Polysomnography (PSG) is the only one diagnostic and important test for sleep and sleep disorders, which is an extension of physical examination & evaluation of sleeping patients.

Polysomnography records 16 different variables and it is an interpretation of EEG (Electroencephalogram), EOG (Electrooculogram), EMG (electromyogram),  EKG Respiratory (Abdomen, Thorax, flow channels, SPO2) channels, Body position channel etc.
(Electrocardiogram). Standard speed of PSG is 10mm/sec (30sec epoch/ page). Advantages of computerized PSG include early data acquisition, display, and permanent storage, easy review, and online record.

Types:

  1. Lab based study
  2. Home based study (with limited channels+
  3. Basa line or Nocturnal PSG usually recording at nighttime.
  4. MSLT (multiple sleep latency test) and MWT (maintenance of wakefulness test) are similar form of PSG, which are conducting at Daytime to detect insomnia and excessive daytime sleepiness. MSLT usually conducted after nocturnal PSG immediate next day, where as MWT (variant of MSLT) does not require prior overnight study.
  5. CPAP: continuous Positive Airway pressure
  6. Bi-PAP: Bi-level positive Airway pressure
  7. Split study with CPAP/ Bi-PAP.
Video polysomnography:  PSG with video recording can differentiate parasomnias, nocturnal seizures, psychogenic dissociative disorders and diurnal movement disorder 
Personally we recommend Lab based study under technician continuous observation particularly for CPAP and BiPAP titration

Why manual score is preferred?

All of the computer-generated reports of PSG have a lot of errors and lead to misdiagnose of the disease. Hence AASM (American Academy of Sleep Medicine) and BRPT (Board of registered Polysomnographic technologists) advised manual scoring for maximum accuracy.

Indications for Polysomnography

  1. OSA / Sleep related breathing disorders.
  2. Night terrors/ Nightmares.
  3. Evaluation of Obesity.
  4. Sleep Hypoventilation
  5. Suspected nocturnal Seizures.
  6. Insomnia, narcolepsy,
  7. Motor disorders like periodic leg movement syndrome (PLMS),
  8. Prior to surgical or dental procedures for OSA (obstructive sleep apnea
  9. Patients with parsimonies (usual/ atypical/ behaviour)
  10. Before undergoing Laser assisted Uvulopharyngioplasty (LAUP). /  UPPP
  11. Sleep Bruxism.
  12. Parasomnias / dyssomnias

Contra Indications:

NO SPECIFIC CONTRA INDICATIONS FOR POLYSOMNOGRAPHY.
All age groups including infants can be advised by the Physician or Pulmonologist for Polysomnography.

Job work:

Process of manual interpretation as following

  1. Identify and mark the wake & sleep stages: stage I (transitional sleep), stage II (intermediate sleep), stage III (delta sleep or deep sleep), REM stage ( active sleep / dreaming sleep/  paradoxical sleep).and total sleep time sleep status( is the sleep is fragmented/ poor/ fair/ good)
  2. Detect the sleep apneas (obstructive sleep apnea, Obstructive Hypopnoea, central apnea, Mixed apnea & RERAs).
  3. Arousal marking
  4. Periodic leg movements
  5. Identify cardiac arrthmias and heart block etc.
  6. Artefact detection.
  7. Seizure activity identification
  8. Hypnogram analysis.
  9. Graphic summary of sleep period Why manual interpretation is preferred?
All of the computer-generated reports of PSG have a lot of errors and lead to misdiagnose the disease. So AASM (American Academy of Sleep Medicine and BRPT (Board of registered Polysomnographic technologists) advised manual scoring for 100% accuracy.

Interpretation by whom:

According to New AASM guidelines the manual interpretation should be done by RPSGT certified professionals from BRPT (Board of registered Polysomnographic technologists) USA.

 
 
 
8 to 10 cents per line for Medical Transcription
$20 TO $25 TO each Sleep Study.  
12 hour, “following morning” turnaround
99%+ accuracy guaranteed
Digital recording