Brief explanation about all the essential parameters monitoring during polysomnography or sleep study with corresponding images for better understanding.Also explain briefly about the split night study.I hope this may be helpful for those who are related to this field.

1. PARAMETERS MONITORED
IN SLEEP STUDY AND SPLIT
NIGHT STUDY
PRESENTED BY:AJAYTOMY
2ND YEAR BSC RESPIRATORY THERAPY
MODERATOR:DR.CHANDRAMAULY

2. PARAMETERS MONITORED
 Electroencephalogram (EEG)
 Electrooculogram (EOG)
 Electromyogram(EMG)
 Oronasal thermal airflow sensor
 Nasal pressure transducer
 Pulse oximetry
 Acoustic sensor
 Respiratory inductance plethysmography belts
 Electrocardiogram(ECG)
 Body position

3. ELECTROENCEPHALOGRAPHY(EEG)
 Used to distinguish between wakefulness and
various stages of sleep.
 Recommended EEG derivations are,
a)F4-M1
b)C4-M1
c)O2-M1

4. EEG electrode position

5. ELECTROOCULOGRAM(EOG)

6.  EOG allows simultaneous recording of both
vertical eye movements (such as blinking) and
horizontal eye movements (both slow and rapid)
 Documents the onset of REM sleep and note the
presence of slow rolling eye movements.

7. ELECTROMYOGRAPHY(EMG)
1.Chin EMG

8. USES
 Helps to determine sleep stages.
 Helps in diagnosis and classification of variety of
parasomnias.
 Used to identify bruxism.

9. 2.Leg EMG

10. USES
 To identify PLMD.
 Restless leg syndrome.
 Other movement disorders.
 To document REM sleep behaviour disorder.
 Record convulsive movements during nocturnal
seizures.

11. RESPIRATORY MONITORING
 Upper airway airflow
 Respiratory effort
 Snoring monitors
 Saturation
 CO2 monitoring

12. UPPER AIRWAY AIRFLOW
 For monitoring upper airway airflow two types of
monitors are used.
 1.ORONASAL THERMAL AIRFLOW SENSOR
 2.NASAL PRESSURE TRANSDUCER
 Here nasal prongs connected to a pressure
transducer detect inspiratory airflow.

13. RESPIRATORY EFFORT
 For monitoring respiratory effort two things can be
used.
 1.ESOPHAGEAL MANOMETRY
 Gold standard for measuring respiratory effort.
 An endoesophageal tube is passed nasally till the
probe is about 5cm above the esophageal-gastric
junction.
 2.RESPIRATORY INDUCTANCE PLETHYSMOGRAPHY
BELTS

14. SNORING
SATURATION

15. CO2 MONITORING
 Capnography or end-tidal co2(ETCO2),monitoring
detects the expired co2 level, which is closely
approximates intra alveolar co2.
 An infrared analyzer over the nose and mouth
detects in the expired gas.

16. ELECTROCARDIOGRAM(ECG)
 ECG abnormalities in sleep apnea patients include
 Marked sinus arrhythmia
 Extra systoles
 Prolonged asystolic episodes
 Atrial or ventricular fibrillation
 Nocturnal angina may show ST segment deviation.

17. BODY POSITIONS
VIDEO CAMERA

18. SPLIT NIGHT STUDY

19. DEFINITION
 Split night studies involves diagnostic
polysomnography during the first portion of the
night followed by CPAP titration for the remainder
of the night.
 This approach has been used to diagnose sleep
apnea and titrate CPAP during a single night and
can reduce costs.

20. INDICATIONS FOR SNS
 Split study-if at least 3hr remain for titration
 AHI>40 during 2hr of monitoring in the initial
diagnostic portion.
 AHI 20-40 in special clinical circumstances

21. ADVANTAGES OF SNS
 For moderate to severe apnea patients the split
night study helps immediate therapy.
 SNS also allows to identify the patients unique
PAP settings in the same night.
 It gives chance to try out several mask types to
find the perfect fit.
 Less costly
 More convenient.

22. DISADVANTAGES OF SNS
 Lower CPAP level derived as compared to full
night studies.
 May not allow enough time for an optimal CPAP
titration or for transitioning to BPAP if that
becomes necessary.
 There are only fewer opportunities for patient
education.
 Higher degree of technologist skill is required.