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Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist

CPT4 code

Name of the Procedure:

Polysomnography (PSG); also known as a Sleep Study or Sleep Test

Summary

Polysomnography is a comprehensive sleep study used to diagnose sleep disorders. It involves overnight monitoring of various body functions during sleep, such as brain waves, oxygen levels in the blood, heart rate, breathing patterns, and eye and leg movements. This procedure is attended by a technologist to ensure accurate data collection.

Purpose

Polysomnography is used to diagnose a variety of sleep disorders including sleep apnea, restless legs syndrome, narcolepsy, and other issues that affect sleep quality. The goal is to identify abnormalities that can lead to treatment plans for improving sleep health.

Indications

  • Excessive daytime sleepiness
  • Loud snoring or choking sounds during sleep
  • Insomnia
  • Witnessed pauses in breathing during sleep
  • Unexplained nighttime awakenings
  • Restless legs syndrome symptoms

Preparation

  • Avoid caffeine and alcohol on the day of the test
  • Refrain from napping on the day of the test
  • Follow your regular medication schedule unless instructed otherwise by your doctor
  • Bring comfortable sleepwear and a list of current medications

Procedure Description

  1. The patient arrives at the sleep center in the evening.
  2. A technologist attaches sensors and electrodes to the patient's scalp, temples, chest, and legs to monitor brain waves, eye movements, heart rate, muscle activity, and oxygen levels.
  3. The patient goes to sleep in a quiet, dark room while being observed via a camera and microphone to monitor sleep behaviors.
  4. Throughout the night, data is collected on various sleep parameters.
  5. In the morning, the sensors and electrodes are removed and the patient can go home.

Duration

The procedure typically takes one entire night, from approximately 8 PM to 6 AM.

Setting

Polysomnography is performed in a dedicated sleep laboratory or sleep center, often within a hospital or specialized clinic.

Personnel

  • Registered Polysomnographic Technologist (RPSGT)
  • Sleep Specialist (Sleep Physician)

Risks and Complications

  • Minor skin irritation from electrodes
  • Discomfort due to sleeping in an unfamiliar environment
  • Very rare: improper data collection leading to repeat testing

Benefits

  • Accurate diagnosis of sleep disorders
  • Development of a targeted and effective treatment plan
  • Improvement in sleep quality and overall health

Recovery

  • No significant recovery period required
  • Resume normal activities immediately after the procedure
  • Follow-up appointment to discuss results and treatment options

Alternatives

  • Home Sleep Apnea Test (HSAT): less comprehensive, focuses mainly on breathing patterns
  • Actigraphy: wrist-worn device that monitors movement patterns
  • Pros: Convenient and comfortable at home
  • Cons: Less detailed and may miss certain sleep disorders

Patient Experience

Patients may feel a bit uncomfortable due to the attached sensors and laboratory setting. However, the rooms are designed to be as comfortable as possible, similar to a hotel room. Mild skin irritation from electrodes can occur, but pain management is generally not needed. Most patients are able to sleep adequately for the test, and the collected data is invaluable for diagnosing sleep issues.

Medical Policies and Guidelines for Polysomnography; any age, sleep staging with 1-3 additional parameters of sleep, attended by a technologist

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