. He or she can easily hear you if you need to get up for any reason—just speak in a normal tone. A bathroom break is easy, you will simply be unhooked from the main cable and you can carry the jackbox with you.

PAP (Positive Airway Pressure) Titration

CPAP (Continuous Positive Air Pressure) or bi-level PAP is the first-line therapy for Obstructive Sleep Apnea. The PAP device delivers air pressure to the back of the airway, splinting it open and allowing you to breathe throughout the night. The pressure is delivered via a mask that fits over your nose (or nose and mouth if needed). We use heated humidifiers with our PAP devices so the air delivered is warm and comfortable.

There is no “one size fits all” air pressure. Our technologists carefully adjust pressure to meet the individual needs of each of our clients. During this process, air adjustments are made and monitored for effectiveness. If apneas, hypopneas, or snoring persists, more adjustments are made until the optimum pressure is achieved.

ASV (Adaptive Servo Ventilation) allows us to treat Primary Central Sleep Apnea and Complex Sleep Apnea.

After all the information is collected throughout the night, the record is reviewed once again in its entirety and scored for sleep stages, awakenings and arousals, and any physical events that occur through the night such as airway obstruction and limb movements. The quality and quantity of your sleep is also evaluated. After this second thorough review, a physician well versed in the field of sleep medicine reviews the data a third time and can advise you and your health care provider as to the state of your sleep health.

At REM Diagnostics, all this is done in an effort to get you a Great Night’s Sleep!