Polysomnography (PSG)

Polysomnography (PSG) is the most important test for the diagnosis of sleep snoring (sleep apnea hypopnea syndrome, OSAHS). Through continuous monitoring of nighttime breathing, arterial oxygen saturation, electroencephalogram, electrocardiogram, heart rate and other indicators, you can know whether the snorer has apnea, the number of pauses, the time of suspension, the minimum arterial oxygen value at the time of suspension, and The extent of physical health effects is an internationally accepted gold standard for the diagnosis of sleep apnea hypopnea syndrome. The polysomnography is the most commonly used sleep monitoring method. It is the most important test for diagnosing snoring. It is the internationally recognized gold standard for diagnosing sleep apnea hypopnea syndrome. Basic Information Specialist Category: Respiratory Examination Category: Other Inspections Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: The lowest oxygen saturation in sleep apnea syndrome, although there is no specific indication of sleep apnea syndrome, but less than 85% can determine sleep apnea syndrome. Normal value: Respiratory disorder index: 0-5 Minimum oxygen saturation: 85-100 Above normal: An adult respiratory disorder index greater than or equal to 5 can be defined as sleep apnea syndrome. negative: Positive: Tips: Monitor the sleeping pills on the day, prohibit drinking, drink coffee, cola, tea and other exciting drinks. Avoid strenuous exercise before monitoring and keep your mental mood stable so as not to affect your sleep. Normal value The respiratory disorder index is less than 5. The minimum oxygen saturation in sleep apnea syndrome is 85%-100%. Clinical significance According to the results of polysomnography, not only can sleep apnea hypopnea syndrome be diagnosed, but also the severity can be judged, and it is convenient to formulate clinical treatment plans and quantitatively evaluate the operation or other treatment effects. Therefore, polysomnography should be performed before snoring and sleep apnea hypopnea syndrome before any treatment is taken. The best way to diagnose sleep apnea syndrome is to monitor sleep, a nighttime test performed at a specific sleep center. A variety of monitors are used to measure various physiological signals during sleep. The parameters include: 1. The respiratory airflow monitor can find the length and frequency of sleep apnea syndrome. Stopping breathing for more than 10 seconds is called a pause. Insufficient breathing usually means that the respiratory airflow drops by more than 50%. 2. Blood oxygen saturation The decrease in blood oxygen saturation is a key manifestation of OSAS patients. 3. Muscle movement Chest movement monitoring can help diagnose whether the pause is central or obstructive. Other types of sleep disorders can be manifested as leg movements, jaw closures, and other characteristic sports. 4. Brainwave sleep can be divided into different typical stages according to brain waves, namely fast phase and slow phase (deep and light sleep), which can be monitored by instrument. 5. Electrocardiogram (ECG) As mentioned earlier, some OSAS patients may have abnormal heart rhythms. 6. The position of the body Sleep apnea syndrome is most likely to occur in the supine position, when the tongue root falls, easily blocking the upper respiratory tract. Two of these assessment methods are often cited to summarize sleep monitoring results. 1. Calculate the mean of the hourly respiratory disturbance by calculating the average of the total number of nocturnal sleep apnea syndrome and hypopnea, ie, the respiratory disorder index RespiratoryDistress Index (RDI), or the pause hypopnea index ApneaHypopneaIndex (AHI) . Adult RDI greater than or equal to 5 can be defined as sleep apnea syndrome. 2. The lowest oxygen saturation in sleep apnea syndrome, although there is no specific indication of sleep apnea syndrome, but less than 85% can determine sleep apnea syndrome. High results may be diseases: pediatric obstructive sleep apnea, sleep apnea syndrome precautions 1 The patient needs to enter the sleep monitoring room to adapt to the environment before 7:00 pm. After the patient has finished his medical history, he will monitor it overnight and leave at 7:00 the next morning. 2 Monitor the day's ban on sleeping pills, ban alcohol, drink coffee, cola, tea and other excitable drinks (unless these have become your daily routine). 3 Monitor the daytime to sleep as little as possible to ensure the quality of sleep at night. 