Do I Need a Sleep Study

Transcription:

Host:  Welcome to Sparrow speaks the podcast with the latest health news and information from Sparrow mid Michigan's, premier community health care leader. I'm your host, Deborah Howell. And today we'll be talking about something that's elusive to so many. A good night's sleep. And about when maybe it's time to ask the question, do I need a sleep study?

Our guest is Dr. Jennifer Eley, a pulmonologist and medical director of the Sparrow sleep lab. Welcome Dr. Ellie.

Guest: Thank you Deborah.

Host: I'm sure everybody wants to be your best friend because they all have questions for you, right?

Guest: Sure. Yeah. I get a lot of questions.

Host: Well, let's begin with this question. What is a sleep.

Guest: Well, that's a great question. So a sleep study can be done a couple of different ways. And so sometimes we do them in a sleep lab where you have to stay in the night away from home. And we do that with people who have things like sleep.

apnea, narcolepsy, occasionally we can do it at home and things like that.

So, Geneva in-lab sleep study. Because we thought you had sleep apnea. We would schedule an appointment. You'd come in about an hour before bed. Get familiar with the lab, meet the tech, and then they're gonna kind of gadget you up a little bit. almost seems like it's head to toe, which essentially is some of the scalp looking for brainwaves.

Couple of on the eyes helping us look for eye movements. One underneath the nose looking for airflow. We get a little. One underneath the chin helping us to see if you have muscle tone that helps us to know if you're in dream sleep, because you're actually paralyzed in dream sleep. And that gives us a great indication there.

And so we'll have some EKG leads some as well because some people who have sleep apnea occasionally have some irregular heartbeats and we like to know what's going on. So we get those things. And then you get a band around your chest, one around your waist. sure. Having apneas we'd like to know, do you make an effort to breathe more than one type of sleep apnea helps us to distinguish between those two?

When you get one on the finger, glows red tells us what your action levels are doing. And a couple on the legs, looking for those restless legs at night, it all feeds into a central connector. Not that way. If you did need to get up in the middle of the night, use the restroom, things like that, just disconnects you get up in the tech would help connect you back in at night, you know, if you had something like narcolepsy.

You get to stay for a day study. So we look at you at night, see how your nighttime is, make sure there's nothing else going on at night that could explain something that would be causing you to be super tired during the day. And so if we think that you could have narcolepsy, you get to stay during the day for a nap.

so you get to nap, five different opportunities there and you lose some of the gadgets you had at night. You're still gonna keep the scalp leads, looking for the EEG. You're going to keep the chin. You're going to gain some arm leads and keep the likelihoods and the rest. You'll get to get rid of, and so Tucky en about every hour and a half or two hours and say, Hey, try to fall asleep. If you do fall asleep, they're only going to let you sleep for 20 minutes. So maybe not as a refreshing nap as you would like to have. And. And so they're looking for things like, do you fall asleep during those naps? If you fall asleep, how long does it take you to fall asleep? And then really? importantly do you dream during those naps?

And so that really helps us to see, do you have something like narcolepsy or you, what we call pathologically sleepy or during the day, then you really should be.

Host: So interesting. You don't let them sleep more than 20 minutes, is that because you don't want them to reach a rep?

Guest: yes. So what we're looking for is Ram. So what we call a sleep onset REM which we would see in, narcolepsy and normally that first stage of dream sleep or REM sleep would occur in about the first 70 to 90 minutes of the night for most people. And so if it happens. Early on that would be consistent with narcolepsy.

So, we don't want people to go longer than that because that could blur the diagnosis for us.

Host: Got it. Okay. Thanks for explaining that, you know, there's so many different sleep disorders, but only some require a sleep study to diagnose what are some of the most common problems that are seen in adult?

Guest: So what we would. Really need a sleep study for sleep apnea, hands down is by far the most common thing that we use a sleep study to diagnose. That can be done in lab can be done at home with a home sleep study. Narcolepsy certainly is another one, not nearly as common but really does need to be an in lab sleep study diagnosis.

A few other not as common ones would be something like REM sleep behavior disorder. I had mentioned really. You're paralyzed in dream sleep and that's a built-in safety mechanisms. So we're not acting out our dreams at night which is good for my husband. I'm often a CA a hopper in the middle of the night. but if you lack that you can act out your dreams and that could be a huge safety issue for patients for their bed partners. So, you know, we suspect that then certainly we like to see you in the sleep lab so we can capture those moments because they don't happen every night there.

But there's. Issues that you don't have to have a sleep study for. Insomnia is a big one. That one is a clinical diagnosis, and really we'd only want a sleep study if we suspected that it co-existed with another sleep problem. Do you have sleep apnea with it as well because they can fuel or feed each other people who have restless leg or at night, we call periodic limb movements asleep.

