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TESTING
(roll over item below to view descrition on right)
Tape Measure - used to measure the neck. A 17 inch neck for men and a 16 inch neck for women indicate higher likelihood of sleep apnea.
Total Recording Time - duration of time from sleep onset to final awakening. In addition to total sleep time, it is comprised of the time taken up by wake periods and movement time until wake-up.
Arousal - abrupt change from sleep to wakefulness, or from a ‘deeper” stage of non-REM sleep to a “lighter” stage.
BMI — Body Mass Index - is a statistical measure of body weight based on a person’s weight and height. Though it does not actually measure the percentage of body fat, it is used to estimate a healthy body weight based on a person’s height. Due to its ease of measurement and calculation, it is the most widely used diagnostic tool to identify weight problems within a population, usually whether individuals are underweight, overweight or obese.
Malampatti - is used to predict the ease of intubation. It is determined by looking at the anatomy of the oral cavity; specifically, it is based on the visibility of the base of uvula, faucial pillars (the arches in front of and behind the tonsils) and soft palate. Scoring may be done with or without phonation. A high Mallampati score (class 4) is associated with more difficult intubation as well as a higher incidence of sleep apnea.
Class 1: Full visibility of tonsils, uvula and soft palate
Class 2: Visibility of hard and soft palate, upper portion of tonsils and uvula
Class 3: Soft and hard palate and base of the uvula are visible
Class 4: Only Hard Palate visible
Epworth Sleepiness Scale - index of sleep propensity during the day as perceived by patients, and derived from the answers to 8 questions.
Pulse Oximetry - non-invasive measure of oxygen saturation; that is the amount of oxygen saturated in the hemoglobin in terms of percentage; not as accurate as the values obtained from an arterial blood gases (ABG) test and should only be used as a gauge of oxygenation. Normal ranges are between 95-100%.
Diagnostic Sleep Study - monitoring of several physiological activities in a sleeping individual. Usually performed to determine the absence or presence of a specific sleep disorder. The sleep study can occur in a sleep disorders center or in a patient’s home with portable recording equipment.
Electromyogram (EMG) - recording of electrical activity from the muscular system; in sleep recording, synonymous with resting muscle activity or potential. The chin EMG, along with EEG and EOG, is one of the three basic variables used to score sleep stages and waking. Surface electrodes are used to record sleep in humans, measuring activity from the submental or masseter muscles. These reflect the changes in resting muscle activity. During REM sleep the chin/cheek EMG is tonically inhibited.
Nasal AirfIow/ Nasal Ventilation - recording of the complete respiratory cycle by measuring inspiratory and expiratory airflow.
Electroencephalogram (EEG) - recording through the scalp of electrical potentials from the brain and the changes in these potentials. The EEC is one of the three basic variables (along with the EOG & EMG) used to score sleep stages and waking. Surface electrodes are used to record sleep in humans, recording potential differences between brain regions and a neutral reference point, or between brain regions.
Polysomnogram (PSG) - continuous and simultaneous recording of physiological variables during sleep, i.e., EEC, EOG, EMG (the three basic stage scoring parameters), EKG, respiratory air flow, respiratory excursion, lower limb movement, and other electrophysiological variables. (Type 1)
Home Sleep Test (HST) — Also known as a Ambulatory test. These are diagnostic machines the patient takes home and administers prior to going to sleep. While currently these test are not accepted by Medicare yet, When these test are read by a sleep physician they can become the medical letter of necessity you need to treat. These can be administered for about the same cost as a deductable of a PSG. (Type 2, 3, 4)