Hospital sleep study: what you need to know

It can be tempting to use an app on your phone to listen to your snoring or ask your partner which type of power tool you sound like, but if you want a true diagnosis of why you’re not getting enough rest you should consider a sleep study.

There are two main types of sleep study you can undertake to give you a path towards treating your sleep issues.

At-home sleep studies, which are performed in your own bed, test for breathing-based disorders and can give you an indication of sleep apnoea, but they can’t go further to look at other potential sleep issues.

A hospital-based sleep study, which captures more types of data and is video recorded and supervised by a sleep scientist, can provide deeper analysis.

To determine what sort of sleep study is appropriate, you should consult your GP, who can refer you for the right test.

But what is it like at the hospital? Will it be easy to sleep? Will there be a one-way mirror with people in white coats on the other side watching you sleep under a dim blue light?

Getting ready for an overnight hospital sleep study

It is normal to have questions about how the sleep study will be conducted and to feel a little anxious about it.

There are often questions about how patients will be able to sleep, Bibi Guillame, sleep clinic manager at Perth Respiratory & Sleep Clinic, said.

"Patients arrive, are admitted and taken to the sleep clinic. At this point they are shown around and we explain the whole process,"

"Typically patients are concerned whether they will be able to sleep. If they can’t, they are worried that the sleep study will be a failure. 

"We reassure them they will be able to sleep and there is the option to have a mild sedative if they are a bit nervous." 

Patients often ask whether the machines will prevent them from sleeping.

"Nothing hurts, there is nothing invasive and there is plenty of time to watch TV and relax and get used to the sensation of the wires before going to sleep," Guillame said.

"We also point out the cameras, which can see them in the dark. Of course, the patient gives their consent to be recorded."

When you sleep you have several wires attached to you to monitor the different aspects of your sleep:

• Six EEG wires attached to the head
• Two ECG electrodes for monitoring the heart
• Two electrodes per leg to monitor muscle tone
• One electrode under the chin to monitor muscle tone
• A finger probe for oxygen
• A cannular to measure the pressure of breath
• Electrodes near the eyes to measure rapid eye movement to detect dreaming

Guillame said staff were very conscious that the equipment shouldn’t push on patients and prevent them from sleeping in a particular way. 

"They shouldn’t feel it if they roll and feel the pull of the wires. If they do feel uncomfortable they should tell us.

"If you want to use the bathroom you can have them taken off during the night. There are sleep technologists available to ensure the data we collect is the best quality and the patient is comfortable."

The sleep clinic is set up like a hotel with a bathroom, a bed and a TV in a private room. The only difference being that you bring your own pillow, food and drink.

Patients are encouraged to do whatever it is they would do at home — whether that is having a glass of wine, watching TV or using their laptop.

Get prepared for the study by keeping as close to the home routine as possible:

• Don't consume any caffeine
• Wear two-piece pyjamas
• Bring your usual pillow (highly recommended)
• Bring your toiletries
• Bring reading materials and electronic devices

Why you might need an overnight hospital sleep study

For the extra convenience and cost, it is worth comparing the added benefit of the hospital-based study when compared with the home study.

The main differences between an at-home and an in-hospital sleep study is the technology used to monitor your sleep and the expertise available.

Your GP or another specialist might refer you to a clinic if they think your sleep is affected significantly beyond sleep apnoea.

A hospital-based sleep study (polysomnograph), covers a range of things:

• Quantity and quality of sleep stages
• Measure of oxygen saturation and breathing
• Correlation of breathing pauses and waking arousals
• Record restless legs and Periodic Limb Movements of Sleep (PLMS) 
• Monitor ECG
• Assess degree of sleep fragmentation
• Detect sleep apnoea and other sleep disordered breathing
• Diagnose REM behaviour disorder
• Diagnose parasomnias
• Record sleep position (e.g. back vs side)
• Monitor and record sound

Following your night in the hospital, your data is analysed and reviewed by the sleep specialists and usually the results are available within a week. 

Typically the results are given directly to the patient where treatment options are discussed, but they can also be given back to the patient’s GP for review.

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