Generally put patients in the sleep lab for that, because that's a clinical diagnosis as well. Again, unless we suspected something else was going along with this and was fueling it as well.

Host: So let's drill down a little bit. What is sleep apnea and what are patients at risk for? If this goes on?

Guest: Okay. That's a great question. So, you know, sleep apnea and there's actually more than one type of sleep apnea. What happens at night is your breathing changes. And we have these pauses in our reading. So our breathing stops completely. An apnea. Sometimes their breathing becomes very shallow and our oxygen levels drop with uh, we call those high popness.

But those can cause you to have disrupted sleep your body smart enough to say, Hey, this isn't right and wakes you up sometimes to Elijah's sleep sometimes altogether. And we often fall back asleep so quickly just don't register that to long-term memory. So fractures or fragments. During the night.

And so the most common form of sleep apnea, obstructive sleep apnea is what most people know about where there's physically an airway obstruction for most people, the tongue rests against the back of the throat and creates that obstruction. And so that's what we see. People will often come in and someone's told me I stopped breathing or gasping or choking a snorting.

And that's waking up from one of those apnea events there. Less commonly. We can see people who have what we call central sleep apnea. And that's literally where your brain tells you not to breathe. Not nearly as common. And there's usually underlying health issues that help us point to that. Oddly enough, heart failure can be a common thing that causes that central sleep apnea.

You can certainly see it in people who've had stroke before in the past or something else, like a brain mass, things like that. And we commonly see it when patients who use opioid medications there.

Host: Got it now, what are some things that might suggest a sleep study could be worn?

Guest: Well, certainly if you know, if you're having poor quality sleep that would be something that would make me want to think about it. So signs that. We look for when we talk to patients is, you know, do you have trouble falling asleep? Do you have trouble staying asleep? And certainly looking for those insomnia questions, you know, are snoring at night, you know, are you waking up at night because I'm gasping for air or choking or trying to get that breath in?

Or perhaps someone else has told me that my sleep has just disrupted or fragmented during the night. Hey get eight hours of sleep in cash. I just don't feel rested in the morning. I need to roll over and go back to sleep. That could mean there's something wrong with your sleep quality. Morning headaches are a frequent thing that we see with sleep apnea.

And certainly daytime sleepiness, you know, you don't have to be. Terribly tired to have sleep apnea, but certainly that is something that we frequently see. You may see things like you know, difficulty concentrating or problems with that short-term memory. Those things are linked to sleep quality.

And so if you sleep quality is not nearly as good as it was. Those things could be problematic as well. So, you know, if you starting to check off one or a couple of those boxes, then maybe it's time to talk to your doctor about, do I need a sleep.

Host: You're doing God's work. I know, because I don't know any woman over the age of 30 who can't, you know, who can really just go to bed and just sleep without any aids. So, anyway, can you tell us all that's offered at the Sparrow sleep?

Guest: Oh, certainly. So we are a full service sleep lab, so we offer night studies. So we call them nocturnal polysomnography. And so we do those infants to adults. So there are kids issues as well that we do through there as well. If you are a day sleeper, so lots of people out there work second and third shift.

We'd want to get you into the sleep lab when you sleep during your night. So we do 24 hours. Studies so that we can capture patients during the time that's optimal for them. We do offer those nap studies. We call them MSLT that multiple sleep latency test is what that stands for. And we do home studies as well.

So we do offer the full gamut when it comes to sleep studies. For those who are. Have sleep apnea. We do have a troubleshooting clinic, which is a phenomenal service for patients. And they're great for mask fit because that's probably the biggest obstacle to overcome with individuals who have obstructive sleep?

apnea is getting that mask to fit and fit well.

So they're comfortable with it so they can fall asleep with it. So It's not disrupting their sleep just as much as their sleep apnea was before they were treated.

Host: It's a big subject and very important, and we need our sleep. So is there anything else you'd like to add to our conversation, doctor?

Guest: certainly you're correct. Sleep is a huge topic. And we could talk about this certainly all night long. But. If people are out there and they're truly worried about their sleep, a good night's sleep is not overrated. And well, no one gets a good night every night. If you're not getting a good night, most nights, talk to your doctor.

there are a lot of things that can be done to make good sleep and not all of it requires a sleep study.

Host: Okay, well, you're giving us a lot of hope today, Dr. Ellie, thank you so much for the great information. What a pleasure to have you on with us today?

Guest: Well, thank you, Deborah. It was a pleasure being here.

Host: Sleep well tonight and get some rest over the weekend.

Guest: Thanks you too.

Host: To learn more about the Sparrow sleep lab, visit sparrow.org/sleep center.

And be sure to subscribe to Sparrow speaks in apple podcasts, Google podcasts, or wherever you listen to your podcast for our additional healthcare topics. I'm your host Deborah Howell. Thanks for listening and have yourself a great day.