How do sleep studies provide useful data when they’re taking you out of your normal routine to a strange place, bed, and hooked up to things?

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Wouldn’t you be basically guaranteed to sleep poorly?

I know just being in a hotel I wake up and flop around all night. Being observed and tested seems telling me that would just make it worse.

In: Biology
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The fact that a person may have a poor night’s sleep in a foreign bed while being monitored actually helps – they want to find out problems, so having you in a situation where you are unlikely to have a randomly good night’s sleep is a good thing.

And the things they are looking for aren’t just ‘I had trouble falling asleep’. The are looking for how well you breathe while asleep, whether you do go through all the proper stages of sleep. These show up whether you are fully comfortable or not.

CPAP wearer and former non-believer in sleep studies here. I had a sleep study done because I was repeatedly falling asleep at the wheel on my way home from work. The trigger for me to go get the sleep study was being pulled over by the police and getting an escort home because I didn’t trust myself to get home.

I had been having episodes of what is often described clinically as sleep paralysis for years. I would nod off while sitting around a table with friends or while at a restaurant. I could hear everything that was going on and I had reactions to it in my mind but I couldn’t move or speak to take part in the conversation. When I woke up it was often with a deep breath and I could just naturally get back into the conversation because I had been taking it all in. Oftentimes no one knew I had been asleep until I snorted or took a big breath.

I went into the sleep study pretty skeptical. I didn’t think I’d be able to sleep. Lots and lots of wires clipped all over me, I was quite anxious. I laid back in the bed and was thinking about what to put on the TV because I usually like to fall asleep with the tube on and the next thing I know I’m getting shaken awake.

The nurse says that I started snoring immediately but otherwise I was sleeping pretty normally until I transitioned into deep sleep. At that point my throat closed completely, I stopped breathing, and I shot back up into light sleep (or some non-deep sleep state). She said that happened all night long. They suggested I probably hadn’t had any good, deep sleep in years based on some of my other health indicators.

So I got a couple of things done. ENT recommended rhinoplasty to fix a deviated septum and turbinate reduction to open up my airway. I also had some stuff done to my sinuses which is too gross to even discuss in public.

And after I healed up I got a CPAP. I immediately stopped snoring and had the deepest, most restful sleep of my life. After about a month with the CPAP I felt like a new person and never even felt drowsy during the day. I lost weight (I was already in decent shape) and a bunch of my other health problems slipped away.

TL;DR – If you really need a sleep study you’re probably so GD tired you could sleep anywhere, including at the wheel of a truck, and any bed is a slice of heaven.

So I’m a registered sleep tech. Since it says ELI5, I will try to explain it like I would to a kiddo in my lab.

We know that not everyone will sleep super great, it’s just realistic to understand that. But depending on why we are seeing you, even 4-5 tossing and turning hours of sleep will show us something. We try to help with noise levels and comfort levels and temperature. True we can only do so much, but I definitely see more sleep than wake people. Yes you’re hooked up to a lot but once your body shuts down to sleep it is more likely that you’ll not notice them.

Truthfully there are people who just can’t sleep. It happens rarely, but it does happen. Sometimes doctors will provide a single dose of a sleep aid like ambien for the night of the study. Since it’s a single dose, it won’t really change your sleep chemistry, just help you stay asleep.

My kid has had a bunch of sleep studies over the last 12 years, and I have asked almost this exact question to a couple sleep doctors/techs before. The general consensus I’ve gotten was that they do the sleep study just to see if they can catch the problem. They know people aren’t going to get great sleep, and they know that many sleep problems don’t happen every night. So they order the test fully aware that it might not pick up on the problem.

They use the data they get from the test WITH your observations and other symptoms. A good sleep doctor won’t completely discount a problem just because they didn’t see it during the sleep study.

My daughter sleep walks, but not every night. She had a sleep study recently to see if there was any obvious reason for her to do this. She didn’t sleep walk during the study, but the doctor still knows that she does sleep walk based on our observations at home. She also has sleep apnea, and they were able to tell (with a decent level of certainty) that the apnea is likely not causing the sleep walking.

Tl:Dr they know you’re not going to sleep well, and they know they might not catch everything. The test is just one piece of the puzzle in sleep medicine.

A bit of information first.

Ruling out Obstructive sleep apnea is 97%~ of the request I receive as a sleep study tech.

Obstructive sleep apnea or osa is when the muscles and soft tissues around your airway relaxes and the tongue loses support dropping down, blocking the airway. This can happen from 0-125 times per hour. (worst I’ve personally seen.) Over 30 is considered severe. Sleeping on your back and your dreaming (R.E.M or rapid eye movement) sleep cycle are the worst for apnea.

Now with this information, during a sleep study as long as you fall asleep for a little bit, the data collected is able to show if the apnea is present or not. Some nights you might have 8 apnea per hours others 12 and sometimes 6. But we can determine that it was present, and worth while to treat, especially if symptoms are present. (Fatigue, high blood pressure, etc). If no apnea was seen during the exam and there was no sleeping on the back and no r.e.m sleep, that might become a inconclusive study. (It’s also ok if it happens, 0 stress on this if you have a study coming up.)

Now insomnia, difficulty to fall asleep is another main concern of alot of the patients I see. The test keep track of the time you spend in each sleep stages, how long it takes you to fall asleep and your sleep efficiency during the study. But you’re not at home, this can vary so much. We don’t have any real values to quantify insomnia. It’s usually more of a psychological side. Stress, anxiety, sleeping habits. Keeping your biological clock (circadian rhythm) steady.

TLDR : first we look at physical issues, that we can measure with wires, which require any kind of sleep (2hours is our lab’s minimum). Then if nothing is found doctors can start to look at other things. The purpose of the sleep study is to rules out the bigger possible issues first.

Also like everything else in the medical world, everyone is different and should be looked at based on their needs.

Hope this helps. 🙂 Questions are always welcomed.

If you’re a daily (nightly) user of Zolpidem (10 mg) and you wanted to get off the medication, would a sleep study have any value?