Polysomnography

The polysomnography ( polysomnography and, shortly PSG ) is a diagnostic procedure for measuring physiological functions and represents the most extensive investigation of sleep a person dar. With this technique, several different body functions are monitored continuously throughout the night. Usually this happens stationary in a sleep laboratory. Using the records of an individual sleep profile can be created, making diagnosis of sleep disorders should be made possible.

  • 3.1 EEG electrodes points
  • 3.2 more measurements

Application

Typical symptoms ( Keynotes ) that can justify an investigation with the help of polysomnography, disturbances in falling asleep, waking up during the night or daytime fatigue are constant; also by third parties perceived strong snoring with breathing interruptions. See also: sleep apnea syndrome.

In sleep medicine polysomnography is recommended for diagnosis of the following sleep disorders according to ICSD -2:

  • Sleep-related breathing disorders,
  • Hypersomnia and
  • Sleep-related movement disorders.

Under certain conditions, the use in insomnia, circadian sleep-wake rhythm disorders, parasomnias and sleep disorders from the group isolated symptoms, normal variants, unresolved problems according to ICSD - 2 is possible. In addition, polysomnography may be used in individual cases for the differential diagnosis and diagnosis by exclusion.

For sleep-related breathing disorders and sleep-related movement disorders and the Cardiorespiratory polygraphy is recommended. In this method, a simplified system are recorded less information. The diagnosis of obstructive sleep apnea is possible after prior comprehensive sleep medical history, unless other diseases or sleep disorders exist.

Polysomnographic criteria for the measurement of fatigue do not exist.

Conduct of the investigation

Recommendations

To carry out this investigation, there are detailed recommendations concerning the measurements, the apparatus and staffing, premises and evaluation.

In Germany, the guideline " non -restorative sleep / sleep " of the German Society of Sleep Research and Sleep Medicine ( DGSM ) recommendations, to this process. After that, the " cardiorespiratory polysomnography in the sleep laboratory with supervision by qualified personnel in sleep medicine " is recommended as a basic instrument and the reference method, the measurement and evaluation in accordance with the current recommendations of the American Society of Sleep Medicine ( AASM ) is to take place. The videometry is considered for the diagnosis of parasomnias and the differential diagnosis as indispensable.

In the medical guidelines on various sleep disorders such as narcolepsy, restless legs syndrome (RLS ) and Periodic Limb Movement Disorder ( PLMD ) and insomnia is recommended in cases or to special cases limited to this method for diagnosis.

Due to the requirements for the accreditation of sleep laboratories through the sleeping medical societies, national and international recommendations for sleep laboratories concerned are binding.

Measurements

The sleeping medically supervised polysomnography in the sleep laboratory is considered as the basic instrument and as a reference method for the diagnosis of sleep disorders apparatus. These include the records of the sleep EEG, EOG, EMG, ECG, respiratory flow, respiratory effort, oxygen saturation, body position, and video, the latter is recommended for the diagnosis of parasomnias, and perimeter forms of epilepsy as indispensable.

Before carrying out the measurements in the sleep laboratory, the patient is usually observed for a day to see its activities and habits. Usually then two nights are spent in the laboratory.

For hospital polysomnography as needed following monitoring functions are performed by default:

  • Brain wave image (EEG )
  • Heart rhythm ( ECG)
  • Oxygen content of the blood ( pulse oximetry )
  • Body temperature
  • Respiratory flow (mouth and nose)
  • Respiratory motion
  • Muscle tension ( EMG)
  • Leg movement
  • Eye movement ( EOG)
  • Body position

In addition, the following measures and measurements can be performed during sleep:

  • Sound recording
  • Video
  • Blood pressure
  • Gastric acid reflux
  • Differences in pressure in the chest
  • Erections
  • Mask pressure ( for respiratory masks )

Details of a Polysomnogramms, as well as measurement

The figure shows the phase 4 ( deep sleep)

EEG electrodes points

  • C3 = upper left central
  • C4 = right above the center
  • A1 = left ear
  • A2 = right ear
  • O1 = left occipital (left occipital )
  • O2 = right occipital (right occipital )
  • Chin EMG ( chin EMG1 left EMG2 chin right)
  • LEMG = laryngeal electromyogram ( EMG1 larynx left EMG2 larynx right)

Further measurements

  • LEOG = left electrooculography (left eye )
  • REOG = right electrooculography (right eye )
  • NAF = respiration of the nasal air flow
  • THO = thoracic respiratory motion
  • IEMG = integrated electromyogram
  • ABD = abdominal breathing motion
  • ECG = electrocardiogram
  • RR = heartbeat distance
  • SAO2 = arterial oxygen saturation
  • BODY = position of the body (S = lateral position )
  • SCM = scanning capacitance microscope
International Classification of Sleep Disorders American Academy of Sleep Medicine Electromyography Digital Object Identifier
655963
de