If you think you may have a sleep disorder, your primary doctor or a doctor that specializes in sleep disorders may send you to a sleep center for diagnosis. There are a large number of sleep centers located across the United States and their numbers are increasing. Sleep centers in the United States must be accredited by the American Academy of Sleep Medicine.
When a person goes to a sleep center, it is usually for an overnight stay. Costs involved for most sleep study tests range from one to three thousand dollars and many need to be repeated twice. The first visit to diagnose the sleep disorder and the second to get accurate settings for any PAP machines that may be needed. Health insurance generally pays all or most of the cost of the tests needed to diagnose a sleep disorder.
Once an appointment has been made, many sleep centers send a sleep diary to the patient. The information from the sleep diary is used by the doctors to understand general sleeping patterns. It is also recommended that no caffeine or alcohol be consumed after 12:00 p.m. on the day of the scheduled test.
Generally the patient packs an overnight bag just as if they were going to stay at a hotel overnight. During the sleep study you wear your own nightclothes and you can use a favorite pillow from home. You can bring a book or magazine if you like to read before falling to sleep. Most sleep centers resemble a hotel room and have a television to watch if that is what the patient usually does before going to sleep at home. Once you are relaxed the sleep center technician starts preparation for the equipment needed to record your patterns of sleep.
Diagnosis from a sleep center study is made using polysomnography which records a continual record of your sleep. In order to take a specific reading slightly more than two dozen small thin electrodes are pasted to specific parts of your body. They are placed under your chin, on your scalp, near your eyes and nose, on your finger, chest and legs, and also over the rib muscles and on the abdomen. These electrodes then record various types of readings during the night. Often an audio and video tape are also made to monitor sleep noises and movement.
Once all the equipment is in place the sleep technician leaves you alone to fall asleep. Even with all the equipment it is not uncomfortable. It is easy to move or turn onto your side. Each bedroom in a sleep center also has an automatic intercom so it is easy to call the technician if needed for such things as a bathroom break. When the sleep study is completed, the technician may wake you. Most studies that are used to diagnose a sleep disorder take seven to eight hours.
The reading are collected on a computer file called a polysonagram and are monitored and analyzed by the sleep technician during the night. The results are then sent for further readings to determine if there is a sleep disorder.
Although a sleep study may not sound comfortable, it is very important to determine and treat any sleep disorder.
The sleep disorder of sleepwalking, also known as somnambulism, affects approximately 14% of school-age children between five and twelve years old at least once. Approximately one quarter of the children with this sleep disorder have more frequent episodes. Sleepwalking is more common in boys then it is in girls. Most children that sleepwalk outgrow the symptoms of this sleep disorder by adolescence as their nervous systems develop.
In children this sleep disorder is thought to be the result of the immaturity of the brain's sleep / wake cycle. Normally the entire brain wakes up at the same time. However, in the case of a sleepwalker, the entire brain does not wake up together. The portion that is responsible for mobility wakes up while the portion responsible for cognition and awareness stays asleep. The child is actually in a deep state of sleep.
With this sleep disorder the brain remains partially asleep but the body is able to move. It is common for the sleepwalker to get out of bed and walk around. Sometimes they get dressed or go outside. Even though the sleepwalker's eyes are open and they see what they are doing, their expression remains blank. They do not respond to conversation or their name being called. A sleepwalker's movements usually appear clumsy. It is not uncommon for them to trip over furniture or knock over things as they move around. A sleepwalking episode usually happens one to two hours after the child goes to sleep. Most of these episodes last for fifteen minutes or less, but some can last for an hour or more.
This sleep disorder in children is usually outgrown and treatment is not generally necessary. In most cases, a parent gently guiding the child back to bed is all that is needed. There is not any need to wake the child.
However, there is about 1% of the population that sleepwalk as adults. Adults that have this sleep disorder did not necessarily have it as a child. In adults a sleepwalking episode can be triggered by stress, anxiety, sleep fragmentation, sleep deprivation, or certain medical conditions such as epilepsy.
Treatment for adults with this sleep disorder is often dependent upon the amount of danger they are in during an episode. For example, a sleepwalker who opens doors and goes outside onto a busy city street is in danger. A sleepwalker that gets up and goes into the living room and sits down on a chair most likely is not in danger. Treatments can include behavioral therapies, self hypnosis, or prescription medication.
A sleepwalker, whether adult or child, needs to have a safe area so that they do not get hurt during an episode. Precautions can be taken to eliminate some dangers. Parents should make sure the child's bedroom does not have any sharp or breakable objects. Doors should be locked at night to keep the sleepwalker from going outside. Sometimes it is necessary to put bells on doors to alert the sleeping parent that their child is sleepwalking. Large glass windows and doors should be covered with heavy drapery to lessen the chance of having the sleepwalker walk through it while it is closed.
A child with the sleep disorder of somnambulism needs to be protected and kept safe during an episode. It is the environment they are in that is the danger more then the sleep disorder itself.
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