Sleep Study Apnea Testing Information
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- Aubrey Johnson
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1 Sleep Study Apnea Testing Information Dear, You are scheduled to pick up the portable Home Sleep Apnea Testing Device on. You will receive a call to confirm the specific time. A Technologist will provide you with instructions on how to: 1. Apply the portable device 2. Turn on and begin testing 3. Turn off and end the testing This should take no more than 30 minutes. You will sleep with the Home Sleep Apnea Testing device overnight in the comfort of your own home. PLEASE READ THE FOLLOWING CAREFULLY 1. LOCATING THE SLEEP CENTER: The is located on the campus of St. Joseph Mercy Livingston Hospital in Howell. Parking is available in front of the building. Enter the main building and take the elevators next to the pharmacy, up to the third floor, turn left down the hallway and the is at the end of the hall. 2. DEVICE RETURN: Please return the device as soon as possible, but no later than 24 hours. 3. THE QUESTIONNAIRE: Please complete the questionnaire and bring the day you pick up the device. 4. DAY OF TESTING: Do not nap and do not drink caffeine after lunch. 5. PRIOR TO TESTING: please register for your Home Sleep Apnea Testing by calling , Monday through Friday between the hours of 8 a.m. and 5 p.m. If you have any questions, please notify the Sleep Disorder Center staff by calling Thank you for allowing St. Joseph Mercy Livingston to provide you with this service R 8/16 (M) Home Study Questionnaire (Page 1 of 6)
2 Your Home Sleep Test WHAT IS HOME SLEEP TESTING? Home sleep testing or HST, occurs when you sleep at home wearing equipment that collects information about breathing during sleep. HST is used to diagnose obstructive sleep apnea. Untreated OSA is associated with medical problems like diabetes. Obstructive Sleep Apnea, or OSA, occurs when the muscles of the throat relax and the airway collapses during sleep. Air cannot get into the lungs and the level of oxygen in the blood goes down. Signs of OSA include: Choking or gasping during sleep Daytime sleepiness or tiredness, even after a full night s sleep Loud or frequent snoring Risks of untreated OSA include: Poor concentration High blood pressure Depression Car crashes LEARN ABOUT HOME SLEEP TESTING HST is different from a sleep study in a lab because you are sleeping at home and using different equipment. There is no technologist at your home like there is in a lab. You will set up the testing equipment yourself. DO I NEED HST? Not everyone should have HST. While HST is used to diagnose OSA, some sleep disorders are better evaluated in a laboratory. HST is primarily used to diagnose OSA. Your health care provider will tell you if HST is right for you. YOU SHOULD NOT HAVE HST IF: You do not have a high risk of OSA Your health care provider thinks that you may have another sleep disorder You have certain medical conditions HOW WILL I GET MY HST EQUIPMENT? You will have to go to a doctor s office or sleep center to pick up the equipment. WHAT SHOULD I DO THE DAY OF MY HST? Keep your regular routine as much as possible Don t nap Don t drink caffeine after lunch Speak with your health care provider about whether or not to take your regular medication the day of your HST HOW DO I USE MY HST DEVICE? You will be given instructions on how to attach the sensors and how to use your HST device. There are many different HST devices that have a variety of sensors and equipment. They all measure information related to breathing and blood oxygen level. They may also measure your heart rate or other information about your body. The HST device collects information while you sleep and stores the data. Ask questions if there is anything you do not understand R 8/16 (M) Home Study Questionnaire (Page 2 of 6)
3 Sleep Questionnaire (Page 1) Fill out completely and bring with you the night of the test. Name: Date of Birth: _ Sex: Male Female Height Weight Neck size _ Check all that apply: I snore or have been told I snore I have been told I stop breathing during sleep I wake up choking, gasping, or short of breath I wake myself up with my snoring I am sleepy during the day I am fatigued throughout the day I fall asleep unintentionally during the day I have memory loss I have problems with concentration I am a restless sleeper I kick my legs at night I have restless legs syndrome I have insomnia How long have you had symptoms that you know of: How does this affect your life and daily activities? What time do you typically go to bed and get up: Weekdays BEDTIME a.m./p.m. WAKE Time a.m./p.m. Weekends BEDTIME a.m./p.m. WAKE Time a.m./p.m. On average, how long do you actually sleep at night? hrs mins Medical History Anemia Diabetes Other blood-borne disease Arthritis Heart Disease Prostate problems Asthma Hepatitis B or C Reflux Cancer Hypertension Seizures COPD Kidney problems Stroke/TIA s Depression/anxiety Migraine headaches Thyroid problems Other (please describe): Allergies (include latex or tape) List Your Current Medications R 8/16 (M) Home Study Questionnaire (Page 3 of 6)
