Sleep Disorders: Sleep Studies
Guest: Dr. Michael Frye - Pulmonary, Critical Care, Allergy & Sleep Medicine, MUSC
Host: Dr. Linda Austin – Psychiatry, MUSC
Dr. Linda Austin: I’m Dr. Linda Austin. I’m interviewing Dr. Michael Frye, who is Associate Professor of Medicine and Medical Director of the MUSC Sleep Center. Dr. Frye, lots of people get sent for so-called sleep studies and, yet, may not understand just what a sleep study is. So, let’s start there. Who are the typical candidates for a sleep study?
Dr. Michael Frye: We generally see patients who have excessive daytime sleepiness as their main symptom for requiring a sleep study. Patients may snore at night. They may have some disruption from jerking legs or pain, or discomfort; particularly anyone who has a sleep-related breathing problem, like snoring, gasping for breath. These lead to excessive daytime sleepiness.
Dr. Linda Austin: So, let’s walk through the process of what happens to a patient who’s coming for a sleep study. What can they expect?
Dr. Michael Frye: Well, they’ll be evaluated by their referring physician. And, many of them will also need evaluation by one of our sleep specialists in the Sleep Center. They’ll be seen in a regular clinic setting and evaluated in terms of their history and physical findings for a sleep study. If the sleep specialist feels like they need a sleep study, or if their referring physician is very confident that they will, they’ll be scheduled for an all-night study in our sleep center.
They come in at about 7:30, 8:30, at night, and they’re prepared by certified sleep technicians that we have on our staff, including sensors that are attached to the skin by glue that can be removed the following morning. These sensors are worn all night, and help the technologists and physicians monitor every aspect of the person’s sleep throughout the night. There’s also audio and video. So, by the conclusion of the study, it’s usually very clear what type of sleep disruption the patient has.
Dr. Linda Austin: It must be very common that people have trouble sleeping just because they’re in a very strange location, isn’t it, or not?
Dr. Michael Frye: Well, there is an entity called the first-night effect, which is where patients will have some apprehension about sleeping in a novel environment. We have a fairly newly renovated lab. It has the appearance, more, of a nice hotel than it does a clinical space, although we’re still able to do all of the monitoring that’s necessary. And so, often, when we’ve seen these patients in our clinic, they’re given a tour of the facility. This is before they come in for their actual sleep study. They’re already very familiar with the surroundings, and they’re less apt to have this first-night effect.
Dr. Linda Austin: Do they sleep in a regular bed, then?
Dr. Michael Frye: It is. And we do have pediatric-size beds. But most of our beds, in our eight-bed lab, are the equivalent of Queen or King-size beds.
Dr. Linda Austin: What is the most common cause of excessive daytime sleepiness, in the patients whom you see for sleep studies?
Dr. Michael Frye: Well, across the board, I would have to say that, not just the patients that get sleep studies, but all comers, insomnia and poor sleep habits would be the most common causes of excessive daytime sleepiness; patients that just don’t allow themselves enough time to sleep during the night.
But, of the patients that we see in the lab, that we sign up for a study, they’re usually people we suspect of having a sleep disorder, such as obstructive sleep apnea. That’s a condition where, due to excessive snoring, patients actually repetitively stop breathing throughout the night. And when they wake up to get their breathing going again, that causes the sleep disruption that leads to excessive sleepiness the next day.
Dr. Linda Austin: What’s the second leading cause?
Dr. Michael Frye: The second thing we’re seeing a lot of these days is periodic limb movement disorder, and restless leg syndrome. That’s a condition where a patient has tremendous discomfort; an aching, gnawing discomfort in their legs, that prevents them from getting to sleep. And then, once they’re asleep, about 70 percent of those patients will have repetitive jerking of their legs throughout the night, at about 30-second intervals. That jerking not only keeps their bed partner awake, but it actually disrupts their own sleep.
Dr. Linda Austin: How about the third leading cause?
Dr. Michael Frye: Well, we do see a number of patients that are suspected of having the OSA (obstructive sleep apnea) but, really, just have simple snoring. They’re suspected of having OSA, but then when we do the study, they’re found to just have simple snoring.
Beyond that, we have a variety of conditions, such as nocturnal seizures, or other repetitive problems, during sleep. There’s a whole variety of pediatric disorders. In fact, about 25 percent of our patients are in the pediatric age group. There are few other labs, really, in our region, or this part of South Carolina, that study as many pediatric patients as we do. So, we get a lot of those repetitive movement disorders, seizures, neurological conditions.
Dr. Linda Austin: Dr. Frye, thanks so much for talking with us today.
If you have any questions about the services or programs offered at the Medical University of South Carolina, or if you’d like to schedule an appointment with one of our physicians, please call MUSC Health Connection at: (843) 792-1414.