Getting checked

Dr Alex Bartle of Sleep Well Clinic NZ talks about diagnosis, treatment, problems and solutions


Patient and doctor Sleep Apnoea Patients and GPs - a 2008 pamphlet - please note that the contact details for SAANZ have since changed.  P.O. Box, 88 Hamilton 3240.   Ph 021344253.







 Notes from Weinmann

© Copyright Weinmann, Hamburg. 
Reproduced in the SAANZ website with the express permission of Weinmann. 
All rights to design and specification modifications reserved.

Whatever happens when you sleep can be examined only while you sleep. The next section tells you about how conventional examination methods are used. You’ll learn that sleep laboratories are available and that you may have to spend at least one night there. You’ll also read about the various stages of nightly sleep and how the lab can document and analyze the structure of your sleep.

How Will My Sleep Be Examined?

When sleep apnoea is suspected, a preliminary diagnosis will be made on the basis of the symptoms of ‘snoring’, ‘tiredness during the day’ and respiratory arrest during sleep.

For this purpose, the patient will be given a wearable diagnostic device to take home. The device measures pulse, snoring noise and oxygen saturation while the patient sleeps. Data are also captured on the position of the body at different times and whether respiratory arrest occurs in certain positions.

If the findings indicate sleep apnoea, the treating doctor may have the patient admitted to a sleep lab for a complete sleep examination (polysomnography).

Normally, the patient reports to the sleep lab between 7 and 10:30 p.m.

In specially equipped rooms at the sleep lab, examination is made of the patient’s respiration (oxygen saturation, respiratory flow and movements, snoring), heart rhythm (electrocardiogram or ECG) and movement. An important portion of the examination consists of a graphic recording of the patient’s sleep. On the basis of the sleep structure, findings can be made regarding the quality of sleep.

This is carried out by measuring brain waves:

  • EEG = electroencephalogram
  • EOG = electro-oculogram and skeletal muscular activity
  • EMG = electromyogram

What Happens While I’m Asleep?

Healthy sleep is characterized by a certain physiological structure which is divided into definite sleep stages:

  • Wake phase
  • Sleep stage 1 or falling asleep phase
  • Sleep stage 2 or light sleep phase
  • Deep sleep phase 3
  • Deep sleep phase 4
  • REM or dream phase (REM = Rapid Eye Movement)

 - Sleep Structures Graph

Someone suffering from sleep apnoea hardly ever reaches the deep sleep phase since he is often disturbed by the arousals working as the body’s emergency reaction. Dream sleep is also often minimized and disrupted. This has, of course, a negative effect on the patient’s condition during the day. If obstructive sleep apnoea is diagnosed after an examination night in the sleep lab, the patient will receive the type of therapy suitable for him - a CPAP device. During the night, each person normally goes through four to six sleep cycles which consist of a certain portion of individual phases in different sleep stages. Each ‘run through’ lasts about 90 minutes. While deep sleep phases are essential for the body’s recuperation, the REM phases are necessary for the processing of mental and emotional events of the day. Tension in the muscles (muscle tone) is lower in deep sleep stages than in sleep stages 1 and 2. REM sleep has the lowest muscle tone of all. At this point we have vivid dreams, evidenced by the rapid eye movements that give this stage its name.

For decades Weinmann has been developing, producing and marketing medical devices for markets around the world. In cooperation with our partners Weinmann design economic health systems for diagnosis and therapy in Sleep Medicine, Home Mechanical Ventilation, Oxygen Medicine and Emergency Medicine.

Where should I go to get help?

Your first port of call should always be your doctor who can then refer you to a sleep clinic.  This is usually to a Hospital Clinic, but if you need to get things sorted quickly and can afford the cost you may prefer to go through a private sleep clinic. Below is a PDF file of sleep services in NZ - this is not a comprehensive list, and remember your first port of call should be your doctor.  Further private clinics can be located via a Google search for "sleep clinics your town NZ" e.g. "sleep clinics Wellington NZ".

NZ Sleep Services PDF

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