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sleep apnea tests – methods
Sleep apnea test results, once the sleep apnea test results are interpreted by the Sleep Specialist and send a report to the patient referring doctor, the patient will then be told the results during a follow-up visit.
If the report comes back with a positive diagnosis for sleep apnea, the doctor will normally have several recommendations to help treat or correct the disorder.
Before we go into the details on how obstructive sleep apnea is treated, we will discuss how a person qualifies for a positive diagnosis. Sleep apnea test results
During the overnight sleep study in the clinic, the monitoring technologist is observing the patient’s various body functions such as breathing, brain waves, heart rate, muscle activity, snoring, body position, and oxygen levels in the blood.
Sleep apnea tests can determine who qualifies for a continuous positive airway pressure device
These various signals all are displayed on a computer monitor in the control room of the sleep center. By observing the multitude of data collected by the computers, the tech can determine if the patient demonstrates obstructive sleep apnea along with multitudes of other sleep disorders.
For the positive diagnosis of obstructive sleep apnea, a person will need to fulfill the criteria listed below.
• A decrease or complete cessation of airflow of 20% or more from baseline lasting more than 10 seconds per event
• A decrease from the baseline measured oxygen level of 3% or more after a respiratory event such as listed above
• An arousal immediately following the respiratory event
• The arousal can be from a change in brainwave activity, increased muscle activity or combination
• A index of averaging 5 or more respiratory events an hour with a combination of arousals and desaturations
CPAP or continuous positive airway pressure will be administered to the patient if the above criteria are met during the first half of the apnea test.
The act of adjusting the air pressure level to correct sleep apnea is called a CPAP titration. After the patient falls back asleep with a CPAP mask on and air flowing into the mask, the tech will slowly via remote control increase the air pressure in increments measured in centimeters of water. (Sleep apnea test results)
The tech ultimately wants to see the patient sleep on their back and at the same time dreaming. The reason for this is because, in that body position and stage of sleep, obstructive sleep apnea will be the most severe. The pressure can finally be adjusted to optimum levels once that happens.
Usually, if the patient does not sleep their back, the tech will request them to try and do so via the intercom.
An ideal test would demonstrate clear cut obstructive sleep apnea at its worst potential in REM sleep while the patient is on their back. Not all patients will sleep in that position just for that reason and will do it unconsciously as they cannot breathe well and have to turn over to do so easier.
Thus, the tech will ask them to turn over to their back if they haven’t yet. This helps document how severe the patient’s apnea can really be.
During the CPAP titration, there can be many situations that can occur to prevent finding optimal pressure. At times there are patients who have difficulty falling or staying asleep with the CPAP mask on due to discomfort.
To help remedy this issue, the tech will have to have the patient try several masks until they are comfortable enough to fall or stay asleep with it on.
Sleep apnea test results. The mask developing leaks during the changes in position is normal on occasion, but if it happens enough to prevent the tech from maintaining stable pressure, the mask will need to either be readjusted or changed to correct the leakage.
It is always best for the tech to be knowledgeable about how the many types of CPAP masks available on the market can work for each and every patient beforehand in order to help with having mask leakage issues. Having the patient use the most comfortable and best-selling mask right away will greatly reduce fitment, patient tolerance, and mask leak issues.
Most patients will be fitted with a mask that seals around the outside of the nose. The reason is that it is the most stable style of mask that provides a good seal along with comfort for most in general. Air escaping from the mouth is quite common and can be a challenge to correct.
If a mouth leak occurs frequently enough, the air pressure will be lost and the patient will continue to have respiratory events. This is also preventing the tech from optimally titrating an accurate pressure as well.
The first step is to lower the air pressure. Lots of times the tech increases air pressure too quickly without allowing the patient to acclimate. By giving the patient more time to adjust, mouth leaks can be corrected. The next step would use an inline heated humidifier.
This device is a water chamber with a warming plate to help provide moisture to the incoming air. The extra moisture flowing into the patient’s airway can sometimes help prevent mouth leaks.
If a heated humidifier does not correct the issue, the tech will have him wear a chinstrap. The strap will keep tension on the jaw and help keep the mouth from dropping open.
The next method to attempt is a change of mask from a nasal mask to a full face mask that covers not only the nose but mouth too.
This type of mask allows the patient to breathe through the mouth as well as the nose. The reason it is not preferred to be used before a nasal mask is due to them not being as comfortable or able to seal as well.
The nasal mask due to their sheer size and amount of surface area it has to try and seal is usually as a last resort.
These methods are what most properly trained techs will do in that order when issues occur regarding mask tolerance; mask leakage and mouth leakage during a sleep apnea test when the second half involves a CPAP titration.
If the sleep test is a full night of titration versus the typical split night, the tech will have more time to try other methods to correct those issues.
Methods such as increasing the height of the head of the bed or switching the CPAP machine to a different operating mode called bilevel. (Sleep apnea test results)
Increasing the height of the head of the bed makes the obstructive sleep apnea less severe and thus allowing the tech to lower the CPAP air pressure.
By doing so, will help correct mouth or lip leakage. On the other hand, using the Bilevel method is exactly what it sounds like. Rather than one constant air pressure when inhaling and exhaling with CPAP, there are two, a higher inhalation pressure and a lower pressure during exhalation.
The drop in pressure during exhalation helps alleviate the issue of air leaks from the mouth and lips as well.
Sleep apnea test results