Dr. Alan Stuart Josselson, 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.

Asthma is a chronic disease where swollen, inflamed airways make it hard to breathe. It is often brought on by specific triggers. While asthma is a common condition, affecting millions of people, it can also be serious and even fatal in severe cases. Treatment involves avoiding triggers and using inhaled corticosteroid medications.

COPD, or Chronic Obstructive Pulmonary Disease, is the name given to two illnesses that both cause difficulty breathing: emphysema and chronic bronchitis. In emphysema, the air sacs of the lungs become damaged, while with bronchitis they become clogged with mucus. COPD is the fourth leading cause of death in the United States. It is almost always caused by breathing irritants into the lungs, such as smoking or heavy pollution.

Pneumonia is a lung infection that can be caused by bacteria, a virus, or fungi. Most healthy people recover from pneumonia in a week or two, but for some people pneumonia can be fatal. There are treatments available for pneumonia, but the best treatment is to prevent getting sick in the first place. People who are at risk should make sure they get a flu shot every year. There is also a vaccine available for the type of bacteria that causes pneumonia.

Lung cancer occurs when abnormal cells inside the lung grow into a tumor, destroying healthy tissue. Because it is so difficult to detect lung cancer in early stages when it has few symptoms, it is the deadliest form of cancer, responsible for the most cancer deaths both in the U.S. and worldwide. Most lung cancer is caused by exposure to tobacco smoke, but between 10-15% of cases are not linked to smoking.

Some problems with the lungs are minor and are not cause for concern. However if symptoms have lasted for a month or more, even if they are minor, it is worth checking with a healthcare professional. A cough, shortness of breath, or excess mucus production that lingers for weeks are all worth getting looked at.

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.