4 Sleep Questionnaire (Page 2) Restlessness I am a restless sleeper I kick or jerk my legs and/or arms during sleep I have restlessness, tingling or crawling sensation in my legs or arms I am unable to keep my legs still prior to falling to sleep I grind my teeth in my sleep Other Complaints When falling asleep or waking up, I sometimes feel paralyzed (unable to move) At night my heart pounds, beats rapidly or beats irregularly I have a lot of nightmares I sleepwalk I have seen or heard things that weren t real when waking up or going to sleep I get sudden weakness or feel like I will fall when I laugh or get angry Other Questions Do you have a regular bed partner?... Yes On average, how long does it take you to fall asleep at night after you turn out your bedroom lights/ minutes? What do you usually do just before turning out the lights and trying to go to sleep (read, watch TV, bath, etc) On average, how often do you wake up during the night? Do you wake up too early, unable to go back to sleep?... Yes Do you usually awaken to an alarm or spontaneously on your own? Do you nap or go back to bed after getting up?... Yes If so, how many times per day? Average length of nap? Do you feel more refreshed after the nap?... Yes Are you bothered by sleepiness during the day?... Yes Do you feel that you get too much sleep at night?... Yes Do you feel that you get too little sleep at night?... Yes Do you usually feel tired during the day?... Yes If so, why do you think this is so? Social History Do you smoke? How much? When did you quit? Do you drink alcohol? How often? Do you drink caffeine? How often? Do you use marijuana or other non-prescription drugs? If so, what? I am a shift worker on rotating shifts I am a permanent or long term night shift worker R 8/16 (M) Home Study Questionnaire (Page 4 of 6)
5 Sleep Questionnaire (Page 3) Family History Is there any one in your family with a sleep problem? If so, please describe: Epworth Sleepiness Scale Use this scale to choose the most appropriate number for each situation: 0 = would never doze 1 = slight chance of dozing 2 = moderate chance of dozing 3 = high chance of dozing Sitting and reading... Watching TV... Sitting in a public place for example, a theatre or meeting... As a passenger in a car for an hour without a break... Lying down to rest in the afternoon... Sitting and talking to someone... Sitting quietly after lunch (when you have had no alcohol)... In a car, while stopped in traffic... Please check all that apply: I take daytime naps I have had auto accidents as a result of falling asleep while driving I fight to stay awake while driving I have had injuries as a result of falling asleep in the daytime Daytime sleepiness is affecting my job or quality of life Total: Best way to reach you: Home Phone: Work Phone: Cell Phone: Other Phone: Address: I authorize the St. Joseph Mercy Sleep Disorders Lab and/or Pulmonary and Critical Care Associates sleep coordinator to leave results via my phone or address provided. Signature Date: Time: R 8/16 (M) Home Study Questionnaire (Page 5 of 6)
6 Driving Directions St. Joseph Mercy Livingston, on the campus of St. Joseph Mercy Livingston From the North Take US 23 South to Exit 67 (Highland Road/M-59). Merge onto MI-59 W/Highland Rd via Exit 67 toward Howell. Drive approximately 11 miles and make a U-turn onto W/Highland Rd /MI-59. Turn Right onto Byron Road. Drive for about ½ mile, Livingston Hospital will be on your right. From the South Take US-23 North to I-96 Exit 60B, left toward Brighton/Lansing. Merge onto I-96 W via the ramp on the left toward Lansing. Take Exit 137 toward County Hwy-D19/Howell/Pinckney. Turn Left onto Pinckney Rd. (Becomes Michigan Ave/MI-155) Drive approximately 1 mile and turn Left onto W Grand River Ave. Turn Right onto Byron Rd. Drive for about ½ mile, Livingston Hospital will be on your left. From the East Take I-96 West to Exit 137 (Hwy D-19/Howell/Pinckney) Turn Left onto Pinckney Rd. (Becomes Michigan Ave/MI-155) Drive approximately 1 mile and turn Left onto W Grand River Ave. Turn Right onto Byron Road. Drive for about ½ mile, Livingston Hospital will be on your left. HOWELL N BRIGHTON DiscoverRemarkable stjoeshealth.org Interstate/freeways to St. Joseph Mercy Livingston St. Joseph Mercy Livingston DiscoverRemarkable stjoeshealth.org From the West Take I-96 East to Exit 133, (MI-59 Exit). Merge onto MI-59/W Highland Rd. Drive approximately 2 ½ miles and turn Right onto Byron Road. Drive for about ½ mile, Livingston Hospital will be on your right. For Directions from your Home address, please visit: SJMAA CampusMap(3.16).indd 2 St. Joseph Mercy Livingston campus follow signs to the smap(3.16).indd 2 stjoeshealth.org R 8/16 (M) Home Study Questionnaire (Page 6 of 6)
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