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BLOG ONSEN® / Healthy body and mind

What is polysomnography and why is it so important?

12 czerwca 2021
Polysomnography, sleep study, sleep examination
Contents
Preparation for polysomnography
Course of polysomnographic examination
Equipment used in polysomnography
Sleep disorders detected by polysomnography
Analysis of polysomnography results
Polysomnography is an advanced diagnostic examination aimed at monitoring various parameters related to sleep and physiological activities during sleep. It is an extremely important diagnostic tool that allows doctors and psychologists to gain a deeper understanding of an individual's sleep functions. It also enables an in-depth diagnosis of sleep disorders that may affect the patient's health.

Well-conducted polysomnographic examination plays a crucial role in identifying and treating various sleep disorders that can significantly impact a patient's daily functioning. By employing polysomnography, it is possible in most cases to tailor a personalized treatment plan, leading to an improvement in the patient's health.
Sleep study, dream analysis, dream dictionary

Preparation for polysomnography

Proper preparation for polysomnography ensures its effectiveness and accuracy. This, in turn, allows doctors and psychologists to conduct a more precise analysis of the patient's sleep during the examination. It also facilitates the accurate diagnosis of any sleep disorders present in the individual.

As with other examinations, the first step in preparing for polysomnography is understanding the procedure. Therefore, the doctor or technician must thoroughly explain to the patient what the examination involves, including the parameters being monitored and later analyzed. The patient should also be aware of the benefits of the examination, understanding the information that will be gathered.

On the day of the examination, the patient should inform the doctor about all medications being taken. Some substances can affect polysomnography results, so it's crucial for the doctor to adjust the procedure to the patient's individual needs. In some cases, the doctor may recommend discontinuing certain medications before the examination.

It is also important to note that at least a few hours before the examination, the patient should limit the consumption of psychoactive substances, including caffeine and alcohol. These substances can affect sleep quality and, most importantly, disrupt natural sleep-wake cycles. Only complete avoidance of these substances before the examination allows for reliable results.

Choosing loose and comfortable clothing is essential, facilitating the attachment of electrodes and sensors. This, in turn, contributes to maintaining comfort and ensures the smooth conduct of the examination. Attention should also be paid to adequate hygiene before coming for the examination, affecting the comfort of both the patient and medical staff.

Sometimes, even the anticipation of the examination can impact sleep quality. Therefore, it's important for the patient to try to remain calm before the medical appointment. Avoiding stress and too much physical activity on the day of the examination can help achieve a more natural sleep environment.
Polysomnography, polysomnographic study, brain studies

Course of polysomnographic examination

Before undergoing polysomnography, it's essential to understand the comprehensive process of monitoring various parameters related to sleep. At the beginning of polysomnography, the patient is prepared for the examination. Electrodes and sensors are placed on the patient's skin to monitor various bodily functions. Electrodes on the head record brain activity, electrodes on the face constantly monitor eye movements, and sensors attached to the chest and abdomen control breathing.

The electrodes on the head are part of the electroencephalogram (EEG), which is the most crucial element of polysomnography. It records brain's electrical activity, specifically each of the five brain waves, including alpha, theta, beta, gamma, and delta. Analyzing brain waves helps identify sleep phases, including REM phase (rapid eye movements) and the nREM phase (non-REM sleep) responsible for deep sleep.

Polysomnography also examines eye movement using electrodes placed on the eyelids. This is essential for identifying the REM phase, during which intense eye movements occur. Meanwhile, special sensors on the chest and abdomen monitor the breathing rhythm. This allows the identification of potential sleep apneas, and thus, an assessment of breathing quality during sleep.

During polysomnography, muscle activity is also examined using electrodes placed on various areas of the body. This enables the monitoring of body movements during sleep, which can be essential in the diagnosis of conditions such as restless legs syndrome and various parasomnias. Muscle activity of the heart is also examined, providing information about the heart rhythm.

