The field of sleep medicine is dedicated to diagnosing and treating people who suffer from sleep related disorders. It is a rapidly growing profession that is in great need of trained personnel.
Sleep Technologist Role
A sleep technologist’s role in a sleep disorder center is vital. Sleep technologists assist in the evaluation and follow-up care of patients with sleep disorders. They interact directly with the patient by placing sensors on the patient’s body that allow them to monitor sleep stages, breathing patterns, heart rate and rhythms, limb movements, oxygen levels, and more. To capture this information they use specialized diagnostic monitoring equipment, computers, and software applications.
Types of Diagnostic Tests Performed by Sleep Technologists
Sleep technologist assist board certified sleep medicine physicians with diagnostic tests conducted at sleep centers. This may include in-lab sleep studies, Multiple Sleep Latency Testing (MSLT) and Maintenance of Wakefulness Testing (MWT). Sleep technologists also score sleep tests prior to the physicians interpretation, and assist patients with their home sleep apnea tests.
Diagnostic tests include:
- Diagnostic Polysomnogram (PSG): This sleep study is ordered when the patient is suspected of having a sleep disorder. It provides a good evaluation of the patient’s typical night at home. Therefore, it presents data helpful in diagnosing sleep-related breathing events and other disorders present during sleep.
- Titration: A titration study should be performed after a PSG reveals that the patient has a sleep-related breathing disorder. The technologist fits the patient for an interface (commonly called a mask) that is used to provide continuous (CPAP), bi-level (BPAP), or adaptive positive airway pressure to the patient through the course of the study. The technologist titrates the positive airway pressure throughout the night to establish a pressure to maintain an open airway.
- ASV Titration: This titration study uses Adaptive Servo-Ventilation (ASV) for the purpose of improving respirations in patients with disease states like Complex Sleep Disordered Breathing, Central Apnea (CA), Mixed Apnea or those who suffer with Periodic Breathing, such as Cheyne-Stokes Respiration (CSR). ETCO2 may also be monitored during an ASV Titration study.
- Split: A split study provides an abbreviated diagnostic PSG and an abbreviated titration in the course of one procedure. The study is initiated as a diagnostic study. After a few hours and if clinical criteria is met, the patient is awakened and positive airway pressure (PAP) therapy initiated for the remainder of the study. Clinical criteria necessary to initiate PAP is established by the Medical Director and is commensurate with American Academy of Sleep Medicine standards. Factors included in the clinical criteria include diagnostic sleep time, apnea-hypopnea index, oxygen desaturations and hypoxic dysrhythmias in response to apnea and/or time remaining to titrate PAP levels. If a patient meets criteria, PAP will be initiated changing the diagnostic PSG to a split study even if a diagnostic PSG has been ordered. Since split studies provide a reduced titration time and patients may have difficulty falling asleep after the initiation of PAP, patients may need to return for a full titration study.
- Multiple Sleep Latency Test (MSLT): An MSLT should be used to provide an objective measure of a patient’s tendency to fall asleep and to assist in the diagnosis of narcolepsy or to address complaints of excessive sleepiness in the absence of obvious sleep disorders such as, OSA or parasomnias. The American Academy of Sleep Medicine’s Practice Parameters for an MSLT state that “polysomnography must be performed immediately before the MSLT” to report factors that may produce false results of the MSLT; such as, quantity and quality of sleep prior to the MSLT and clinical sleep disorders such as OSA, and circadian phase disorder. This test is conducted during the day and entails a series of 5 naps occurring every 120 minutes giving the patient an opportunity to nap for 15-35 minutes.
- Maintenance of Wakefulness Test (MWT): This study is a measurement of the patient’s ability to stay awake for a set period of time. This test is frequently used to test truck drivers, pilots and other transportation professionals whose alertness is related to safety. Like the MSLT, this study is conducted during the day. It consists of 4 naps conducted every 120 minutes during which the patient must try to remain awake for up to 40 minutes.
- Home Sleep Apnea Testing (HSAT): Sleep tests are performed at the patient’s home using a portable device that they initiate. The sleep center provides patient education including operation of the device and on call support technicians assist the patient with questions while at home. HSATs are ordered for patients whose insurance dictates home sleep apnea testing; generally healthy patients without co-morbidities such as morbid obesity, high blood pressure, diabetes and pulmonary disease and that are suspected of having sleep disordered breathing versus other sleep disorders.
Review the following organizations for additional resources
To learn more about becoming a Sleep Technologist, visit Prospective Students.
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