Dr. Zhanna Fast, MD

In order to receive a CPAP device, patients must receive a prescription from a physician. Some patients may be asked to complete an overnight sleep study known as a titration study. A titration study monitors patients' sleep using a mask attached to a CPAP machine. The technician may monitor and adjust the CPAP's air pressure throughout the night. The purpose of a titration study is to determine the appropriate air pressure for patients with obstructive sleep apnea (blocked upper airway). Once an appropriate CPAP pressure is identified, physicians or sleep technicians may recommend a specific brand or style of device to the patient for long-term use.

CBT is one of the most widely studied forms of psychotherapy, and it has been shown to be extremely effective for a variety of mental illnesses. Some of the issues that respond well to CBT include mood disorders, personality disorders, eating disorders, substance abuse, sleep disorders, and psychotic disorders. In some cases, CBT has been shown to be as effective or even more effective than medication. One of the interesting things that the scientific study of CBT has shown is that CBT actually changes the way the brain works, physically improving its function.

CBT differs from traditional psychotherapy in a few key ways. One of the most important distinctions is the emphasis on the power and responsibility of the patient in CBT. The patient will be encouraged to be the one asking the questions in CBT therapy, and most patients are assigned homework to complete outside of therapy sessions. There is a concept in CBT that everyone has power the power to change how they feel, even if they cannot control the situation, and this can be very empowering for patients. Because of this power shift, the therapist-client relationship is not as critical to success in CBT as it is in other modes of therapy. Patients should still get along well with their therapists, but they do not need a deep, dependent emotional connection to them. Finally, because CBT often treats a specific issue or problem, it is usually shorter in duration than traditional therapy. While some therapies may continue for years, CBT lasts on average just 16 sessions.

The most widely performed sleep test is the traditional polysomnogram (PSG). This test is typically used to determine whether patients have sleep apnea (lapses in breathing while asleep). Polysomnograms are conducted overnight in a specialized sleep clinic or sleep center, where a patient enters the sleep center and is assigned to a room with a bed, medical equipment, and monitoring system. An overnight sleep technician attaches electrodes to the patient's head, chest, and legs. This application process lasts for around an hour. A sleep technician watches and evaluates the patient as they sleep. Objects such as a comfortable pillow from home, toiletries, and small personal items may be helpful in easing patients into sleep in unfamiliar surroundings.

Patients receive their physician-interpreted sleep study results within a few weeks of the test. If sleep apnea is detected, patients may be asked to return for a titration sleep study. A titration study involves the same procedures and electrode placement of a polysomnogram, but also includes a mask attached to a CPAP (continuous positive airway pressure) machine. The CPAP machine brings pressurized air to the patient. The technician may monitor and adjust the CPAP's air pressure throughout the night. The purpose of a titration study is to determine the appropriate air pressure for patients with obstructive sleep apnea (blocked upper airway).

A split night study combines the polysomnogram and titration sleep studies into two sessions on the same night. Split night studies enable patients to complete both studies quickly instead of waiting weeks in between tests and may expedite the interpretation of results and treatment.

Multiple sleep latency test (MSLT) measures how fast someone is able to fall asleep. Unlike other sleep tests, this test is performed during the day. It may take place after an overnight sleep study. The MSLT test monitors napping and potential for daytime sleepiness and exhaustion.

At-home sleep tests are fully conducted by patients in their own homes. Patients attach fewer electrodes, a breathing sensor, a microphone, and a data collection device to themselves and sleep in their own beds. The following morning, patients gather the data collection device and return it to their medical providers. While at-home sleep tests are convenient, they are not recommended for patients with severe sleep problems. At-home sleep tests are less precise than clinical tests and do not measure brain activity.

Sleep studies are essential to helping patients receive accurate sleep disorder diagnoses and proper treatment. A sleep study can be the first step towards higher quality sleep and physical health.