Polysomnographic examination lasts throughout the night, as the patient's sleep is monitored from the moment of falling asleep to waking up. This provides a complete picture of sleep structure, allowing the identification of any potential difficulties. The data is then analyzed by specialists. Doctors interpret the results, identifying any sleep disorders, and then create and adjust a comprehensive treatment plan to the individual needs of the patient.
EEG, EMG, EOG, sleep study, polysomnography analysis

Equipment used in polysomnography

As a rule, polysomnographic examination is based on advanced equipment that allows monitoring parameters related to sleep and the functioning of the body during sleep. One of the main components is the electroencephalogram (EEG), which records the brain's electrical activity. Electrodes placed on the scalp monitor brain waves, enabling the identification of different sleep stages, including REM and nREM sleep.

Another device is the electromyogram (EMG), which monitors muscle activity during sleep. Electrodes placed on various areas of the body record muscle movements, which is significant in identifying restless legs syndrome and other movement disorders.

The electrooculogram (EOG) is also used to monitor eye movement. Electrodes are placed on the eyelids to record rapid eye movements characteristic of the REM stage. This is important for assessing whether the patient goes through the sleep stages correctly.

The use of an electrocardiogram (EKG) is standard, serving to record the activity of the heart muscle using electrodes placed on the heart. This provides information about heart rhythm, including arrhythmias. It is an essential element in diagnosing sleep disorders related to the cardiovascular system.
In polysomnography, a lot of specialized equipment is used.
Polysomnography also utilizes respiratory sensors that monitor breathing during sleep. These sensors are placed on the chest and abdomen to assess the respiratory rhythm. This allows for the identification of sleep apnea and other potential respiratory issues.

Less frequently, thermocouples may be used to measure body temperature, which is useful in cases of night sweats and other thermoregulatory disorders. In some cases, to obtain a comprehensive assessment, systems for audio and video recording are employed. This allows for the recording of sleep sounds and any movements that may be difficult to observe based solely on electrophysiological data.

The equipment used in polysomnography is highly technologically advanced, enabling a comprehensive analysis of sleep to identify associated disorders. Thanks to these tools, doctors can provide patients with a precise diagnosis and personalized treatment plan, improving the quality of their sleep and life.
Polysomnography, polysomnographic study, sleep apnea

Sleep disorders detected by polysomnography

Polysomnography is an indispensable diagnostic tool that allows for the effective identification of various sleep disorders that can significantly impact health and, therefore, the quality of life of each patient. Polysomnographic examination is most commonly performed on patients with sleep apnea, experiencing interruptions in breathing during sleep. Sleep apnea can lead to hypertension and heart diseases, as well as other serious conditions. Polysomnography identifies the frequency and type of apneas, aiding in treatment.

This examination also detects restless legs syndrome (RLS), affecting an increasing portion of the population, as well as the rarer periodic limb movement disorder (PLMD). During polysomnography, movements of the legs during sleep are monitored, allowing for the identification of these disorders. These patients often experience unpleasant sensations in the legs, prompting movements to alleviate them.

It also identifies nighttime epileptic seizures, which affect not only individuals with diagnosed epilepsy but also seemingly healthy individuals. Recording brain activity during sleep allows doctors to effectively identify potential epileptic seizures, enabling tailored treatment to the individual needs of the patient.

It is worth noting that some people suffering from chronic headaches experience them mainly at night. Polysomnography provides information about changes in sleep structure related to the occurrence of headaches, which is useful for appropriate treatment of these conditions. Besides, it is a tool in diagnosing parasomnias, including sleepwalking, and helps identify the occurrence of nightmares, which can degrade the quality of life. Continuous monitoring of body movements and brain activity allows the identification of specific behaviors.
Sleep stages, deep sleep, how to fall asleep deeply

Analysis of polysomnography results

What allows doctors to understand the profound aspects of a patient's sleep and then identify potential disorders is the analysis of polysomnography results. Sometimes, the analysis of polysomnographic testing may seem to take a considerable amount of time, but it needs to be thorough. Through this analysis, it's possible to develop a personalized treatment plan, which is crucial for the patient.