4 need to start the night at night, as much as possible to reduce the amount of water before going to sleep. 5 bathing, shampooing, changing clothes before monitoring, men must shave their beards, do not use cosmetics. 6 It is best to bring a pair of loose pajamas and pajamas. The pajamas must be in a style that can be unwound from the front to place the electrodes. 7 patients can bring their own newspapers, books, radios, etc. according to their own sleep. 8 In addition to serious complications or self-care, generally do not need to accompany the bed. 9 Avoid strenuous exercise before monitoring, and keep your mental mood stable so as not to affect your sleep. 10 Avoid upper respiratory tract infections before monitoring. Inspection process 1. Install EEG electrodes Standard sleep staging is generally based on C4/A1 or C3/A2 lead record maps. Apply conductive paste to the mounting electrode and fix it with a waterproof tape. Installation of eye-moving electrodes: Standard sleep monitoring requires monitoring of ocular electricity using at least two leads. One of the electrodes should be placed 1 cm above the outer iliac crest of the right eye, and the reference electrode should be placed behind the outer ear or the mastoid. The other electrode should be placed 1 cm outside the left lateral eye of the left eye, with the reference electrode placed behind the contralateral ear or the mastoid. Installation of myoelectric electrodes: The electromyogram of the mandibular and tibialis anterior muscles was recorded and the electrodes were placed in the jaw or under the jaw and in front of the tibia. 2. Measuring nose and mouth airflow The commonly used measurement method is the oral and nasal thermal flow sensor. The sensor is fixed to the nose and mouth with a tape, and the amount of tidal volume and the presence or absence of breathing stop are determined according to the change of the temperature of the exhaled air. 3. Record chest and abdomen breathing exercises Piezoelectric crystal recording devices are the most commonly used devices for recording respiratory motion. Placed on the chest and abdomen, it can increase the tension of the chest and abdomen when the chest and abdomen expand, and convert it into an electrical signal. The chest and abdomen belt is tied horizontally to the nipple level of the chest and the umbilical level of the abdomen, and the elastic is suitable. 4. Measuring oxygen saturation The pulse oximeter is the easiest, most reliable, and non-invasive method for assessing oxygenation in blood flow. It is only necessary to clip it to your fingertips and fix it. 5. Install the click detector The snoring is measured by a small microphone, usually fixed with glue around the patient's trachea, recording the presence and loudness of the snoring, and can also be used to detect the patient's molar activity at night. 6. ECG Generally, polysomnography records only one lead ECG, usually I lead, II lead or V5 lead, so it can only be used as a reference for heart rhythm and heart rate changes or to identify some basic ECG abnormalities. 7. Start the official record, observe the signal collection at all times during the monitoring process, and closely observe the patient's nighttime behavior, especially the breathing, blood oxygen and heart condition. In the event of an emergency, rescue measures should be taken in a timely manner. 8. For patients who are treated with nasal CPAP at the same time, the optimal CPAP value should be the lowest pressure that can cause all apnea, hypopnea, hypoxic saturation and wake-up response to disappear. Generally, the pressure is increased every 10 minutes, increasing by 0.098 to 0.196 kPa (1 to 2 cm H2O) each time. After each increase in pressure, observe the patient's sleep quality (including presence or absence of wake-up response), inspiratory flow, oxygen saturation, presence or absence of apnea, hypopnea, and snoring until the optimal pressure. 9. After 7 hours of morning monitoring, the patient will finish the recording, gently awaken the patient, measure the blood pressure immediately after the patient wakes up, remove all the recording electrodes from the patient, wipe off the conductive adhesive and remove the adhesive tape. After the system automatically analyzes the processed data, the analysis results are played back and the monitoring report is printed. Not suitable for the crowd Generally there are no people who are not suitable. Adverse reactions and risks Generally no adverse reactions.