
Published:Thu, 18 Feb 2010 00:46:37 GMT
Thomas Goetz is the Executive Editor of Wired and the author of The Decision Tree , a new book about how tracking and research can better inform our own health decisions. Here, as......
Published:Thu, 18 Feb 2010 00:24:29 GMT
Thomas Goetz is the Executive Editor of Wired and the author of The Decision Tree, a new book about how tracking and research can better inform our own health decisions. Here, as ......
Published:Tue, 16 Feb 2010 17:03:21 GMT
TUESDAY, Feb. 16 (HealthDay News) -- The breathing woes that accompany severe sleep apnea may be counterbalanced by this silver lining: those with the condition report fewer night......
Published:Mon, 15 Feb 2010 17:14:58 GMT
This is the first large study to address both reported dream and nightmare recall frequency in a clinically evaluated sample of patients with a high frequency of severe OSA......
Published:Mon, 15 Feb 2010 15:21:52 GMT
A study in the Feb. 15 issue of the Journal of Clinical Sleep Medicine shows that patients with severe obstructive sleep apnea (OSA) report a significantly lower frequency of nigh......
A polysomnogram will typically record a minimum of eleven channels requiring a minimum of 22 wire attachments to the patient. Two channels are for the EEG, one or two measure airflow, one is for chin movements, one or more for leg movements, two for eye movements (EOG), one for heart rate and rhythm, one for oxygen saturation and one each for the belts which measure chest wall movement and upper abdominal wall movement.
Wires for each channel of recorded data lead from the patient and converge into a central box, which in turn is connected to a computer system for recording, storing and displaying the data. During sleep the computer monitor can display multiple channels continuously. In addition, most labs have a small video camera in the room so the technician can observe the patient visually from an adjacent room.
The electroencephalogram (EEG) will generally use six "exploring" electrodes and two "reference" electrodes, unless a seizure disorder is suspected, in which case more electrodes will be applied to document the appearance of seizure activity. The exploring electrodes are usually attached to the scalp near the frontal, central (top) and occipital (back) portions of the brain via a paste that will conduct electrical signals originating from the neurons of the cortex. These electrodes will provide a readout of the brain activity that can be "scored" into different stages of sleep (N1, N2, N3 which combined are referred to as NREM sleep, and Stage R which is rapid eye movement sleep or REM, and Wakefulness).
The electrooculogram (EOG) uses two electrodes; one that is placed 1 cm above the outer canthus of the right eye and one that is placed 1 cm below the outer canthus of the left eye. These electrodes pick up the activity of the eyes in virtue of the electropotential difference between the cornea and the retina (the cornea is positively charged relative to the retina). This determines when REM sleep occurs, of which rapid eye movements are characteristic, and also essentially aids in determining when sleep occurs.
The electromyogram (EMG) typically uses four electrodes to measure muscle tension in the body as well as to monitor for an excessive amount of leg movements during sleep (which may be indicative of Periodic Limb Movement Disorder, PLMD). Two leads are placed on the chin with one above the jaw line and one below. This, like the EOG, helps determine when sleep occurs as well as REM sleep. Sleep generally includes relaxation and so a marked decrease in muscle tension occurs. A further decrease in skeletal muscle tension occurs in REM sleep. A person becomes partially paralyzed to make acting out of dreams impossible, although people that do not have this paralysis can suffer from REM Behavior Disorder. Finally, two more leads are placed on the anterior tibialis of each leg to measure leg movements.
Though a typical electrokardiogram (ECG or EKG) would use ten electrodes, only two or three are used for a polysomnogram. They can either be placed under the collar bone on each side of the chest, or one under the collar bone and the other six inches above the waist on either side of the body. These electrodes measure the electrical activity of the heart as it contracts and expands, recording such features as the "P" wave, "QRS" complex, and "T" wave. These can be analyzed for any abnormalities that might be indicative of an underlying heart pathology.
Nasal and oral airflow can be measured using pressure transducers, and/or a thermocouple, fitted in or near the nostrils; the pressure transducer is considered the more sensitive. This allows the clinician/researcher to measure rate of respiration and identify interruptions in breathing. Respiratory effort is also measured in concert with nasal/oral airflow by the use of belts. These belts expand and contract upon breathing effort.
Pulse oximetry helps determine changes in blood oxygen levels that often occur with sleep apnea and other respiratory problems. The pulse oximeter fits over a finger tip or an ear lobe.
Snoring may be recorded with a sound probe over the neck, though more commonly the sleep technician will just note snoring as "mild", "moderate" or "loud" or give a numerical estimate on a scale of 1 to 10.