The first step in the polysomnography analysis is the evaluation of sleep stages, which helps determine the duration of REM sleep and the duration of NREM sleep in the patient. Assessing the entire sleep structure allows the medical team to understand whether the patient goes through a full sleep cycle, which is crucial for restorative sleep.

The analysis also involves examining the electroencephalogram (EEG) recording, which represents brain electrical activity. Therapists analyze patterns of brain waves, identifying periods of wakefulness and deep sleep. The division of sleep into stages enables the examination of their occurrence. Any deviations from the norm may indicate various disorders, such as sleep apnea or parasomnias.
Polysomnography allows for obtaining interesting information about sleep and its course.
Another element of the polysomnography results analysis is determining eye movement during sleep. This is done through electrooculography (EOG), primarily responsible for identifying the REM sleep phase, characterized by rapid eye movements. Lack of stability in eye movements can indicate serious health issues, such as restless legs syndrome, or other sleep disorders.

Recording muscle activity during the test allows monitoring body movements during sleep. This is achieved through electromyography (EMG), which detects electrical impulses. It proves useful in the diagnosis of parasomnias and any difficulties related to sleep motor skills. It operates similarly to electrocardiography (EKG), which provides information about the heart rhythm during polysomnography, helping identify irregularities.

Consideration is also given to movements of the chest and abdomen, allowing assessment of the respiratory rhythm. This helps in the identification of sleep apnea, which can be dangerous. External factors, such as noise, which can affect sleep, are also taken into account. Sometimes, the patient's environment significantly influences sleep quality.

We also encourage you to explore other articles on the best sleep and health blog, as well as the Encyclopedia of Healthy Sleep prepared by the ONSEN® team of specialists. For those who care about spine health, we recommend a set of spine exercises prepared by our physiotherapist.
Mattresses, mattress selection, how to choose a mattress

FAQ: Polysomnography

What is polysomnography?

Polysomnography is a diagnostic procedure that involves the comprehensive monitoring of various physiological parameters during sleep. During polysomnography, the activity of the brain, eye movements, muscle tension, heart activity, breathing, blood oxygen levels, and body movements are recorded. It may sometimes include additional factors. The primary goal of polysomnographic testing is to assess the quality of sleep and detect any potential disorders.

How to prepare for polysomnography?

Instructions for preparing for polysomnography are provided directly to patients by the facility conducting the examination. Standard preparation for polysomnographic testing may include avoiding caffeine and alcohol before bedtime, maintaining typical sleep habits, and bringing comfortable sleepwear.

How long does polysomnography take?

The duration of polysomnographic testing can vary, but it typically lasts from six to eight hours. Patients arrive at the facility in the evening and are then connected to monitoring equipment for the examined parameters. The testing continues throughout the night until the patient is definitively awakened.

Which doctor can recommend polysomnography?

Any doctor can recommend polysomnography. Typically, it is done by pulmonologists, cardiologists, psychiatrists, or neurologists. However, family doctors may also recommend it. Often, doctors refer patients for polysomnography based on a request from a psychologist, who cannot issue such referrals themselves. The decision to recommend polysomnography depends on the patient's symptoms and difficulties.

Is polysomnography covered by the National Health Fund (NFZ)?

Yes, polysomnography is covered by the National Health Fund (NFZ), but only in facilities that have a relevant contract with the NFZ. The procedure is carried out as a one-day hospitalization and requires a referral to the hospital, which must be issued by a doctor who also practices within the NFZ system.

Contents
Preparation for polysomnography
Course of polysomnographic examination
Equipment used in polysomnography
Sleep disorders detected by polysomnography
Analysis of polysomnography results
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