Most sleep disorders can be managed conservatively with a combination of good sleep education, medication and behavioural modification. In certain conditions like obstructive sleep apnoea, specific therapy may include positive airway pressure therapy (pressurised air delivered via a mask) or upper airway surgery.
Difficult cases are referred to physicians trained in the management of sleep disorders. Many sleep disorder clinics are staffed by health professionals in multiple disciplines, such as neurologists, respiratory physicians, ENT surgeons, psychologists and psychiatrists.
Most sleep disorder clinics have sleep laboratory facilities for sleep studies. PSG and MSLT recordings are performed by qualified PSG technologists. For patients with obstructive sleep apnoea, respiratory therapists assist in special sleep studies in which positive airway pressure is applied at various settings so that optimal therapeutic pressure settings can be determined.
Sleep patterns can be studied in the laboratory using machines which record brainwave activity, breathing, heart rate and limb movements during sleep. The most common types of sleep studies are:
PSG involves staying overnight in the sleep laboratory and being hooked up to a machine which is monitored by sleep technologists. At least 6 hours of sleep are recorded using electrodes attached to the scalp and limbs, special belts across the chest and abdomen, airflow monitors and ECG leads. PSG is usually indicated in patients in whom sleep related breathing disorders and abnormal movements in sleep are suspected.
The MSLT follows the overnight PSG, comprising four 20-minute naps at two-hour intervals throughout the day. It is indicated for the diagnosis of narcolepsy and also to assess the severity of sleepiness in patients who complain of excessive daytime sleepiness.
